Volume 8, No. 1 • Spring 1993

Recovering CRNA Disputes Writer’s Idea that Past Abusers Should be Feared, Identified

To the Editor

I would like to respond to Mary Locke’s letter in the winter APSF Newsletter, concerning substance abusers “being allowed to continue to administer anesthetics…”. As a recovering alcoholic and an active member in A.A., I have a vested interest in this ethical realm. It is necessary to make the distinction between an active abuser and a recovering substance abuser.

I agree with Ms. Locke that an anesthetist who is actively using any controlled substances should not be allowed to administer anesthesia. If any staff member exhibits suspicious behavior which might indicate he or she is currently using these drugs, they should be promptly confronted by someone in authority, submit to drug screens and required to attend rehab. Yes, every group or hospital should have a strict policy, that continued employment depends on random checks upon their return and remaining drug free.

Alcohol can be as potent a depressant as opiates, barbiturates, and benzodiazepines, yet in the same issue, it was reported that Dr. Hendon of the University of California at San Diego presented data that 75% of the 85 subjects in his questionnaires drank alcohol on a regular basis. Because alcohol is legal and widely used, the OR doesn’t dose the day after the Christmas party or other social functions, when many are undoubtedly hung over or have consumed alcohol within 12 hours of administering anesthesia.

A recovering substance abuser, from alcohol, drugs or both, has NO mind altering substances in their system whatsoever, and is therefore more mentally dear than someone who has used any of these recently. To include identification of an anesthesia provider as a recovering substance abuser on the consent form, per Ms. Locke’s suggestion, is sheer nonsense. The patient doesn’t have to fear the former substance abuser, but rather the anesthetist who is currently “using.’

I regret that, for obvious reasons, I must remain anonymous, but I hope this won’t preclude my letter being printed. [Editor’s note: Under usual circumstances, anonymous letters will not be considered. The nature of this comment on the important issue of the relation of substance abuse among anesthetists to anesthesia patient safety prompted this exception.]