Editorial Comment 10/13/2020: : OUD Among Healthcare Workers – Another Sort of Immune Response

The ASAM Board of Directors met over the weekend preceding this issue of ASAMW.  It is a quarterly convocation, at one time a two-day affair: more recently one day, and via virtual platform.  The members of the Board are all unpaid volunteers, for whom travel and rooming is always at their own expense.  These past, recent meetings have necessarily been hosted by a flow of electrons, and consequently blissfully economic.  Because the Directors are all volunteers, and the Board meetings are only a fragment of their volunteer duties with ASAM, the spirit of collegiality was unusually strong.  So, the embedded article hit me a bit more forcefully than it might otherwise have done.

It is about healthcare workers’ susceptibility to substance use disorders (SUDs), emphasizing their proximity to the substances.  And it differs a bit from most similar articles in not concentrating on any one class of worker, but rather grouping together physicians, nurses, the lot.  Of what it particularly reminded me, because the analogy is so close at hand, are the principles of control in an infectious pandemic.  Not a direct analogy, but a suggestive one, that we reduce the incidence of SUDs in our colleagues by 1) surveillance; 2) the willingness to intervene compassionately; and 3) the recognition of our own symptoms.  In speaking of the public health requirements of COVID-19 in a small, isolated state, Hawai`i, its Director of Health was quoted this week: “I know people are fatigued,” she said. “But I think if we all keep the mindset that, ‘What I do keeps you safe, what you do keeps me safe,’ and if we work together, we can do this.” [Elizabeth Char, MD, 07 October 2020].  I believe that this principle extends to our risk of, and our treatment of SUDs among our colleagues.  

 Editor-in-Chief: Dr. William Haning, MD, DFAPA, DFASAM