"Doc, cut the crap, we know you've been writing bad scrips," the Drug Enforcement Agency agent said. It wasn't until that point — when state police and the DEA were sitting in his primary care office — that Peter Grinspoon, MD, admitted he was hopelessly addicted to opiates.
"The windows in my office didn't open, otherwise I might have jumped out and fled," Dr. Grinspoon wrote in a recent op-ed in the Los Angeles Times. "As it were, I was charged with three felony counts of fraudulent prescribing."
Dr. Grinspoon described how, despite physicians' mission to heal patients, many struggle with serious issues of their own that have a severe impact on their health. For instance, while estimated rates of addiction among the general public to drugs and alcohol range from 8 percent to 10 percent, those rates are 10 percent to 15 percent among physicians, according to Dr. Grinspoon.
There is extensive literature that details the epidemic of physician burnout, depression and anxiety. While practicing medicine has never been a lax career, the challenges that physicians face have only increased over recent years. Physicians are more than twice as likely to commit suicide as the general population, and many physicians say they would choose a different career path if they could start over, Dr. Grinspoon writes.
The natural response for humans in distress is to search for easily accessible relief. For physicians, that is often in the form of prescription medicine. According to a 2013 study in the Journal of Addiction Medicine cited by Dr. Grinspoon, 69 percent of physicians abused prescription medicine "to relieve stress and physical or emotional pain." "Given how addictive they are, that's like trying to put out a fire by dumping gasoline on it," he wrote.
Physicians who slip into addictions rarely seek help. And while state medical boards are largely comprised of physicians and should therefore know to treat addiction as a disease, they often handle it like a crime, according to Dr. Grinspoon. In most states, including Massachusetts where Dr. Grinspoon practiced, the state medical society operates a Physician Health Service. The service works with the medical board and offers resources for physicians struggling with addiction. However, even if a physician seeks treatment voluntarily, there is no guarantee punishments will be withheld.
Ultimately, Dr. Grinspoon lost his medical license and his marriage. He served two years of supervised court probation (his three felony charges were dismissed), and he was out of work for nearly four years. Dr. Grinspoon was "dragged [and] disgraced in front of the state board where I was interrogated for hours by a hostile, aggressive attorney."
Finally, Dr. Grinspoon rebuilt his career. He has been in recovery since 2007. After he regained his medical license, he was asked to join the Physician Health Service as an associate director, and he now helps other physicians with addiction. Dr. Grinspoon cites studies that found once they get help, physicians often excel at rehab, achieving success rates of 70 percent to 80 percent — an incredibly high rate for addiction.
Physicians who slip into the clutches of addiction must be treated with compassion and care, Dr. Grinspoon says, not with sanctions and punishment. The latter describes a worst-case scenario for physicians and their patients.
"Instead of reflexively revoking or suspending licenses, state medical boards can usually ensure patient safety by keeping doctors at work under careful monitoring," he wrote. "I've seen the recovery process return better doctors to productive practice, strengthening the qualities most people want in a caregiver — humility, empathy and patience."