University of New South Wales, Sydney, New South Wales, Australia.
National Drug and Alcohol Research Centre (NDARC), University of New South Wales (UNSW), Sydney, New South Wales, Australia.
Intern Med J. 2023 Jun;53(6):939-945. doi: 10.1111/imj.15729. Epub 2022 Aug 31.
There have been few large-scale nationally representative studies on the prevalence of substance use among doctors. In addition, the association of different medical specialties with the use of different substances requires further research.
To investigate how the use of alcohol, tobacco and illicit drugs varied between junior doctors enrolled in different specialty training programmes.
A secondary analysis was conducted on a national survey of 12 252 Australian doctors. The population of interest was junior doctors currently enrolled in a specialty training programme, termed vocational trainees (VT; n = 1890; 15.4% of the overall sample). Self-report prevalence of current alcohol, tobacco and illicit drug use were assessed and hazardous alcohol use was assessed using the Alcohol Use Disorders Identification Test. Logistic regression was used to examine the association between specialty and substance use, adjusting for demographic characteristics when required.
One in six VT reported hazardous levels of alcohol use (n = 268; 17.3%). After adjusting for confounders, the association between the prevalence of alcohol use and the specialties of emergency medicine/intensive care unit (odds ratio (OR) 2.15; 95% confidence interval (CI) 1.40-3.32; P < 0.001), anaesthetics (OR 2.53; 95% CI 1.35-4.76; P = 0.004) and obstetrics/gynaecology (OR 1.89; 95% CI 1.19-3.02; P = 0.007) remained significant. No significant associations were found between tobacco use/illicit drug use/hazardous alcohol use and medical specialty.
While rates of substance use and hazardous alcohol use in VT are similar, if not lower, than the general population, it poses a concern that there are higher rates of alcohol use in certain medical specialties.
针对医生群体中物质使用的流行情况，仅有少数大规模的全国代表性研究。此外，不同医学专业与不同物质使用之间的关联需要进一步研究。
调查不同专业培训项目中的初级医生使用酒精、烟草和非法药物的情况。
对澳大利亚 12252 名医生的全国性调查进行了二次分析。研究对象为目前正在参加专业培训项目的初级医生，即职业培训生（VT；总体样本的 15.4%，n=1890）。评估当前酒精、烟草和非法药物使用的自我报告流行率，并使用酒精使用障碍识别测试评估危险饮酒情况。Logistic 回归用于检查专业与物质使用之间的关联，在需要时根据人口统计学特征进行调整。
1/6 的 VT 报告存在危险水平的酒精使用（n=268；17.3%）。在调整混杂因素后，酒精使用的流行率与急诊/重症监护（OR 2.15；95%置信区间（CI）1.40-3.32；P<0.001）、麻醉科（OR 2.53；95% CI 1.35-4.76；P=0.004）和妇产科（OR 1.89；95% CI 1.19-3.02；P=0.007）之间的关联仍然显著。在吸烟、使用非法药物或危险饮酒方面，与医学专业之间没有显著关联。
虽然 VT 中的物质使用和危险饮酒率与一般人群相似，如果不低的话，但某些医学专业中更高的酒精使用率令人担忧。
