title: The prevalence of substance use disorders in American physicians.
abstract: BACKGROUND
  There have been few studies on the prevalence of substance use disorders (SUDS) in the physician population at large nor have any studies compared the prevalence of SUDS in American physicians by specialty.
  
  
  METHODS
  We conducted a national study of SUDS in a large sample of U.S. physicians from all specialty disciplines using the AMA Physician Masterfile. Substance Use Disorders (SUDS) were measured using validated instruments.
  
  
  RESULTS
  Of the 27,276 physicians who received an invitation to participate, 7,288 (26.7%) completed surveys. 12.9% of male physicians and 21.4% of female physicians met diagnostic criteria for alcohol abuse or dependence. Abuse of prescription drugs and use of illicit drugs was rare. Factors independently associated with alcohol abuse or dependence were age (OR = .985; p < .0001), hours worked (OR = .994; p = .0094), male gender (OR = .597; p < .0001), being married (OR 1.296; p = .0424) or partnered (OR 1.989; p = .0003), having children (OR .745; p = .0049), and being in any specialty other than internal medicine (OR 1.757; p = .0060). Specialty choice was strongly associated with alcohol abuse or dependence (p = .0011). Alcohol abuse or dependence was associated with burnout (p < .0001), depression (p < .0001), suicidal ideation (p = .0004), lower quality of life (p < .0001), lower career satisfaction (p = .0036), and recent medical errors (p = .0011).
  
  
  CONCLUSIONS
  Alcohol abuse or dependence is a significant problem among American physicians. Since prognosis for recovery of physicians from chemical dependency is exceptionally high, organizational approaches for the early identification of problematic alcohol consumption in physicians followed by intervention and treatment where indicated should be strongly supported.
authors.affiliation: University of Washington, Seattle, WA.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Oreskovich
authors.forename: Tait
authors.initials: T
authors.lastname: Shanafelt
authors.forename: Lotte N
authors.initials: LN
authors.lastname: Dyrbye
authors.forename: Litjen
authors.initials: L
authors.lastname: Tan
authors.forename: Wayne
authors.initials: W
authors.lastname: Sotile
authors.forename: Daniel
authors.initials: D
authors.lastname: Satele
authors.forename: Colin P
authors.initials: CP
authors.lastname: West
authors.forename: Jeff
authors.initials: J
authors.lastname: Sloan
authors.forename: Sonja
authors.initials: S
authors.lastname: Boone
mesh_terms: D000437:Alcoholism / Q000453:epidemiology*; D003863:Depression / Q000150:complications / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D010815:Physician Impairment / Q000706:statistics & numerical data*; D015995:Prevalence; D011788:Quality of Life; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000453:epidemiology*; D059020:Suicidal Ideation; D014481:United States / Q000453:epidemiology