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The Physician Health Programs: A New Paradigm of Care Management for Addiction

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Robert L. DuPont, M.D.-
Member, RiverMend Health Scientific Advisory Board for Addiction & Psychiatry. President Institute for Behavior and Health, Inc.

Dr. Robert DuPont addresses the RiverMend Health Scientific Advisory Board on Physician Health Programs (PHPs) and his processes for treating addiction.

To watch lecture visit: http://vimeo.com/98469113

For more information visit: http://www.rivermendhealth.com/scientific-advisory-board-addiction.html

Published in: Health & Medicine
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The Physician Health Programs: A New Paradigm of Care Management for Addiction

  1. 1. Robert L. DuPont, M.D., President Institute for Behavior and Health, Inc. www.ibhinc.org The Physician Health Programs: A New Paradigm of Care Management for Addiction
  2. 2. New Thinking about Addiction
  3. 3. Physician Health Programs (PHPs)
  4. 4.  Evaluation and Intervention – Interventions include Medical Director or other senior person from PHP discussing issues raised leading to formal evaluation – Formal evaluations generally include full diagnostic interview with collateral assessment for substance use and other psychiatric medical conditions  Monitoring Contract – Usually for 5 years – Consequences for failure to adhere to recommendations may include further evaluation, treatment and reporting to the state licensing board – “Safe Harbor” provision: postpone/defer impending sanctions the PHP system
  5. 5.  Formal Treatment – All programs require total abstinence from alcohol and from nonmedical drug use – 69% of participants began treatment in residential care; 31% began treatment in intensive outpatient treatment  Long-Term Support & Monitoring – 95% of PHP participants participated in AA, NA, etc. – 70% required worksite monitors – Drug tested average 4 times/month in first year (48 tests/year); by fifth year average was 20 tests/year PHP Addiction Care
  6. 6. Dealing with Relapse
  7. 7. • Large majority of physicians were practicing and were drug- and alcohol-free • Of all physicians at 5 year follow-up (n=802): –78% of sample were licensed or working –4% had retired or left practice voluntarily –11% had their licenses revoked –3% unknown status PHP Results
  8. 8. • Over the course of 5 years: – 78% of all physicians had zero positive drug tests – 14% had only 1 positive – 3% had only 2 positives – 5% had 3 or more positives • 20+ drug test panel • Two-thirds of the PHPs (68%) routinely utilized ethyl glucuronide (EtG) to detect recent alcohol exposure PHP Long-Term Drug Test Results
  9. 9. Estimated Costs
  10. 10. • Compared to standard probation after a one-year period, HOPE probationers were: • 55% less likely to be arrested for a new crime • 72% less likely to use drugs • 61% less likely to skip appointments with their supervisory officer • 53% less likely to have their probation revoked • 48% fewer days of incarceration Hope Probation
  11. 11. • The future of drug treatment is harnessing the principals of the PHP experience in many other settings in which treatment occurs Future Directions

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