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Heal Thyself 

What happens when an addict owns a prescription pad?

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The announcements pour out constantly from the Washington State Department of Health, broadcasting the crimes of once-trusted medical professionals. They list sexual misconduct, physical abuse, medical incompetence and financial exploitation. But other times, they highlight a different sort of struggle: addiction.

Richland dentist James Huffman “intentionally overdosed on Vicodin he took from stock at his dental practice.” Everett dentist Russell Clark had his license suspended after charges that he prescribed one patient “excessive amounts of controlled substances,” split the drugs with him, and “contributed to the hospitalization of at least one person.”

With pill-popping protagonists headlining TV shows House and Nurse Jackie, the premise of doctors and dentists addicted to their own supply is familiar. But in the real medical world, an entire infrastructure has developed to help heal the healers.

The Washington Physicians Health Program (WPHP), a small, independent nonprofit, was founded in 1986 to guide the recovery of health professionals. This month Gov. Jay Inslee signed a new bill that doubled the license renewal fee for dentists from $25 to $50 to help increase the funding for that program. (Physicians already pay a $50 renewal fee.)

“I don’t think anybody is immune from the power of addiction,” says Rep. Marcus Riccelli, D-Spokane, the bill’s sponsor.

The idea of helping doctors recover from addiction hasn’t always been accepted. “A number of years ago, in the ’80s and early ’90s, we didn’t have a way to deal with these people other than take their license from them,” says Lisa Hodgson, a director at the state Department of Health. But the thinking has changed. She says the medical community now understands that addiction is a disease — and it needs to be treated like any other disease.

The most common addiction among doctors is alcohol, says WPHP Medical Director Charles Meredith. Next comes opioid dependence, including Vicodin and OxyContin.

Addiction can still threaten doctors’ careers. The state Department of Health’s Quality Assurance Commission investigates incidents of drug abuse and can suspend licenses, order treatment, publicize transgressions, and even bar doctors from practicing in other states.

And the threat of career-ending punishment can stop doctors and dentists from seeking treatment. If there hasn’t been any patient harm or sexual misconduct, the WPHP allows doctors to reach out for help without immediately putting their license at risk. Yet the vast majority of doctors are involuntarily referred to the program by their employees, peers or law enforcement.

In many cases, doctors are required to temporarily leave their practice and attend an out-of-state inpatient facility specializing in treating addiction in medical professionals. Even when they return to practicing medicine, they remain in a monitoring program — random urine tests are conducted with a witness standing beside them and watching them pee — for the next five years.

Comparatively, the program is remarkably successful. About 83 percent remain sober after five years, Meredith says. If they fail a drug test, they sometimes start the program over again. After that, the sobriety rate rises to 95 percent.

The bill’s fiscal note estimates the license fees could generate about $146,700 a year — useful for an organization that’s been expanding to help doctors with mental illness. “At times we’ve been significantly understaffed,” Meredith says. “We continue to receive an increasing number of referrals annually.” 

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