Source: The Guardian (UK)
Contact:  http://www.guardian.co.uk/
Pubdate: Fri, 04 Sep 1998
Author: Sarah Boseley, Health Correspondent

ALARM OVER JUNIOR DOCTORS' DRUG ABUSE

There were calls for random dope testing in the medical profession yesterday
as a report emerged showing that one in three male junior doctors uses
cannabis and more than 10 per cent of both sexes take other drugs, from
ecstasy to LSD and cocaine.

A study in this week's Lancet medical journal reveals that heavy drinking
and the use of illicit drugs are common among young doctors in their early
20s. A survey of 90 house officers, one year after graduation from Newcastle
university, reveals that of the 93 per cent who drank, 60 per cent exceeded
the recommended safe limits. A quarter of men and a third of women indulged
in "binge drinking" - consuming more than half the recommended limit (14
units for a woman and 21 for a man) in one session.

The doctors said they drank for pleasure, and three quarters claimed their
drug use was also recreational. More than 35 per cent of men and 19 per cent
of women used cannabis, more than 11 per cent using it weekly or monthly.

The other drugs, used by 13 per cent of men and 10 per cent of women, were
hallucinogenic mushrooms, LSD, ecstasy, amyl nitrite, cocaine and
amphetamines.

While Farhad Kamali from the Wolfson Unit of Clinical Pharmacology at
Newcastle university and colleagues, the authors of the study, acknowledge
that the drink and drugs pattern is not dissimilar to that of other people
of the same age, they are concerned at the implications.

"The current drinking habits, illicit drug use and stress in some junior
doctors are of concern, not only for their own well-being, but also how they
may affect patient care," they write. They ask whether routine or random
drug and alcohol screening should be introduced, pointing out that they
exist in the army and some industries in the UK and among doctors in the
United States.

Dr Kamali said he and his colleagues proposed to do further studies of older
groups of doctors to see whether "once they mature and reach a position of
responsibility they will curb their unhealthy lifestyles".

Mark Porter, an anaesthetist in Coventry who chairs the British Medical
Association's Junior Doctors Committee, said he was sure the drinking and
drug taking were no different from that of other young people. "In terms of
marijuana use, I don't think there is anything to be worried about," he
said. "The long-term effects are probably less dangerous than alcohol.

"We do know that the medical profession as a whole is more prone to
alcoholism than the general population." The stress of the job was part of
the reason. The study found the junior doctors were stressed and anxious.

On a rota to work one night in four, doctors often worked all night, then
spent a night recovering, then crammed four nights' social life into two, Dr
Porter said.

But Patrick Dixon, whose book The Truth About Drugs will be published on
Monday, claims one doctor in 10 is dependent on either drink or drugs, and
alleges that deaths and injuries result.

"If your mother has a hip replacement operation on a Monday morning and is
admitted by two anaesthetists and a medical team of three, there is a 50 per
cent risk that one of the five will be incompetent because of intoxication
or withdrawing from intoxication.

"Research shows you are four times more likely to be involved in job-related
accidents if you are on drink or drugs. The medical equivalent of that is
slipping with the scalpel or prescribing the wrong dose. When we make
mistakes, people get sick and if they are very sick, they die.

"If a doctor has a blood alcohol level that would make it illegal to drive a
car, they should not be in an operating theatre."

He wanted to see random drink and drug testing in the NHS, he said, but the
British Medical Association disagrees, arguing it would have major civil
liberties implications. "We have not seen evidence that testing health
professionals is necessary, or that it would be effective. If such a
proposal were to be put forward, the BMA would want to consider it very
carefully," it said in a statement.

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Checked-by: Don Beck