PeaPod puts his finger on a very important question:
Why is it that doctors turn away from an evidence-based intervention – one they are happy to prescribe to patients – and go for a route where the evidence base appears less robust? Why are they afforded access to residential treatment of reasonable duration and intensity when their patients are not?
He’s referring to the fact that doctors are not placed on methadone maintenance.
Large scale studies from the United States, often from Physician Health Programme participants, confirm that many doctors get into problems with opiates. In almost all of these studies, the preferred treatment method is focussed on abstinence (most often through residential or intensive out-patient treatment). Less than one percent are prescribed maintenance treatment.
When we look at the data from the big treatment outcome studies and we look at research on people in abstinent recovery, we find that full recovery is achievable for many. In fact lifetime addiction/recovery research suggests recovery is the norm. Maybe doctors know this and choose not to go with harm reduction or maintenance.
Maybe the doctors who treat addicted doctors expect that full recovery is possible and their doctor patients pick this up. We know the value of hope, aspiration and positive expectation. Doctors in the Practitioner Health Programme in London are referred to 12-step mutual aid groups and to the nationwide British Doctors and Dentists Group, a mutual aid organisation. This is good practice.