A new article published in the Journal of the Neurological Sciences reviews neuropsychological impairment associated with substance use by physicians; describes common neurocognitive deficits following use of various drug classes; and reviews the neurocognitive impact of pharmaceutical treatments for opioid use disorder (OUD). Authors emphasize the importance of continued testing/monitoring for physicians with substance use disorders (SUDs) following acute treatment.
In response to this review article, Robert L. DuPont, MD and Mark S. Gold, MD authored a commentary published in Clinical Psychiatry News, noting that to understand the controversy over the use of medication-assisted treatment (MAT) in the care management of physicians with OUDs requires:
An understanding of state PHPs and how those programs oversee the care of physicians diagnosed with SUDs, including OUDs;
Recognition that medical practice in relationship to SUDs is treated by state licensing boards as a safety-sensitive job; and
An understanding of the historical context of the unique system of care management for physicians which began in the early 1970s.
"Dr. Polles and colleagues call attention to the unique care management of the PHP for all SUDs, not just for OUDs, because the PHPs set the standard for returning physicians to work who have the fitness and cognitive skills to first do no harm. They emphasize the importance of making sustained recovery the expected outcome of SUD treatment. There is a robust literature on the ways in which this distinctive system of care management shows the path forward for addiction treatment generally to regularly achieve 5-year recovery. The current controversy over the potential use of buprenorphine and buprenorphine plus naloxone in PHPs is a useful entry into this far larger issue of the potential for PHPs to show the path forward for the addiction treatment field." Read more.