Risk of mortality and suicide associated with substance use disorder among healthcare professionals: A systematic review and meta-analysis of observational studies

Fatal Drug Overdose Risks of Health Care Workers in the United States : A Population-Based Cohort Study

BACKGROUND

Despite an unprecedented increase in drug overdose deaths in the United States, the risks faced by U.S. health care workers, who often have access to controlled prescription drugs, are not known.

OBJECTIVE

To estimate risks for drug overdose death among health care workers relative to non-health care workers.

DESIGN

Prospective cohort study.

SETTING

United States.

PARTICIPANTS

Health care workers (n = 176 000) and non-health care workers (n = 1 662 000) aged 26 years or older surveyed in 2008 and followed for cause of death through 2019.

MEASUREMENTS

Age- and sex-standardized drug overdose deaths were determined for 6 health care worker groups (physicians, registered nurses, other treating or diagnosing health care workers, health technicians, health care support workers, and social or behavioral health workers) and non-health care workers. Adjusted drug overdose death hazards (and 95% CIs) were also evaluated, with adjustment for age, sex, race/ethnicity, marital status, education, income, urban or rural residence, and region.

RESULTS

Approximately 0.07% of our study sample died of a drug overdose during follow-up. Among health care workers, annual standardized rates of drug overdose death per 100 000 persons ranged from 2.3 (95% CI, 0 to 4.8) for physicians to 15.5 (CI, 9.8 to 21.2) for social or behavioral health workers. Compared with those for non-health care workers, the adjusted hazards of total drug overdose death were significantly increased for social or behavioral health workers (adjusted hazard ratio, 2.55 [CI, 1.74 to 3.73]), registered nurses (adjusted hazard ratio, 2.22 [CI, 1.57 to 3.13]), and health care support workers (adjusted hazard ratio, 1.60 [CI, 1.19 to 2.16]), but not for physicians (adjusted hazard ratio, 0.61 [CI, 0.19 to 1.93]), other treating or diagnosing health care workers (adjusted hazard ratio, 0.93 [CI, 0.44 to 1.95]), or health technicians (adjusted hazard ratio, 1.13 [CI, 0.75 to 1.68]). Results were generally similar for opioid-related overdose deaths and unintentional overdose deaths.

LIMITATION

Unmeasured confounding, uncertain validity of cause of death, and one-time assessment of occupation.

CONCLUSION

Registered nurses, social or behavioral health workers, and health care support workers were at increased risk for drug overdose death, suggesting the need to identify and intervene on those at high risk.

PRIMARY FUNDING SOURCE

National Heart, Lung, and Blood Institute.

[Elective Course "Meaningfullness and Self-Care in Daily Clinical Practice"]

How future physicians can learn about role models during their medical training - an approach on teaching personal skills as described in the new "National Competence-based Catalogue of Learning Objectives in Medicine 2.0".

It Takes a Village: A Narrative Review of Anesthesiology Mentorship

Mentorships play a critical role in the development of physician careers and should be tailored within a structured, evidence-based mentoring program to ensure mutual benefit and avoidance of pitfalls. We offer a narrative review of the current literature and commentary on mentoring at the medical student, GME trainee, and early career faculty levels within anesthesiology, and propose a framework on which an effective mentoring program can be implemented.