Urine Drug Tests for Doctors?

Is Drug Testing Worth It?

Fitzsimons, who headed the effort to test urine at Massachusetts General for the last four years, said he found few difficulties.

Both Fitzsimons and Collins say their two departments don't have enough people to statistically prove that urine testing can affect addiction among anesthesiologists. But both doctors said they are happy with the results of the programs.

"I feel that our results are significant, and that further study is needed, but so far, we are pleased," said Fitzsimons. "All I can basically tell you is that our incidence is down, but ... to really determine if this is an effect to detect or defer substance abuse, a multi-institutional study needs to be done."

Fitzsimons and Collins argue that early detection and deterrents can significantly reduce the impact of addiction among anesthesiologists. Fitzsimons estimates that treatment and rehabilitation costs alone can run as high as $100,000 per doctor, not including time spent out of work.

Even when a resident anesthesiologist returns from treatment, a risk of relapse and death lingers.

"Our death rate for treated residents who return to anesthesia is horrible: one out of nine is going to die," said Collins.

"Drug testing gives the realization that it's not just a rule that we have to follow, but that there's some teeth in this," Collins added. "Knowing that, people are generally reluctant to break the rules."

Yet, despite their excitement, and despite the static rate of addiction in the past 20 years, Berry said the American Society of Anesthesiologists (ASA) has decided to use other tactics to stave off addiction, rather than recommending urine testing.

The ASA is implementing a "wellness initiative" to help anesthesiologists deal with stressors in their lives, in addition to the existing recommended education materials to help other doctors recognize addiction, he said

Other agencies have tried to tackle the problem as well. The Anesthesiology Residency Review Committee of the ACGME mandates all residency programs to include drug addiction awareness, and according to rules by the Drug Enforcement Administration, all programs use a check system for the powerful drugs used by anesthesiologists.

"Narcotics are controlled substances; they have a very tight regulation," said Berry.