Akvardar Yildiz, Türkcan Ahmet, Cakmak Duran
Dokuz Eylül U Tip Fak, Psikiyatri AD.
Turk Psikiyatri Derg. 2002 Autumn;13(3):238-44.
In today's medical community, there is growing concern about substance use among physicians, not only because of their own health, but also because of the potential adverse effects on their clinical practices. Physicians affect public health both by treatment and preventive studies and as role models. Prevalence data concerning substance abuse are generally lacking. There is no consensus on the rates of substance abuse being higher among physicians than among the general public. Physicians are less likely to smoke cigarettes and use illicit substances (like marijuana, cocaine and heroin) and more likely to use alcohol and two types of prescription medications--benzodiazepines and minor opioids--compared with their age groups. Doctors are at special risk of developing addiction problems owing to the strain of medical practice, erosion of the taboo against injecting and using opiates, and particularly access to supplies. The most common precipitating factors mentioned are physical pain and illness, usually chronic, with family tragedy such as death of a wife or child next. The third most common factor is an addicted wife. Stress, overwork and marital problems are also mentioned. No data were found about physicians' substance use in Turkey. This article generally aims to review the knowledge on the prevalence of substance use among physicians, the drug of choice, the development of dependence, the treatment and prognosis and to discuss the importance of this issue by evaluating three cases treated at the Alcohol and Drug Addiction Treatment and Research Center (AMATEM), Bakirköy State Hospital for Mental and Neurological Diseases.
在当今医学界，人们越来越关注医生的药物使用问题，这不仅关乎他们自身的健康，还因其可能对临床实践产生不利影响。医生通过治疗和预防研究以及作为榜样来影响公众健康。关于药物滥用的流行数据普遍缺乏。对于医生中药物滥用率是否高于普通大众，目前尚无共识。与同龄人相比，医生吸烟和使用非法药物（如大麻、可卡因和海洛因）的可能性较小，而使用酒精以及两种处方药——苯二氮䓬类药物和小剂量阿片类药物的可能性较大。由于医疗工作的压力、对注射和使用阿片类药物禁忌的淡化，尤其是药品的可得性，医生面临着成瘾问题的特殊风险。提到的最常见诱发因素是身体疼痛和疾病，通常为慢性病，其次是家庭悲剧，如妻子或孩子的死亡。第三大常见因素是妻子成瘾。压力、过度工作和婚姻问题也被提及。未找到关于土耳其医生药物使用情况的数据。本文旨在总体回顾关于医生药物使用流行率、首选药物、依赖的发展、治疗和预后的知识，并通过评估在巴基尔柯伊州立精神和神经疾病医院酒精和药物成瘾治疗与研究中心（AMATEM）治疗的三个病例来讨论这个问题的重要性。
