Substance use disorder in the anaesthetist: Guidelines from the Association of Anaesthetists: Guidelines from the Association of Anaesthetists

This is a guideline published by the Association of Anaesthetists in the UK. It summarises the risks of substance use disorder specifically for anaesthetists and critical care physicians and suggests a pathway of management. It explores the risk factors of substance use disorders specific to anaesthetists, the regulation and monitoring of individuals identified as having the disorder, the role of the Medical Director in coordinating the care of the clinician and referral to appropriate services, the pharmacological and counselling treatments available and the strategy for returning to work.

The article does a good job of highlighting the major issues of substance use disorder in the anaesthetic workplace. The suggestions made are generally very broad sweeping statements (e.g. there needs to be a return to work program, there needs to be support for the clinician with the disorder, there needs to be supervised return to work with regular follow-up), but there are some occasional specific suggestions that are useful (e.g. utilising specific support groups such as SMART recovery, planning a return to work in another centre when relationships have broken down and having a senior colleague trained in mentoring to help trainees with the disorder return to work).

Its major benefit is to highlight the issue of substance use disorder in anaesthesia and critical care and to try to de-stigmatise it, however, the practical suggestions for implementing the programs are mostly broad over-arching statements with few specific strategies.

Reviewed by Dr Patrick Rubie