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Introduction: Substance use among physicians can have negative impacts on their health, quality of life, and patient care. While Physician Health Programs (PHPs) have proven effective, many physicians with substance use disorders (SUDs) still face obstacles in seeking help. Our study explores the expectations, attitudes, and experiences of French physicians regarding the implementation of a specialized healthcare system (SHS) for addiction, and their opinions on the factors that could improve the effectiveness of such a service, with a focus on substance use disorders (SUDs). Methods: We conducted a web-based survey from April 15 to July 15, 2021, which included questions about sociodemographic characteristics, substance use, and attitudes toward a specialized healthcare system (SHS) for physicians with SUDs. Results: Of the 1,093 respondents (62.5% female), 921 consumed alcohol (84.2%), and 336 (36.4%) were categorized as hazardous drinkers (AUDIT-C≥4 for women and ≥5 for men). The mean AUDIT-C score was 3.5 (±1.7 SD), with a range from 1 to 12. Factors associated with hazardous alcohol consumption included coffee consumption [OR 1.53 (1.11-2.12)], psychotropic drug use [OR 1.61 (1.14-2.26)], cannabis use [OR 2.96 (1.58-5.55)], and other drug use [OR 5.25 (1.92-14.35)]. On the other hand, having children was associated with non-hazardous alcohol consumption [OR 0.62 (0.46-0.83)]. Only 27 physicians (2.9%) had consulted a specialist in addiction medicine, while 520 (56.4%) expressed interest in such a consultation. The main barriers to accessing a dedicated consultation were denial (16.3%), physician self-medication (14.3%), fear of judgment (12.8%), and confidentiality concerns (10.2%). Conclusion: A specialized consultation with trained professionals in a neutral location can improve access to care for healthcare workers and maintain patient confidentiality and anonymity. Prevention and awareness can reduce addiction stigma and help peers in need. The improvement of healthcare workers' addiction culture and detection of addictive behavior in peers depends on academic addiction medicine. [ABSTRACT FROM AUTHOR]

Résumé: Les données actuelles montrent que les troubles liés à l'usage de substance sont moins fréquents chez le sujet âgé. Toutefois ces données peuvent être liées au fait que cette moindre fréquence est liée aux spécificités de cette population et notamment à l'inadéquation de certains critères du DSM-5 avec le mode de vie des sujets âgés. Toutefois il n'existe pas de donnée concernant la répartition des critères du DSM-5 d'addiction chez des sujets âgés. Notre étude avait pour objectif de décrire la répartition des critères DSM-5 du Trouble lié à l'usage de l'alcool et de benzodiazépine dans une population de 59 patients âgés de 80 ans, de décrire les différences entre les groupes de patients souffrant d'une addiction et ceux indemnes d'addiction et de déterminer les facteurs sociaux démographiques associés avec le diagnostic dans notre population. Nous avons observé que 45 % des sujets régulièrement exposés à de l'alcool ou des benzodiazépines avaient un diagnostic de Trouble lié à l'usage de substance. Les critères 1, 2, 4, 9, 10 et 11 du DSM-5 étaient retrouvés significativement plus fréquemment chez les patients présentant une addiction que chez ceux ne présentant pas d'addiction. Sur l'analyse en régression les critères 1, 4, 6, 9, 10 et 11 ainsi que le nombre d'unités d'alcool consommées par jour étaient associés au diagnostic d'addiction. Les autres facteurs sociodémographiques n'étaient pas associés au diagnostic. Cette étude pilote met en évidence que certains critères d'addiction du DSM-5 semblent être plus pertinents à rechercher chez les sujets âgés. Background: Substance use disorder (SUD) is commonly thought to be less frequent among the elderly than among younger adults. However, this disorder could be insufficiently screened in this population. And the diagnosis could be difficult to make especially because of specificities of this population. The diagnosis is based on the criteria of the DSM-5. Nevertheless, DSM-5 criteria were elaborated for younger adults and some of them could be inappropriate for older adults. Methods: We studied the frequency of the DSM-5 criteria in a population of 59 patients aged around of 80 years, non-dependent and exposed to alcohol or benzodiazepines. We collected data relative to age, gender, type of residence (self-home or retirement house), medical past history, current treatment. Patient were also asked about their alcohol consumption, time of exposition, quantity of alcohol ingested or dose of benzodiazepines ingested and frequency of consumption. Alcohol consumption was reported as alcohol unit per day (one unit containing 10-gram alcohol). Frequency consisted in number of days with consumption in a week. Concerning benzodiazepine with evaluated the quantity by converting dose in equivalent diazepam per day. We determine the frequency of each criterion and the association with SUD diagnosis. Results: We found that 45% of patients presented a diagnosis of SUD. DSM criteria 1, 2, 4, 9, 10 and 11 were found significantly more frequently in patients with addiction than in those without addiction. On the regression analysis criteria 1, 4, 6, 9, 10 and 11 as well as the number of units of alcohol consumed per day were associated with the diagnosis of addiction. The other socio-demographic factors were not associated with the diagnosis. Conclusion: This pilot study highlights that certain DSM-5 addiction criteria seem to be more relevant to seek in the elderly. [ABSTRACT FROM AUTHOR]