It's important to look at substance abuse among anesthesiologists, he says, because they have a somewhat "unique ready personal access to potent narcotics and hypnotics, and unlike most physicians, we personally administer the drugs, draw them up in a syringe, and give it in an intravenous line."
That's not the usual practice for the majority of other physician groups, who may prescribe a drug but not personally administer it.
He adds that "physician impairment is potentially a patient safety issue, and we want to do everything we can to protect our patients, another area I think we need to think about."
Warner says that residents whose substance use disorders are detected are usually caught stealing or diverting drugs, similar to the manner in which the catheterization lab tech at Exeter Hospital in New Hampshire, David Kwiatkowski, diverted fentanyl through syringes set out for patient use.
"Some are actually caught using, or someone finds needles in the call room," Warner says.
What happens to these residents after they're caught is what Warner thinks should be up for discussion. Currently, "the majority go into some sort of treatment program, whether inpatient or outpatient, and the majority attempt to return to residency and continue training, and some go into another medical specialty."