Hazardous use of alcohol and illicit drugs is not uncommon among junior doctors, with some specialities such as anaesthetics, emergency medicine and obstetrics having higher rates, a survey of 1890 vocational trainees has revealed.

The national survey conducted by the National Drug and Alcohol Research Centre (NDARC) at the University of NSW found that one in six trainees (17.3%) reported hazardous levels of alcohol use, with significantly higher rates for emergency medicine/ICU (OR=2.15), anaesthetics (OR=2.53) and obstetrics/gynaecology (OR=1.89). Rates of risky alcohol use were higher for males (20.6%) compared to females (15.2%).

The overall prevalence of illicit drug use among trainees was 4.8%, with higher rates seen in males compared to females (6.3% vs 3.7%) and in specialities such as anaesthetics (10.6%), psychiatry (8.5%) and surgery (6.9%), while physicians training in internal medicine reported rates of 2.6%.

The areas with highest use of illicit drugs were inner metropolitan (6.1%) and remote locations (7.5%), whereas the lowest use was seen in rural locations (0.8%).

The study authors said the levels of risky alcohol use and illicit drug use were lower than reported in the general population but still cause for concern.

The higher rates seen in some specialties might be due to the cultural norms within different specialties as well as easier access to drugs, stress, environmental exposure and psychiatric comorbidities,” they suggested.

“It is possible that certain personality types or temperaments may be associated with both specialty choice and the likelihood of alcohol use,” they added.

The authors said substance use among junior doctors was a concern because it was a time when such behaviours started, and other studies had shown that risky substance use was likely to continue and sometimes progress to the point where it impaired a practitioner’s ability to practice.

The findings could therefore be used to inform such discussions, around the issues of substance use patterns within medical specialties or among doctors-in-training,” they said.

“Medical schools and postgraduate training programmes need to consider the implementation of evidence-based strategies to ensure that doctors are trained in how to approach and recognise work-related substance use problems in themselves and in colleagues and to ensure that specialised help is available when needed,” they suggested.

The findings are published in the Internal Medicine Journal.