Takeaway
If you’re concerned about a colleague’s substance use affecting their work, reach out to departmental leaders rather than confronting them yourself. Early, nonjudgmental action can save lives and careers.
Lifelong learning in clinical excellence | February 24, 2026 | 2 min read
By Zeina Moukarzel, MD, MHM, MPH, founder, lamsaleb.org
Dr. Emile’s story
In the corridors of the operating room Dr. Emile walked with grace and precision. As a respected anesthesiologist, he dedicated his life to healing others, often at the expense of his own well-being. Behind his composed facade, however, a silent struggle unfolded—a clandestine battle with the allure of substances that promised temporary relief from the relentless pressures of medicine.
I realized this on a night shift. I’d just emerged from the intensity of the operating room, the sterile scent of antiseptic still clinging to my scrubs, and sought refuge in the quietude of the doctors’ lounge. When I opened the drawer near the bed, looking for a notebook and a pen to write some thoughts, I saw a small bag containing white powder—an unsettling secret hidden in the heart of the hospital. Suddenly, Dr. Emile entered the room and with a swift and mechanical motion, retrieved the small bag containing the white powder from the drawer.
Without uttering a word to me, Dr. Emile pocketed the bag and left the room as abruptly as he’d entered. The door creaked softly as it closed behind him. I was breathless—even the room seemed to hold its breath. And I wasn’t certain what I should do.
I silently reflected on the complexities that often lay beneath the surface of the medical profession. As the gravity of the situation settled, I grappled with a mix of emotions—concern for Emile’s well-being, the weight of deciding what I should do, and a sense of shared vulnerability that bound us all in the challenging realm of healthcare.
A few facts:
1. Substance use disorders occur in physicians on par with the general population, about eight to 12%, with alcohol use disorder most prevalent. Higher rates occur in emergency medicine specialists, psychiatrists, and anesthesiologists.
2. There’s a significantly higher risk of mortality because of easy access to addictive, and potentially lethal, medications.
3. Even when healthcare professionals recognize they have a problem, they may not seek help because of concerns about licesnsure and career setback, as well as social stigma.
If you’re worried that a colleague might have a substance use disorder:
1. Know the signs of substance use disorder.
2. Refrain from judgment.
Substance use disorder is an illness that can be treated.
3. Avoid approaching your colleague one-on-one.
Instead, inform, for example, the chair of the department or division director.
Substance use disorder is a chronic illness that can be treated. All healthcare professionals should know the signs and symptoms, as well as who to call when worried about a colleague. Afterward, offer support and guidance toward treatment if appropriate. Remember, you may save a life!
This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.