Drug and alcohol use by dental healthcare professionals and students

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Substance abuse in dentists

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<ul><li> 1. Drug and Alcohol Use by Dental Healthcare Professionals and Students George A. Kenna, Ph.D., B.S.Pharm., R.Ph. Assistant Professor of Psychiatry Center for Alcohol and Addiction Studies Brown University, Providence RI Clinical and Investigational Pharmacist Miriam Hospital, Providence, RI American Academy of Oral Medicine 4/12/14 </li> <li> 2. Learning Objectives: Discuss the prevalence of alcohol and other drug use by dentists compared to other healthcare professionals and to the general population Consider if suicide rates are higher in the dental profession Know the basics for identifying substance use disorders (SUDs) in yourselves and colleagues Recognize the basics for treatment and support Understand the importance for dentists and dental students to be involved in ongoing education of SUDs American Academy of Oral Medicine 4/12/14 </li> <li> 3. While not citing any prevalence studies of substance use by dentists, Hedge (1985) estimated that as many as 15% to 18% of dentists could be addicted to drugs and alcohol. Chemical dependency has received much attention as a national problem, and current evidence suggests that it may be more widespread among dentists than among the overall population of the United States. (Clarke, Chiodo, &amp; Cowan, 1988. ) The health professions may attract those vulnerable to drug abuse because of their emotional impairment due to alcoholic and emotionally abusive parents. (Coombs, Drug Impaired Professionals, 1996) Speculative Comments: American Academy of Oral Medicine 4/12/14 </li> <li> 4. Several studies of dental students (Bowermaster, 1989; Sammon et al; 1991; Sandoval et al., 1988; 1990) suggested that many dentists come from dysfunctional families or families with a history of alcoholism or chemical dependency. e.g. Sammon et al. (1991) reported that 35-39% of students at two dental schools had an alcoholic parent or grandparent. Chiodo and Tolle (1997) drawing on non-representative disciplinary action data, deduced that dentists were at higher risk for substance use and abuse than the general population, and questionably concluded the literature had consistently reported disproportionately higher rates of chemical dependency in HCPs. Speculative Comments: American Academy of Oral Medicine 4/12/14 </li> <li> 5. Used qualitative or treatment samples Poor use of measures Assessed only one healthcare profession Used professional organizations to recruit No consideration of Type II error Problems with many previous studies included: Prevalence of Alcohol and Other Drug Use and Abuse in Healthcare Professionals The major aim of this study was to investigate the prevalence of substance use in the major groups of HCPs using methodologically sound criteria. American Academy of Oral Medicine 4/12/14 </li> <li> 6. Method Used validated measures Stratified by zip-codes Randomly chose Dentists, Nurses, Pharmacists, Physicians licensed in Rhode Island, but living in RI, MA or CT only. 6 contacts over 8 weeks: Social-exchange theory (Dillman, 2001) 7 page self-report survey N = 479/697 Response rate 68.7% MDs = 63.4% to RNs = 73.3%. American Academy of Oral Medicine 4/12/14 </li> <li> 7. Dentists Registered Nurses Pharmacists Physicians Number of Licensees* 755 18,927 1,917 4,174 Gender Men 80.3 Women 19.7 Men 10.7 Women 89.3 Men 51.6 Women 48.4 Men 74.3 Women 25.7 Demographics Supplied by the Rhode Island Department of Health Note. The Department of Health figures differ from those used for the study as they include all licensees regardless of state of residency. (Kenna Dissertation, 2003) American Academy of Oral Medicine 4/12/14 </li> <li> 8. American Academy of Oral Medicine 4/12/14(Kenna &amp; Wood, Journal of the American Pharmaceutical Association, 2004). </li> <li> 9. American Academy of Oral Medicine 4/12/14(Kenna &amp; Wood, Journal of the American Pharmaceutical Association, 2004) </li> <li> 10. American Academy of Oral Medicine 4/12/14(Kenna &amp; Wood, Journal of the American Pharmaceutical Association, 2004) </li> <li> 11. American Academy of Oral Medicine 4/12/14 (Kenna &amp; Wood, Journal of the American Pharmaceutical Association, 2004). American Academy of Oral Medicine 4/12/14 </li> <li> 12. American Academy of Oral Medicine 4/12/14Kenna &amp; Wood, Drug and Alcohol Dependence, 2004 </li> <li> 13. Alcohol Use and Misuse During the Past Month Dentists (n = 81) Nurses (n = 70) Pharmacists (n = 87) Physicians (n = 69) NHSDA 2002 Quantity by Frequency Index Mean drinks/ month (SD) 26.7 * (21.9) 20.5 (18.8) 18.4 (15.9) 17.9 (20.3) Mean drinking days/month 12.6* (8.4) 10.7 (7.9) 9.3 (6.7) 10.0 (7.8) Mean drinks/drinking day 2.1 (1.1) 1.9 (.86) 2.0 (1.0) 1.7 (.88) Heavy episodic alcohol use (%) 15.9 * 8.5 12.0 7.7 18.1 Heavy alcohol use (%) 0.9 0.8 0 1.9 5.7 Consider self a heavy drinker (%) 0.9 0 0 1.9 Consider self a problem drinker (%) 0.9 0 0 0 Kenna &amp; Wood, Drug and Alcohol Dependence, 2004 *P</li></ul>

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