editorial comment paraphernalia now understands why mom always said that I should have gone to medical school!

Exhausted, driven and with easy access to powerful drugs, many doctors are becoming addicts. These doctors are often terrified that their addictions will destroy their careers, so they keep mum about their habits.

These were the findings of research by social worker Elca Erlank, who became curious about addiction among health professionals after counselling several doctors at the Magalies-
oord rehabilitation centre.

The research is the subject of an article in the South African Medical Journal. In 2001, 79 doctors with substance abuse problems were reported to the Medical and Dental Professions Board. In 2002, when Erlank completed her thesis, 59 were reported.

"There are many more doctors with substance abuse problems who go unreported."

"They themselves keep quiet because they are afraid that they could lose their licences to practise," Erlank said.

"Most of these doctors I interviewed had their own practices and gave out medicines. They could use as much as they wanted. The doctors had severe addictions by the time they were reported."

"Most of the doctors said their colleagues and their families knew about their problem, but nobody had wanted to become involved by reporting them."

The doctors most often became addicted to sleeping tablets and pethidine, a synthetic form of morphine. A smaller number abused alcohol.

Of all the doctors reported, only 20 agreed to be interviewed.

Six of them were from the Western Cape and 12 from Gauteng. All of these doctors had been abusing substances for at least six years.

The doctors typically abused drugs to relieve anxiety, tension, depression and the stress of their jobs. Most said the drugs also helped them to overcome the insomnia that resulted from long, irregular working hours.


Half said that a lack of professional support had contributed to their habit.

Most of the doctors interviewed had several characteristics of what is known as the "type A" personality, which is perfectionist, competitive, ambitious and always in a hurry.

None had characteristics of the more relaxed "type B" personality, which is less vulnerable to stress.

An addicted doctor could place patients at risk, Erlank wrote in her thesis, so the public and the doctor's colleagues should "take responsibility to help the specific doctor to get help".

"Doctors won't admit that their judgment is impaired," said one of the doctors.

"I made plenty of mistakes and got away with them. I was very lucky. So there weren't serious consequences but potentially it could have been disastrous, if I think back."

"I remember reading somewhere that if you're very tired you could inject just a little bit of pethidine. So I did it, worked for another day then slept," said another doctor.

Erlank found that 45% of the doctors interviewed had a parent who had been an addict. More than half felt that they could not share their problems with their families.

There is no former research on substance abuse among South African doctors, said Erlank, but studies from other countries show that doctors are more likely to develop addictions than the rest of the population, in part because they can easily procure strong drugs.

By Jo-Anne Smetherham

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