ABSTRACT
Misuse of substances can affect a doctor’s performance both directly and indirectly. Direct effects are largely dependent upon the type of substance misused and the nature and extent of misuse. Indirect effects include psychosocial complications such as financial difficulties, social withdrawal and isolation, involvement in criminal activity, and the blurring of professional boundaries. The misuse of drugs and alcohol by doctors has been described in several studies. Studies comparing substance misuse among doctors with the general population frequently report higher prevalence rates among doctors. An early study reported that physicians were 30 to 100 times more likely than the general population to become addicted to narcotics. Work-related stress, anxiety and burnout are thought to be factors significantly contributing to the misuse of substances with consequent impairment in the work performance. Stress levels among doctors are also dependent upon organisational factors.
