Anesthesiolgists and Addiction

[rangrz]

^

I was again making a critique on the the way the article was written, not on you. I was referring to the fact the way it is written makes it seem as if that profession is full of incompetent boobs who nod out sitting in front the cart instead of watching the capnography or whatevs. But it just is not the case.

I am not a fan of incompetence myself, esp not in a demanding and safety critical field like that. But I see the incompetence as incompetence, be it from shooting sufenta, from >75 hour weeks for residents, or from simply being a lazy sack of shit. I just did not like the way the article seemed to imply that this most elite and selective of fields was rife with it.

 

[hthr007]

you can't apply that logic to opiates and not anxiolytics and antidepressants. there is not much difference between being on maintenance on opiates, and being on maintenance on SSRIs or other medicines, imo.

if somebody ODs in the operating room, he's not a functioning/sustainable addict. he wouldn't have made it to that point in his career in the first place, he'd still just be chasing the rabbit

Even though the article says that most addictions take place after med school I agree with this point.

 

[hthr007]

^

I was again making a critique on the the way the article was written, not on you. I was referring to the fact the way it is written makes it seem as if that profession is full of incompetent boobs who nod out sitting in front the cart instead of watching the capnography or whatevs. But it just is not the case.

I am not a fan of incompetence myself, esp not in a demanding and safety critical field like that. But I see the incompetence as incompetence, be it from shooting sufenta, from >75 hour weeks for residents, or from simply being a lazy sack of shit. I just did not like the way the article seemed to imply that this most elite and selective of fields was rife with it.

The article did seem to imply that ALL anesthesiologists are terrible people which isn't the case.

Everyone -- anesthesiologist, truck driver, cab driver, retail worker, etc must know their limits for harm reduction of themselves and others if they're responsible for.

If they someone cant handle the stress that comes with the territory they should pursue another career field if their usage makes them incompetent, incompetence being key.. No one is forcing them in a high stress profession. They need to know their limits and whether or not they're capable of using while at work; it's pretty obvious to tell if they can't handle it -- unattentive, nodding out, cutting corners...all indicative drug use should be saved for when they do not have work.

 

[slimvictor]

I'm perfectly capable of believing what I want to, I don't think It's your place to tell me not to care about a matter when it's evident that I do. Thank you.

I'm not trying to offend anyone.

All I did was post an article that I found interesting. I wasn't looking for an argument like most of you who posted on here seem to be by belittling me or making my opinion seem stupid. there's a way to have a discussion tactfully and still respect the other persons opinion rather than jumping down their throat when you have differing opinions.

This anesthesioloist fucked up, so CLEARLY he was NOT more than capable of doing his job under the influence. Big difference between a functioning user and a complete idiot which the doctor in the article proved to be. Two lives were lost due to his negligence and that's awful.

The surgeon my grandmother had fucked up because he was a dumbass for numerous reasons I prefer to not get into at the moment. It's something I feel strongly about.

When someone fucks up on the drugs s/he was using on a loved one and causes them to die then maybe your opinions will change.

I don't think that anyone was purposefully belittling you or making you seem stupid.
I am sorry that you felt that way. But more sorry about your grandmother's situation. You clearly feel strongly about it, so I guess that it must have been terrible. Sending some healing vibes your way.

I was happy that you posted this article, and also that you commented on it.
I have no problem with your opinion - in fact, it was an interesting, worthwhile debate to me, so I put in my two cents' worth.

Peace.

 

[Crankinit]

I'm usually all for people's right to use drugs, but I think being fucked up while performing surgery and stealing from patients is definitely crossing the line. It's pretty disgusting behavior and gives all opiate users a bad name.

 

[Voxide]

i'd prefer someone on maintenance to someone on withdrawal.

i'd prefer someone on opiates to someone taking new untested synthetics due to drug tests.

in a maintenance context, opiates don't impair coordination. many many surgeries have been performed by opiate addicts. iirc the doctor who first started using sterilizing operating rooms was one.

I'd prefer someone who is....sober

And sorry, but there is no way you're going to convince me that being on that potent of a painkiller doesn't impair any functions even on maintenance. He's responsible for people's LIVES. He's not some dipshit sales clerk, he's a hospital worker.

 

[opi8]

If opiates were regulated this wouldn't be a problem.

To those of you who think these doctors were "fucked up" on painkillers, you have no idea what dependance to opiates is like. There is no high any more. There's only sick, or not sick.

It is said in the article that these were some of the best of the best. The only reason casualties occurred is probably because he had to be sneaky about when and how he got his fix.

 

[hthr007]

I'd prefer someone who is....sober

And sorry, but there is no way you're going to convince me that being on that potent of a painkiller doesn't impair any functions even on maintenance. He's responsible for people's LIVES. He's not some dipshit sales clerk, he's a hospital worker.

^^ amen

 

[Crankinit]

I think the issue is the environment they were forced to work in. Having to scrounge their drugs in secret meant they couldn't plan out their use, taking enough to maintain during work then getting their nod on when they go home. If you only have a few seconds to grab a hit and don't know when your next is coming, you're going to grab as much as possible, probably without even exact measurement due to the surreptitious nature of your dosing.

Once again, prohibition claims a victim.

 

[highhooked]

I'd prefer someone who is....sober

And sorry, but there is no way you're going to convince me that being on that potent of a painkiller doesn't impair any functions even on maintenance. He's responsible for people's LIVES. He's not some dipshit sales clerk, he's a hospital worker.

The question is whether withdrawl impairs function more so than a maintenance dose of opiates?I would say that yes withdrawl does fer sure especially from a severe habit.

But yea of course you woukd want someone who is sober...but that isn't any fun to talk about.

 

[Cane2theLeft]

It's been years since I read that article so I'm not sure if it's mentioned but the doctor featured (Jeffrey Junig) got clean and became a suboxone doctor. He now maintains the suboxone talk zone blog which is extremely informative. He used his experience with addiction coupled with his medical knowledge to become an advocate for addicts and dedicates his life to helping people get clean without judgment or the level of ignorance regarding addiction you too-often see in medical professionals.

As a side note, he was also briefly a BLer. It's a shame he didn't stick around and get more involved here.

 

[phenmetrazine]

I'm not really sure how I feel about this issue. I certainly would like a doctor to be as clearheaded as possible if he was going to do surgery on me. If for instance he was an addict, this would obviously mean that he would be at his best while on a maintenance dose of his drug of choice. Of course I would really prefer that he was a teetotaler that had never let an intoxicating drug into his body intentionally, but this is the real world and perfect situations are far from the usual. In the end, the best I could hope for is a doctor who has much esteem in his profession and he knows how to not let any personal habits interfere with my safety, whatever those habits may or may not be. That being said, I do not believe that a known addict should be actively involved in life or death surgery. The reason being is that if there is an accident, they would obviously be blamed because of their drug usage regardless of the nature of the accident.

 

[hthr007]

It's been years since I read that article so I'm not sure if it's mentioned but the doctor featured (Jeffrey Junig) got clean and became a suboxone doctor. He now maintains the suboxone talk zone blog which is extremely informative. He used his experience with addiction coupled with his medical knowledge to become an advocate for addicts and dedicates his life to helping people get clean without judgment or the level of ignorance regarding addiction you too-often see in medical professionals.

As a side note, he was also briefly a BLer. It's a shame he didn't stick around and get more involved here.

Wow, very interesting!!

 

[slimvictor]

I'm not really sure how I feel about this issue. I certainly would like a doctor to be as clearheaded as possible if he was going to do surgery on me. If for instance he was an addict, this would obviously mean that he would be at his best while on a maintenance dose of his drug of choice. Of course I would really prefer that he was a teetotaler that had never let an intoxicating drug into his body intentionally, but this is the real world and perfect situations are far from the usual. In the end, the best I could hope for is a doctor who has much esteem in his profession and he knows how to not let any personal habits interfere with my safety, whatever those habits may or may not be. That being said, I do not believe that a known addict should be actively involved in life or death surgery. The reason being is that if there is an accident, they would obviously be blamed because of their drug usage regardless of the nature of the accident.

I agreed with you 100% until you said

I do not believe that a known addict should be actively involved in life or death surgery.

I would not have a problem with a sugar addict, or a coffee addict, or some cannabis addicts. Nicotine addicts are probably okay as well.

 

[Crankinit]

sugar addict... cannabis addicts.

Lol.

 

[Thorns Have Roses]

^Gambling addicts would be a no-no as well.

 

[Solide]

I would not have a problem with a sugar addict, or a coffee addict, or some cannabis addicts. Nicotine addicts are probably okay as well.

I would. GP's, nurses, pharmacists, radiologists, .. Use drugs, be high, be withdrawing as long as you can still do your thing. But a surgeon? I don't want someone using sharp instruments around my vital organs doing ANY drug. Not even nicotine or caffeine or cannabis. (Sugar is fine). Even lack of sleep I wouldn't be comfortable with.

I guess I'm maybe setting the bar a little high but damnit I like my organs

edit:

^Gambling addicts would be a no-no as well.

Yes, yes they would.

 

[slimvictor]

I would. GP's, nurses, pharmacists, radiologists, .. Use drugs, be high, be withdrawing as long as you can still do your thing. But a surgeon? I don't want someone using sharp instruments around my vital organs doing ANY drug. Not even nicotine or caffeine or cannabis. (Sugar is fine). Even lack of sleep I wouldn't be comfortable with.

I guess I'm maybe setting the bar a little high but damnit I like my organs

You may not have left any human surgeons left on your "acceptable" list, once you refuse to accept caffeine and lack of sleep.
I think that you are not being realistic.
It's not like drinking some green tea before operating on you would be very likely to influence the operation.
In fact, if it did so, the odds are that the surgeon would be better able to focus for longer periods, based on studies of the affects of caffeine.
Maybe you could find a Mormon doctor? But the lack of sleep thing might wipe the possible list clean.


I honestly can't understand why you would not be comfortable with a tea-drinker operating on you.
Or, to be honest, that you would not care if the surgeon consumed a good serving - say, 50 grams - of sugar before operating. That would be a lot worse than drinking a green tea for concentration and precision, to my mind.

 

[Transcendence]

This is why I kind of wanted to become an anesthesiologist assistant. Free fentanyl for life: priceless. Getting caught and fired/arrested before you pay back your student loans:

 

[MyDoorsAreOpen]

I was never interested in going into anesthesiology, but I know a number of classmates from medical school who were. From what they said, the stigma in the profession surrounding recreational drug use borders on the extreme. The vetting process for a typical anesthesiology residency is designed to weed out anyone who's even considered bending their minds chemically. It's a job for the perpetually sober, for people whose world has no place for recreational drugs, never did and never will. It's a very similar job to being an airline pilot, in this way.

Right now, all you guys' debating about whether an opiate-positive anesthesiologist is intoxicated or maintaining is all very academic. This kind of debate is anything but academic when it's happening in court, after someone couldn't be revived. When the shit hits the fan, nobody is going to have much sympathy for that anesthesiologist's arguments that his positive urine test for opiates meant that he was more functional than he's otherwise have been, and that that test result couldn't have been the cause for his inability to keep the plaintiff's family member alive. Try and see this from the patient's perspective, and from a general medico-legal risk management perspective. If the anesthesiologist never uses opiates at all to begin with, then and only then can drug use be entirely eliminated as a potential factor in any mistakes he makes.

Is the guy who hails a taxi and smells alcohol on the cabby's breath really ready to buy a story about how the cabby drives better with a few drinks in him, and that he's lucky his driver isn't about to go into delirium tremens? Of course not -- he's ready to find another cab!

I understand people's readiness in here to defend people's personal freedom to do drugs, but I think often too little attention is given to how one person's decision to use drugs might be interpreted by people who [would] place their trust in that person.