Say Something: Addressing Physician Alcohol Use Disorder, Depression, and Suicide

Rates of alcohol use disorder, depression, and suicidal ideation are all greater among physicians and medical trainees than the general population,^1–12 despite education levels and financial resources that insulate physicians from some risk factors such as poverty and lack of access to mental health care. Many of these problems are driven by a medical culture that prizes stoic perfectionism and stigmatizes asking for help.

This article seeks to quantify the problem of physician substance use disorder, depression, and suicide, and then provide steps we can all take to reduce the incidence of these conditions for ourselves and our colleagues.

Recent studies suggest that while the misuse of illicit drugs is less common among physicians and medical trainees than the general population, alcohol use disorder is more common.¹ About 10% of the U.S. population has alcohol use disorder,² while surveys indicate the rate may be 32% among medical students³ and 13% among emergency medicine residents.⁴ Debt and financial instability among students and residents may lead to stress and maladaptive coping through alcohol use.^3,4 But the problem persists after training, with both male physicians (13%) and female physicians (21%)¹ experiencing higher alcohol use disorder rates than the general population. The sex discrepancy may be related to the disproportionate effect on females of certain risk factors for alcohol use, such as work-home conflict (see “Risk factors for alcohol and substance use disorders among medical trainees and physicians”).⁵