In Part 1, we made the case that a career in modern medicine meets the diagnostic criteria for addiction. Medicine can be unhealthy, yet we carry on or feel unable to make healthy changes. In this Part 2, we explore how to get sober if you’re addicted to medicine.
Clearly, no clinician will truly maintain that a medical career is addictive. However, because we can, we will use the science of addiction treatment and push the metaphor as far as we can go. We will even paraphrase the (awesome) 12 steps which have helped countless addicts find sobriety and serenity (I should know, I am a recovering addict, as well as a recovering physician).
When in active addiction, we build up a strong defense mechanism which soothes us and tells us everything is ok. The house may be burning down. We may be injecting drugs with a rusty needle. Our livers may be cirrhotic. Our house may be repossessed from gambling debts.
But, denial tells us, everything will be ok, if… we get just one more “hit” (read of heroin, alcohol, the slots, or surgery). Then everything will feel better.
Which it does. For a while. And over time, it becomes less effective. So we need more (check out Tolerance in the previous post).
Denial is also an important defense against the values breaches that we must all undertake to be successfully addicted to medicine. We must compromise our principles. We must skip our kids’ sports events and parents’ evenings; miss our anniversaries; forget important events.
We must also be so tired and distracted that we are not present emotionally even when we are there spiritually.
Denial is a strong defense, cunning, baffling, and powerful. It allows us to make all sorts of cognitive compromises in order to carry on what we are comfortable doing.
I often wonder what my child self would say if given a glimpse upon my addict self some 30 years in the future. Probably something like, “What did this to us?” or “Are you really happy now?”
Only when taking a good hard look at ourselves, often with the support of trusted loved ones, can we start to see the truth.
Sadly, for many of us it takes a “rock bottom” – where literally one cannot sink any lower – to break down the defenses of denial and start to take stock. It took my rock bottom of addiction, mental illness and suicidal ideation to shake me awake.
Once awake, however, fear took over. There was no way I was going to ask for help. I read the DSM addiction section and ticked enough of the boxes to know I was in trouble. My inner clinician knew this, and would have known exactly what to do. However, this did not mean I spoke to a professional. At least not yet.
Fear was my main obstacle. Internal fear: of failure, shame, falling low, imperfection, and admitting I was not well.
External fear: of the licensing authorities, hospital credentialing, medical malpractice, HR, and losing my job and reputation. As it turns out, by not getting timely help, I lost most of those anyway. Given my time over, perhaps if I had had the cojones to reach out, I may still be practicing.
So when the fear was slightly less powerful than the need to do something, I spoke to my family doctor, and started on the road to recovery.
His first step was to take stock of the damage. The equivalent of labs, an EKG, and a liver ultrasound.
For doctors addicted to medicine, this would mean taking a look at:
This is the hardest and easiest stage. “Staying sober” for 24 hours is very possible. Almost anyone can do that.
Addicts say the longest anyone can be sober is 24 hours. Then the next day starts, with all its challenges and joys.
But when we look at a lifetime of change, without our preferred fix, then the idea of recovery can feel impossible. That’s why all decent addiction programs break down change into bite-size chunks. Sometimes it’s 1 hour or 1 minute at a time.
But the longer you stay in recovery from addiction to medicine, the easier it gets.
If you have walked this how to get sober journey, and found a new serenity, life-work balance, and joy in (or outside) medicine, in time you may start to think of all the suffering physicians out there who are still in denial or don’t know where to turn.
Like you at the start, they had now idea how to get sober if they were addicted to medicine.
Part of this stage is love and service to others. This may be achieved by:
In this article, we explored how to get sober if you’re addicted to medicine. There are 6 steps (not to be confused with 12 steps) taking us from denial to love and service.
While written tongue-in-cheek, but with the utmost respect for the founders and followers of 12-step programs, there is a core of truth here.
And from personal experience, the steps of addiction recovery are more than about sobriety – they are about discovering what is truly important and living an aligned life.
If you are struggling, please reach out to us, come to a group, find a coach, or drop us an email.
We would LOVE to hear from you, wherever you are in the world, and whatever your current challenges are.
Physicians Anonymous is here for you. Doctors supporting doctors.