Delayed Action

Drug abuse in the healthcare field can go undetected because of the structure of the healthcare industry. Healthcare providers may be less supervised than in other industries. For example, physicians work independently and come under scrutiny only in a healthcare facility setting. Furthermore, healthcare professionals have the capability to self-diagnose and to self-treat and may not have another provider complete an objective assessment which might reveal substance abuse. Acknowledging substance abuse may put the individual at risk of suspension or revocation of the license to practice.

There can also be a "white wall of silence" among healthcare professionals when it comes to reporting a colleague for substance abuse. Although they want to help their colleague, no one wants to be responsible for a colleague losing his or her license—or expose themselves to inadvertently making false accusations.

Silence is not the right course of action. First, there is an ethical obligation to report suspected abuse to protect patients who are being treated by the healthcare provider. Healthcare facilities and regulatory boards are sensitive to the need to maintain confidentiality during the handling of the allegation and subsequent inquiry. Second, the addicted person actually becomes a patient and should be given the best and most appropriate care. That care includes treatment for the addiction. Keeping silent about suspicion of addiction is actually harmful to the substance abuser and violates the ethical responsibilities of the healthcare provider.

Substance abuse is considered a handicap. Therefore, the healthcare provider who is employed by a healthcare facility may be protected by state and federal employment discrimination laws such as the Rehabilitation Act (29USC, Section 706). This Act requires employers to continue employment of a substance abuser as long as the employee can perform their job function and is not a threat to safety or property. This means that the healthcare provider's responsibility might be temporarily reassigned until treatment is completed.

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