Monitoring programs enhance recovery outcomes

A Nurse Expert on Addiction Recovery

Monitoring programs which set stringent requirements for licensed professionals who have demonstrated substance abuse has a long track record of documented success.  For decades, these tightly structured programs have monitored professionals practicing medicine, law, nursing, and aviation, to name a few.   Such programs have provided a highly effective, non-public method of enhancing public safety, while increasing the likelihood that such professionals would maintain a lasting recovery.

Accountability to remain within the parameters of such monitoring programs clearly rests on the shoulders of each individual participant.  Adherence to the programs requirements is usually deemed as highly desirable because the license to practice one’s profession hangs in the balance.  As this corresponds directly to their livelihood, most professionals in monitoring programs are extremely invested, and highly motivated, to achieve a successful, if not stellar, outcome.

Thus, the professional monitoring program’s stage is set by a potent form of leverage which is exerted upon the monitored professional because of its ability to restrict or rescind their privilege to practice.  Such leverage is a formidable contender which effectively competes against any desire to re-engage in alcohol and other drug use.  

Going far beyond what their name implies, monitoring programs do more than mandate random  toxicology reports.  Although such testing is usually performed for an average of five or more years, customarily there are other stipulations such as formal evaluation, diagnosis and treatment of the addictive disorder by certified experts.  Inpatient treatment is often followed by an extensive period of after-care on an outpatient basis. 

Initially, a compulsory leave of absence from all professional duties is stipulated by most monitoring programs as such a reprieve enhances the professional’s ability to cultivate recovery skills.  Documented 12 Step program attendance is often required for two or more times per week, as well as weekly attendance at peer support group meetings populated solely by others in the same profession who are also participants in the monitoring program. 

Recent research on physician monitoring programs demonstrate that 78% of 904 physicians monitored for five years or longer showed no return to alcohol or other drug use (DuPont).  Long-term success rates of pilot monitoring programs reported by the aviation industry note abstinence rates exceeding 85% (Aviation Medicine Advisory Service).  Similar rates of success have been noted in other professional monitoring programs, such as nurses (Trossman).

Presently, the long-term recovery outcomes for the general population typically range between 40%-60% (Angres).  Although it would be an extremely difficult undertaking to generate the quality or quantity of leverage currently used by programs monitoring licensed professionals and adapt it to the general public, such interventions may hold the key to enhancing recovery outcomes for all.

References

Angres, D.H., Bettinardi-Angres, K., & Cross, W.  (April 2010).  Nurses with chemical dependency: Promoting successful treatment and reentry.  Journal of Nursing Regulation. 1(1), 16-20.

DuPont, R., McLellan, A.T., Carr, G., Gendel, M., & Skipper, G.E.  (2009) How are addicted physicians treated?  A national survey of physician health programs.  Journal of Substance Abuse Treatment.  37(1), 1-7.

Trossman, S.  (2003).  Nurses and addiction: Finding alternatives to discipline.  American Journal of Nursing.  103(9), 27-28.

Aviation Medicine Advisory Service, FAA-Sanctioned pilot alcohol abuse programs in business aviation.  Accessed online on 7/4/2011.at http://aviationmedicine.com/articles/index.cfm?fuseaction=printVersion&articleID=18