“The silence around alcoholism and addiction means more of us will suffer longer and harder while in the throes of this highly treatable illness. If it were more openly discussed, we would have fewer myths surrounding the illness.” GettyImages/ZoranZeremski Nothing ruins a perfectly good conversation more than being “accidentally” insulted by a colleague during an otherwise friendly, supportive dialog. It happened to me recently during an online exchange in which colleagues rallied behind one of our own for a workplace stress-related issue. In an attempt at sympathetic commentary, the inadvertent offender blithely offered the following unhelpful comment (and I paraphrase for brevity): “At least you’re not a drug addict.” It can be challenging for those who have only limited experience with alcoholism and addiction to refer to these disorders in casual conversation. My advice? Unless you are 100 percent sure you are well-educated on the subject, don’t go there. Referencing substance abuse should never be lightly undertaken, in my experience. In doing so, you not only risk insulting any recovering drug addicts in the room (which is bad enough), but you are also propagating negative stereotypes about substance abuse, which include erroneous, morally charged notions that often keep active addicts and alcoholics from getting the help they deserve. Unfortunately, I run across this kind of thing more often than you might think. As much as we have been preoccupied recently with the topic of mental health in our profession, alcoholism and addiction rarely get credit for being as pervasive and problematic as they truly are. Instead, we list anxiety, depression, and burnout among the everyday objects of our collective dismay, with suicide cited as the ultimate outcome of their progression. The ugly in-between disorders, commonplace as they may be, somehow get left out of most discussions. Somewhere in there, the dirty little secret of drug and alcohol addiction somehow gets buried. That only makes sense, I guess. After all, substance abuse is always messy. Deceit, denial, and theft—along with physical and moral decrepitude—are its typical features. Addiction is never pretty, even when those who experience it never show any of these signs while on the job (and most will not). However, the less we discuss the problem, the more likely it is to fester unchecked and the further away we will get from giving those who suffer the chance to recover. So, when I hear “accidental” invectives uttered against alcoholics and addicts, I tend to look on the bright side: Here’s a chance to set the story straight—even if it is just by a little bit. With that in mind I thought I would offer you some helpful info, including a brief list of myths regarding the average drug and alcohol-addicted veterinarian: Myth #1) Very few suffer from alcoholism and drug addiction The truth is far from it. In fact, the American Veterinary Medical Association (AVMA)’s Committee on Wellness reckons 11 to 13 percent of veterinary professionals suffer from substance abuse disorders. This is especially impressive given that the National Insititute of Health (NIH) estimates a lower rate among the entire medical professional spectrum (closer to 10 percent).1 So, just think about it: More than one out of every 10 veterinarians you know is an addict or alcoholic. Impressive, right? Myth #2) I would know if I was working with an addict or alcoholic You probably would not. The vast majority of veterinarian substance abusers do not drink or drug while at work. In other words, they are not shooting up in the bathroom or taking swigs from the bottle while at their desk. They will not look or act impaired. Their ability to work never appears to wane. They are masters of managing to keep up the appearance of wellness. In fact, this kind of subterfuge is a hallmark of the illness for some. It is how they manage to deny to themselves—and everyone else around them—that they are ill. Some will go so far as to continue to rack up credentials and achievements so they can continually prove to the world that they could not possibly be alcoholic or drug addicted. Myth #3) Drug addiction and alcoholism are not diseases. They are moral failings born from a weak character and a lack of willpower Substance abuse disorder is a well-recognized disease entity with distinct genetic component and ties to a wide variety of other mental health disorders. Addiction research has shown distinct differences in how the brains of addicts tend to “overreact” to toxic stimuli, leading to a compulsion to continue to seek the same toxin over and over. This explanation is a gross oversimplification, but for anyone who finds this research interesting, there is a lot of it out there for you to explore. Whatever you do, you can’t go blaming anyone’s moral fiber for alcoholism any more than you can a diabetic, a cancer sufferer, or an Alzheimer’s patient. Myth #4) Drug addicts and alcoholics are different. Drug addicts are affected more severely Nope. It is pretty much the same thing. In fact, over-eating and gambling seem to work the same way in the brain, but the more we study it, the fewer differences we find in how the brain responds to these trigger stimuli. The myth seems to persist only because drug addiction tends to kill you faster. This makes sense since you can only put so much alcohol into your body on any given day. Not so with certain other substances, right? Myth #5) Substance abuse is curable. People who don’t get well don’t want to be helped Once an addict/alcoholic, always an addict/alcoholic. Treatment is possible… a cure is not. This is, unfortunately, the truth of it. We have thus far found no medical approaches promising to eradicate alcoholism/addiction in an individual. Unfortunately, the disease seems to be so multifactorial and varied that it is frustratingly elusive to the medical profession. Myth #6) Veterinarians with substance abuse shouldn’t practice. I sincerely hope that is not true or we would stand to lose more than 10 percent of our workforce, and I, for one, would not be practicing, either. The reality is that veterinarians with this disease tend to be highly productive, and it tends to affect their work lives primarily in the later phases, where they crash and burn (sometimes spectacularly). Most veterinarian addicts/alcoholics end up identifying their problem and quietly entering treatment of their own accord, but this does not happen quickly or easily. A great deal of suffering is typically involved, and many will lose everything they have worked for along the way—most notably, their health and their families, but sometimes their jobs, their practices and their savings, too. Their colleagues rarely hear about it and most substance abusers go to great pains to make it stay that way. The silence around alcoholism and addiction means more of us will suffer longer and harder while in the throes of this highly treatable illness. If it were more openly discussed, we would have fewer myths surrounding the illness, fewer shame-throwers would be tolerated, and more veterinarians would have clearer paths to getting the care they so desperately deserve. I sincerely hope we get much closer to this possibility before I’m ready to exit the profession. I won’t be holding my breath. We’re still a long, long way away from where we need to be on this topic. Patty Khuly, VMD, MBA, runs a small animal practice in Miami, Fla., and is available at drpattykhuly.com. Columnists’ opinions do not necessarily reflect those of Veterinary Practice News. References https://www.promises.com/addiction-blog/stressed-depressed-veterinarians-fall-prey-to-addiction/
