workforce euthanize people’ s pets. But this is an area that needs more research, and actually this is what we’ ll be looking into next – suicides among healthcare professionals more generally and how we can find ways to prevent them in future.
workforce euthanize people’ s pets. But this is an area that needs more research, and actually this is what we’ ll be looking into next – suicides among healthcare professionals more generally and how we can find ways to prevent them in future.
What factors put healthcare professionals at a higher risk of substance abuse and premature death? Overall, we found that these deaths generally involved females in their mid-40s, with a mental health problem, exposure to opioids and / or benzodiazepines, personal and / or professional stress, and the intent to self-harm.
What was revealed about the drugs of choice for specific professions? We found some significant associations between specific occupations and certain drug types. Some of them are what we were seeing in the literature previously, and some were a little bit different. We saw that opioid use was very common among paramedics. Antidepressants or antipsychotic drugs were very common among psychiatrists and psychologists. The veterinarians tended to use barbiturates usually used in animal euthanasia. Most of these cases involved intentional self-harm or suicide. Alcohol use was also common among the veterinary group in particular.
The medical practitioner group also involved a subset of cases where death was caused by abuse of an anaesthetic called propofol, and of these, the majority were suicides. Compared to the low number of Australians employed as anaesthetists, we found that the rate of deaths among this particular profession was very high. We know that this is a high risk profession in terms of drug abuse from previous international studies, so this just indicated that it’ s a problem we see in Australia too.
What we did see that was different from the literature was that previous research has shown that nurses, dentists and pharmacists usually misuse opioids specifically, and drugs like morphine and pethidine that are available or well accessible in their workplace. In this study, we found that they also misused other drugs, mainly benzodiazepines and also antidepressants and antipsychotics.
There are a range of different drugs that were being used. In about 20 per cent of cases overall, the drugs were being diverted from the workplace. These healthcare professionals were actually taking them from their workplace.
How were the drugs typically obtained? Most of the cases involving drugs obtained through the workplace involved healthcare professionals taking IV drug solutions, like anaesthetics among the medical practitioners or barbiturates among the veterinary group. There were also a number of nurses stealing pharmaceutical opioids from the workplace and combining them with other prescription and over-the-counter drugs.
How might these insights inform approaches to healthcare professionals’ drug use and mental healthcare needs? This study highlights the need for creating a culture where healthcare professionals feel like they can speak out about their problems. We know from previous research that many healthcare professionals either don’ t seek help, or they treat themselves or seek treatment privately. Many don’ t speak out about their problems with drug use and mental illness because they fear stigmatisation and losing their jobs. Job loss typically leads to financial problems and relationship issues, not to mention compromising the career they’ ve worked so hard for all their lives, and the risk of malpractice lawsuits. But we need to remember that doctors and other healthcare professionals are human too. They need support like the rest of us, but it seems they don’ t feel they can speak up to get the help they need.
Also, we have to keep in mind that this study only looked at healthcare professionals that had died from drug misuse. Given the tendency to keep their drug misuse secret, it’ s reportedly very difficult to estimate the prevalence of drug misuse among living [ and practising ] healthcare professionals. We may just be scratching the surface of a much wider problem in this industry. I think this highlights a real opportunity for prevention. We hope this will help inform those decisions that are really up to the industry bodies and relevant regulation boards for each of these healthcare professions. ■
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