Concern about impairment from alcohol and drugs in health-care professionals in the United States and in other countries has waxed and waned during the twentieth century. Until the 1960s, ALCOHOL, the OPIATES, and other PRESCRIPTION DRUGS were the primary concerns. More recently, the concern was extended to MARIJUANA and COCAINE.

Although there are many estimates of addiction rates among physicians, the prevalence of alcohol and other drug problems within the entire health-care profession is unknown. Brewster (1986) reviewed published estimates of U.S. addiction rates among physicians and found that available reports were not adequate to support firm conclusions about the prevalence rates. Adding to the difficulty is the physician's ability of self-medication, and the fact that much of the detection of abuse to begin rehabilitation can come only after a voluntary confession.

Physicians (since we do have data on them) are as...