(HealthDay News) – Substance use disorder (SUD) is seen among a proportion of anesthesiology residents during training and is associated with a high rate of relapse, according to a study published in the Dec. 4 issue of the Journal of the American Medical Association, a theme issue on medical education.

David O. Warner, MD, from the Mayo Clinic in Rochester, MN, and colleagues conducted a retrospective study to describe the incidence and outcomes of SUD among anesthesiology residents who began training in programs from July 1, 1975, to July 1, 2009. Participants included 44,612 residents contributing 177,848 resident-years for analysis. Participants were followed for incidence and relapse.

The researchers found that 384 residents had evidence of SUD during training, with an overall incidence of 2.16 per 1,000 resident-years. Following the initial rate increase there was a period of lower rates in 1996–2002; since 2003, the incidence was highest (2.87 per 1,000 residence-years). Intravenous opioids were the most common substance category, followed by alcohol, marijuana or cocaine, anesthetics/hypnotics, and oral opioids. During the training period, 28 residents died, with all deaths related to SUD. Based on a median follow-up of 8.9 years, the cumulative proportion of survivors experiencing at least one relapse by 30 years after the initial episode was 43%. The category of substance used did not impact the rates of relapse and death. There was no change in relapse rates over time.

“Among anesthesiology residents entering primary training from 1975–2009, 0.86% had evidence of SUD during training,” the authors write.

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