Substance misuse among health care workers: national survey of occupational physicians

Background National Health Service (NHS) occupational health departments assist in the identification and assessment of substance-use disorders among health care workers (HCWs) and are involved in the management of an individual's return to work after treatment. Aims To determine the experience and training of NHS occupational health physicians (OHPs) in identifying substance misuse among HCWs. Methods A national, cross-sectional, postal-based questionnaire was administered to the Association of National Health Occupational Physicians membership. Results A total of 145/224 (65%) OHPs (55% male), with a mean age of 49 years (SD +/- 9.1; range 28-76), who had worked in the NHS on average for 9.6 years took part. The majority of respondents were consultant grade (59%). Since taking up their NHS post, 26% had received no training in substance misuse. Of those who had undergone formal training, the mean duration received was 2.8 days for drugs and 3.5 days for alcohol. OHPs reported that they did not feel sufficiently trained in this area. Most (65%) did not routinely include standardized screening tools or deliver 'brief interventions' (78%), although many reported that they would routinely ask about substance use when there was no clear indication of use (42%). The majority did not feel they were adequately supported (54%) in this work, nor did they have adequate resources for these patients within their organization (68%). Conclusions OHPs see HCWs with substance-use problems as part of their work, but the support provided is likely limited by insufficient training and inadequate support.