Struck by how clueless he was to the young man's problem, Roy decided to ask his staff if they saw signs of addiction.
"When he died, I sent out a questionnaire out to every single resident, any nurse who had worked with him, any doctor," said Roy. "I got 100 percent response on the questionnaire, and nobody suspected anything."
Yet, after this experience, Roy said he would still be wary of implementing urine drug testing to screen for drug abuse.
"He was too smart. He would have figured out the testing so fast," said Roy. "That sounds good in theory, but there are so many flaws in it."
For decades, anesthesiologists have tried addiction education programs and accounting safeguards in hospitals to detect drug abuse.
"In spite of our efforts, the incidence remains about the same," said Dr. Arnold Berry, an anesthesiologist and a member of the Committee on Occupational Health of the American Society of Anesthesiologists.
Berry said estimates of anesthesiologists who are addicted to medication range from only 1 to 2 percent.
"The most recent study in training programs suggests the (addiction) rate has stayed the same for 20 years," he said.
The low number is, at once, a motivation to steer clear from extreme measures like urine testing, and a misleading figure for the size of the problem.
"Although the percentages are not high, when you do have a case, often you discover it when they're dead," said Dr. Gregory B. Collins, section head of the Alcohol and Drug Recovery Center, at the Cleveland Clinic Foundation. "The first thing you often realize in these cases, it's a kid dead in the bathroom with a needle in his arm."
After his experience, Roy said his department considered doing urine testing but was put off by the extra cost and the work it takes to make sure urine testing isn't being subverted with fake urine or strategic drug use.
"Also, this is demeaning for people. They don't want somebody watching them," Roy said. "We were happy that at least another program was willing to do it to find out where they were encountering difficulties."
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