The identification and management of the drug impaired doctor.

BACKGROUND Problem drug use occurs within the medical fraternity as it does in other parts of the population. However, doctors have traditionally been discouraged from admitting vulnerability and frequently fail to recognise or respond to early signs of problem alcohol and drug use. OBJECTIVE This article aims to identify sequential strategies to assist the doctor to detect and intervene early when problem drug use arises in themselves or a colleague. DISCUSSION Where treatment and monitoring is instituted early in problem drug use, outcomes are typically positive while late acknowledgment commonly results in sanctions for the impaired practitioner and greater risk to patients. Medical boards in Australia have developed supportive mechanisms for doctors to facilitate early management. Procedures are aimed at maintaining or restoring ability to work while maintaining public confidence.