Should Health Professionals Teetotal?

I recently published the article “Avoid ‘Shots in the Dark’ to Maintain Pristine Professional Boundaries” in Psychiatric Times to demonstrate how drinking alcohol in public may lead well-meaning licensed health professionals onto the slippery slope of boundary violations and costly career jeopardy.

Across the U.S., millions of doctors, nurses, and other licensed health professionals are permitted to perform the sacred work of healing others because we have been authorized to do so by licensure boards in one or more states. In these days of telemedicine, many of us hold numerous licenses. Because of the existence of national practice databases and credentialing protocols, a licensure issue in one locale can mushroom into legal trouble in multiple states.

The disinhibiting effects of alcohol are often in the mix when health professionals are accused of behaving unprofessionally. For this reason, I advise colleagues and clients to drink sparingly, especially in public situations involving peers, staff, or patients. Indeed, we might be safer abstaining altogether. Of course, people who are pregnant, enrolled in monitoring programs, or who suffer from alcohol use disorders shouldn’t be drinking at all.

What about cannabinoids? Although tetrahydrocannabinol (THC) is a psychoactive substance with a different profile than alcohol, it, too, is an intoxicant that may jeopardize the professional well-being of those who use it. This is especially the case in states where using it is not legal. But even where cannabis use is permissible, measurable THC levels may create pricey complexity for health professionals who are drug-tested for whatever reason. Until we possess the ability to distinguish between the THC that entered your system on a workday, and the residue of a single THC gummy that you ingested in the middle of your 2-week vacation to Colorado, avoiding cannabinoids may be another ‘Better to play it safe, rather than be sorry’ best-practice to consider and incorporate.

Alternatively, you can trust state licensing boards to accept your version of the events that bring you to their attention. If you end up hiring an attorney, remember that the ones who know how to defend you after an operating under the influence (OUI) arrest are generally not the same ones who know how to represent you before the licensing board. So you may have to hire two attorneys, or more if you are licensed in multiple states.

Because this pandemic has brutalized our profession, many of us have used or misused alcohol and/or cannabinoids to mitigate the day-to-day stress and strain. At the same time, the expectation to behave in a completely and utterly professional fashion at all times has never been greater. These words of caution represent a blunt attempt to inspire you to watch your own back.

Steve Adelman, MD, is a coaching and consulting psychiatrist and can be reached at his self-titled site, AdelMED.

This post appeared on KevinMD.