Avoid Burnout

A few weeks ago, on our weekly North Carolina opioid treatment program providers’ conference call, our conversation drifted to burnout. The conversation was helpful to me. We talked about what burnout feels like, what contributes to it, and what we can do about it.

It may seem odd to talk about burnout so close to Christmas and other holidays, but I’ve always felt the most burnout right before an expected time away from work. It’s like I know I’m getting days off soon, so doing my job until that date is particularly onerous. Or maybe I’m just peculiar.

On our call, someone mentioned that half of the available Addiction Medicine fellowships remain unfilled and voiced concern about that. Participants of the group said it might be because our job isn’t easy, and we deal with disappointment daily, and our patients tend to die if they don’t stay in treatment.

One person said it’s helpful for providers to get therapy for themselves, and I agreed with that. I told the group to remember there is a 12-step group for friends and family of people with alcohol and other substance use disorders: Alanon groups. I told the group that I’ve learned things at those meetings that help me at home and at work.

I also told the group that when I get depressed about patients not doing well in treatment, I start looking at patient drug screens. I do this quickly, going down the patient list in Methasoft, our software program. When I do this, I am reminded that most of our patients are doing well. About three-quarters of our patients have negative drug screens or are only positive for marijuana. I consider those patients to be successful, considering they all had a diagnosis of active opioid use disorder when admitted.

I never saw success rates like this when I worked in primary care, treating other chronic illnesses.

It reminds me that the treatment we provide – access to medication to treat opioid use disorder – has more evidence to support its benefits than any other treatment for chronic illness I can think of. That’s an antidote for burnout.

Here are some other ideas that help with burnout:

1. Take care of your physical health. We tell patients to do this, but are we setting good examples? Eat right, go to the doctor for routine medical health screens, get to the dentist periodically, and get enough sleep. We all know what to do.
2. Have a life outside of work. This is big. I must remind myself of this one frequently. Don’t let work become your whole identity. When you are at home, is your mind also at home, or are you thinking about a work situation? Try to keep your mind and your feet in the same place.
3. Have a creative outlet. Right now, I make craft items out of recycled materials.

What is your artistic outlet? It could be something you’ve never considered as art:  cooking, decorating your house, or doing home renovations, or something else.

• Don’t have unrealistic expectations. People with substance use disorders often use substances. Some people are lucky to enter treatment and never use drugs again, but that’s not the journey for most. Expect relapse to happen during treatment. Relapse is never OK, but if the patient is lucky enough to live through it, help them figure out why it happened so they can avoid a similar situation in the future.
• Do some kind of aerobic exercise if your physical condition permits. Besides health benefits, exercise can make a dramatic difference in my ability to handle stress. It doesn’t have to be heavy exercise; even going for a walk can reduce stress.
• Nurture your spiritual health. This doesn’t necessarily mean participation in an organized religion, although for some people it may. For me, anything that connects me to other people and to the God of my understanding is spiritual. I feel better and more centered when I regularly make time for prayer and meditation. Obviously, people find different things that nurture them spiritually.

Despite the stresses, many of us prefer to work in the field of addiction treatment, for various reasons. For those people, working in the field of addiction treatment is an avocation, not just a vocation. 

For me, I love to see the positive changes in patients’ lives, and to feel like I had some small part in that. In this field when addicts find recovery it isn’t just their lives that improve; families and then communities benefit, too. I didn’t see that when I worked in primary care.

I have the best job in the world. When I’m feeling burned out, I need to remember this.