The prevalence of substance use in anaesthesia practitioners in South Africa

Abstract

Background: In the United States the mortality associated with substance abuse among anaesthesia residents is twice that of non-anaesthesia residents. Since no data exist, the primary objective of this cross-sectional study was to establish the prevalence of substance use in South African anaesthesia practitioners. Secondary objectives were to compare the prevalence in male and female practitioners, and in private and state practice anaesthetists. Years of experience and level of training were explored as possible risk factors for hazardous or harmful use. Methods: Participants completed a self-administered, validated WHO questionnaire, over a ten-day period surrounding the 2018 South African Society of Anaesthesiologists (SASA) congress. All doctors practising anaesthesia in South Africa were eligible. Recruitment was via an email link sent to all SASA members, as well as a web-based link at the congress. Results: A total of 1 961 SASA members and 113 non-members (anaesthesiologists, registrars and non-specialists) were invited to participate (total 2 074). There were 434 responses (response rate 20.9%, margin of error 4.18%); 364 were suitable for analysis. The most commonly lifetime-used substances were alcohol (92.8%), tobacco (42.3%), cannabis (34.7%), and sedatives (34.4%). Questionnaire scores defined low-, medium- and high-risk categories according to substance use during the previous three months. Sedative (12.6%) and alcohol (12.1%) users were deemed to be at moderate risk. The prevalence of opioid use was 1.9% (n = 7). Prevalence of substance use was similar in male and female practitioners, as well as in those working in private practice or in state hospitals. Conclusion: The prevalence of current use of alcohol and sedatives is of major concern. A significant proportion of respondents were assessed to be at moderate risk of hazardous or harmful substance use. Gender and practice setting have little impact on substance use. Wellness efforts should be aimed at all anaesthesia practitioners in South Africa.