Robert L. DuPont, M.D.- Member, RiverMend Health Scientific Advisory Board for Addiction & Psychiatry. President Institute for Behavior and Health, Inc. Dr. Robert DuPont addresses the RiverMend Health Scientific Advisory Board on Physician Health Programs (PHPs) and his processes for treating addiction. To watch lecture visit: http://vimeo.com/98469113 For more information visit: http://www.rivermendhealth.com/scientific-advisory-board-addiction.html

1. Robert L. DuPont, M.D., President
Institute for Behavior and Health, Inc.
www.ibhinc.org
The Physician Health Programs:
A New Paradigm of Care Management
for Addiction

2. New Thinking about Addiction

3. Physician Health Programs (PHPs)

4.  Evaluation and Intervention
– Interventions include Medical Director or other senior person from PHP
discussing issues raised leading to formal evaluation
– Formal evaluations generally include full diagnostic interview with
collateral assessment for substance use and other psychiatric medical
conditions
 Monitoring Contract
– Usually for 5 years
– Consequences for failure to adhere to recommendations may include
further evaluation, treatment and reporting to the state licensing board
– “Safe Harbor” provision: postpone/defer impending sanctions
the PHP system

5.  Formal Treatment
– All programs require total abstinence from alcohol and from
nonmedical drug use
– 69% of participants began treatment in residential care; 31%
began treatment in intensive outpatient treatment
 Long-Term Support & Monitoring
– 95% of PHP participants participated in AA, NA, etc.
– 70% required worksite monitors
– Drug tested average 4 times/month in first year (48 tests/year);
by fifth year average was 20 tests/year
PHP Addiction Care

6. Dealing with Relapse

7. • Large majority of physicians were practicing and were drug-
and alcohol-free
• Of all physicians at 5 year follow-up (n=802):
–78% of sample were licensed or working
–4% had retired or left practice voluntarily
–11% had their licenses revoked
–3% unknown status
PHP Results

8. • Over the course of 5 years:
– 78% of all physicians had zero
positive drug tests
– 14% had only 1 positive
– 3% had only 2 positives
– 5% had 3 or more positives
• 20+ drug test panel
• Two-thirds of the PHPs (68%)
routinely utilized ethyl glucuronide
(EtG) to detect recent alcohol
exposure
PHP Long-Term Drug Test Results

9. Estimated Costs

10. • Compared to standard probation
after a one-year period, HOPE
probationers were:
• 55% less likely to be arrested for a
new crime
• 72% less likely to use drugs
• 61% less likely to skip
appointments with their
supervisory officer
• 53% less likely to have their
probation revoked
• 48% fewer days of incarceration
Hope Probation

11. • The future of drug treatment is harnessing the principals
of the PHP experience in many other settings in which
treatment occurs
Future Directions