Hidden Risk: Clinician Substance Use

Longitudinal Swedish study finds physicians and nurses reporting problem drinking or illicit drug use had about twice the risk of rating their care as poor 1 year later

By
Kerri Miller
March 5, 2026
4 min

Conexiant

Overview

A longitudinal study in Sweden found that healthcare workers who reported problem drinking or illicit drug use were significantly more likely to rate the quality of care they provided as poor one year later. The study highlights the need for nonpunitive approaches to address substance use among clinicians.

Background

Substance use among healthcare professionals is a critical issue that can impact both clinician well-being and patient care quality. Understanding the relationship between clinician substance use and self-rated care quality is essential for developing effective interventions. This study provides valuable insights into the prevalence of substance use among physicians and nurses and its implications for care delivery.

Data Highlights

Measure	Baseline Prevalence	Follow-up Poor Care Rating
Problem Drinking	3.8%	25%
Illicit Drug Use	1.3%	28.9%

Key Findings

3.8% of healthcare workers met criteria for problem drinking at baseline.
1.3% reported illicit drug use, with higher prevalence among physicians (1.8%) compared to nurses (0.9%).
15.9% of participants rated their care as poor at follow-up, increasing to 28.9% among those with illicit drug use.
Both problem drinking and illicit drug use were associated with poor self-rated quality of care after adjusting for profession, sex, and experience.
Self-reported measures may have led to underreporting due to stigma.

Clinical Implications

Healthcare organizations should implement nonpunitive strategies to support clinicians struggling with substance use, including confidential health programs and peer support initiatives. Early identification and intervention are crucial to mitigate risks to both clinician well-being and patient safety.

Conclusion

This study underscores the importance of addressing substance use among healthcare professionals to enhance care quality. Continued research and supportive measures are essential for safeguarding both clinician health and patient outcomes.