Rates of apparent substance use disorders among anesthesiology residents have recently been at their highest level since 1975, researchers said.

Disciplinary records and other data sources on more than 44,000 individuals starting anesthesiology residencies from 1975 to 2009 identified 384 with evidence of substance use disorders during training, for an overall rate of 2.16 per 1,000 resident-years, according to David O. Warner, MD, of the Mayo Clinic in Rochester, Minn., and colleagues.

The incidence has shown an unevenly increasing pattern, with sharp increases followed by declines, the researchers reported in the Dec. 4 issue of the Journal of the American Medical Association.

But the rate from 2003 onward has been the highest on average, with a mean of 2.87 cases per 1,000 resident-years (95% CI 2.42-3.39), compared with rates of 0.5 to 1.5 per 1,000 from 1975 to 1985.

Among 284 residents with substance use problems whose specific drugs-of-abuse were known, the most popular were IV opioids such as fentanyl (137 individuals), followed by alcohol (85), anesthetic and hypnotic drugs such as benzodiazepines (46), marijuana (33), and cocaine (30).

Warner and colleagues also found that relapse rates remained mostly unchanged during the study period.

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