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

At a Glance

Category	Detail
Condition	Substance use among healthcare workers
Key Mechanisms	Self-reported problem drinking and illicit drug use impacting care quality
Target Population	Healthcare workers in Sweden, including physicians and nurses
Care Setting	Healthcare facilities

Key Highlights

3.8% of participants met criteria for problem drinking; 1.3% reported illicit drug use.
Higher prevalence of illicit drug use among physicians (1.8%) compared to nurses (0.9%).
28.9% of those with illicit drug use rated care quality as poor.
25% of those with problem drinking rated care quality as poor.
Study emphasizes the need for nonpunitive approaches to substance use in healthcare.

Guideline-Based Recommendations

Diagnosis

Use modified CAGE questionnaire for problem drinking assessment.
Assess illicit drug use through self-reporting of nonprescribed stimulant or cannabis use.

Management

Implement clinician health programs and peer assistance initiatives.
Provide workplace-based early support systems for healthcare workers.

Monitoring & Follow-up

Regularly evaluate self-reported quality of care among healthcare workers.
Monitor substance use trends in the healthcare setting.

Risks

Potential underreporting of substance use due to stigma.
Selection bias due to modest response rates.

Patient & Prescribing Data

Healthcare workers aged 69 years or younger in Sweden.

Confidential pathways for seeking help are crucial for clinician well-being.

Clinical Best Practices

Encourage open discussions about substance use without fear of professional consequences.
Establish confidential support systems for healthcare workers.