The investigators in collaboration with the American Medical Association have conducted a national drug use survey of 9,600 U.S. physicians stratified by medical specialty and by career stage. The first two years of grant support have been adequate to administer the survey, and in the remaining period prepare national descriptive data on physician drug use prevalence, to compare drug use rates by medical specialty, and by stage of medical career. A third year of support is requested in order to perform additional data analyses: i) to describe the prevalence of drug use among physicians by demographic, professional development and post-stratification variables; ii) to examine in detail the degree to which being in a medical specialty influences a physician to use substances, including the influences of drug availability and prescribing practices, by occupational and risk factors; iii) describe the adverse health, social, and occupational effects associated with drug use in this population; iv) to describe physician's attitudes toward use of controlled drugs by colleagues and their awareness of sources of help; v) to describe the natural history of physician drug use from early residency training through professional practice and retirement, within the limitations of cross-sectional survey data on physicians at different stages of their medical careers. The risk factors identified as well as recommendations for preventive and educational programs will be communicated to the relevant bodies of the American Medical Association, the specialty societies, and medical educators.
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