What’s the cost of being a doctor in recovery?

I am a physician in recovery and just celebrated my fifth-year anniversary on October 11, 2017.

While in active addiction, my drugs of choice were benzodiazepines and opioids that I washed down with top-shelf alcohol. Near the end of my usage, I was diverting scheduled drugs in order to feed my addiction. After an unsuccessful suicide attempt, I finally admitted myself for treatment.

As part of the treatment process, I enrolled with our state’s physician help program (PHP). Because of my diversion, they were obligated to report me to the medical board who in turn suspended my license for six months. After that time period, the suspension was stayed, but it still meant that my license was restricted. The difference is moot since you can’t work in clinical practice either way.

The board restrictions led to my board certification with the American Board of Family Medicine being revoked.

The diversion led to a DEA investigation, subsequent charges and a conviction for obtaining controlled substances by fraud. When the Centers for Medicare and Medicaid Services learned of the conviction, I was placed in the Office of the Inspector General exclusion list, meaning that federal payors will not enroll me in their programs. That exclusion cascades down to private insurers as well.

My addiction and subsequent recovery lifestyle changes led to a divorce. Legal defense and DEA fines led to my having to withdraw, with a 10 percent penalty since I was under 59 and a half, over $150,000 from my retirement account.

When I returned from treatment, I became a pariah among my physician colleagues in the health care corporation where I had worked for 22 years. What I needed at that fragile early recovery stage were kudos and a pat on the back. What I got were cold shoulders. I was quickly escorted to the exit and asked never to return. They said it was something to do with protecting the company’s reputation and image. Having “one of me” there would be tarnishing.

Despite all of this, there is good news. Through hard work my license has been returned to an unrestricted status, my board certification reinstated and a restricted DEA certificate granted. I have remarried and am fortunate to have a woman in my life who understands and supports my recovery lifestyle. I have a new career in health informatics which pays as well as clinical medicine.

Though life has slowly returned to some semblance of normalcy, there are painful wounds that remain; ones that serve as a reminder of my past as well as how fragile recovery is. The legal conviction will be there for life, reminding me of the consequences of my disease. On August 15, 2017, I lost a daughter to suicide after a long battle with mental illness and addiction. Why I’ve remained in recovery while she failed will forever haunt me. I would have gladly put the rope that snuffed her life out around my neck to save her. In a heartbeat. Without a second thought.

I accept the consequences of my addiction and am learning to live with the grief of my daughter’s death. I fight the demons, some of whom inhabit human bodies, whispering among themselves that her death was further punishment for my actions.

I don’t feel sorry for myself. Frankly, I’m glad to be alive. Physically, emotionally, mentally and spiritually, I’ve never been healthier. My life experiences make me better equipped to practice clinical medicine than ever before. Though health informatics is interesting, I miss the patient care. There is a drug epidemic in our society, and I’m standing on the sidelines. I’m far more compassionate and empathetic than I was before my recovery.

My desire to return to clinical practice is like a soldier who’s fought a difficult battle wanting to return to the trenches. Why in the world would they do that? Because it’s not about them. It’s about their brothers and sisters who are still fighting the war.

Stories like mine are not unusual among those in my profession. Seeking help for substance use disorder can mean huge consequences for physicians. Fair or not, it’s the price we pay for getting better.

I’ve witnessed the lack of understanding that many physicians have regarding how to treat those suffering from addiction as well as those in recovery. Substance use disorder is a chronic disease and needs to be treated as such. “Diabetes” needs to be at the top of a diabetic patient’s problem list because maintaining good glycemic control can decrease the severity of complications such as retinopathy, nephropathy, and neuropathy. Likewise, “recovery” needs to be at the top of a patient in recovery’s chart for if it fails, so too does physical, mental, emotional and spiritual health.

With rare exceptions, doctors shouldn’t prescribe controlled substances to a recovering addict with the advice to “fill it if you need it.” Our brains don’t work that way. We’ll fill those prescriptions, more than likely abuse them and potentially return to the hell of addiction. I’ve experienced this type of clinical scenario as have many friends of mine in recovery.

I share my story freely to anyone who will listen. I imagine some of those in my audience are physicians struggling with their own substance use disorder. They are among the estimated 10 percent of impaired doctors in active practice. After hearing my story, will they get the help they need or hide further in their addiction closet? The former could subject them to journeys like mine; the latter could endanger their lives as well as those of their patients.

Many have said that I deserve what happened to me; that I should never return to clinical practice. In today’s social media society, those type of judgments are rendered in anonymity. It’s like water off of the back of a duck to me. Insert your feet into my shoes, walk in them for five years and then get back to me.

The cost of recovery has been great professionally and personally. The reward is a renewed life. Though I walk with scars and a limp, overall it has been worth the pain. Sometimes I wonder, though, who else out there would pay this hefty price for recovery.

Luther Philaya is a family physician.

Image credit: Shutterstock.com

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