Return to Work for Healthcare Professionals with Substance Use Disorders: Clinical, Legal, and Ethical Challenges

摘要

Occupational health providers (OHPs) and other clinicians who assess readiness to work have a difficult task in assessing return to work for healthcare professionals (HCPs) with substance use disorders (SUDs). About 10 to 15 % of HCPs will misuse drugs or alcohol at some time in their career, yet they are often reluctant to seek help. This paper reviews the clinical challenges of assessing SUDs in HCPs, including risk factors, prognosis, and limited evidence base for work restrictions. Furthermore, ethical and legal challenges throughout the return to work process are reviewed for stakeholders such as HCPs with SUDs, OHPs, other providers, employers, and the public at large. Suggestions are made for stakeholders, particularly for OHPs and other providers, who are navigating this complex environment.