Neuropsychological impairment associated with substance use by physicians

Abstract

Physicians and other healthcare professionals are at increased risk for the development of substance use disorders when compared to the general population. Substance use is associated with impairment in neuropsychological functioning, which may impact physicians' ability to practice with reasonable skill and safety. This review describes common neurocognitive deficits observed following use of various substance classes, including stimulants, benzodiazepines, cannabis, alcohol, and opioids. It also reviews the neurocognitive impact of pharmaceutical treatments for opioid use disorder. Clinical implications, including evaluation, treatment, and planning for return-to-work, are discussed. The importance of continued testing/monitoring following the acute treatment phase is emphasized. A case example highlights important issues that must be considered when a physician is referred due to suspected impairment.

Keywords: Addiction; Medication-assisted treatment; Neurocognitive testing; Physician impairment; Substance use disorder.