Doctors Are as Vulnerable to Addiction as Anyone. California Grapples With a Response.

Published

1 year ago

January 4, 2024

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BEVERLY HILLS, Calif. Ariella Morrow, an internal medicine doctor, gradually slid from healthy self-esteem and professional success into the depths of depression.

This story also ran on LAist. It can be republished for free.

Beginning in 2015, she suffered a string of personal troubles, including a shattering family trauma, marital strife, and a major professional setback. At first, sheer grit and determination kept her going, but eventually she was unable to keep her troubles at bay and took refuge in heavy drinking. By late 2020, Morrow could barely get out of bed and didnt shower or brush her teeth for weeks on end. She was up to two bottles of wine a day, alternating it with Scotch whisky.

Sitting in her well-appointed home on a recent autumn afternoon, adorned in a bright lavender dress, matching lipstick, and a large pearl necklace, Morrow traced the arc of her surrender to alcohol: Im not going to drink before 5 p.m. Im not going to drink before 2. Im not going to drink while the kids are home. And then, it was 10 oclock, 9 oclock, wake up and drink. Ariella Morrow, a Los Angeles-area internist, fell into a deep depression and started drinking heavily after a succession of family traumas and a major professional setback. She finally sought help for alcohol dependence and depression at a clinic in Texas.(Bernard J. Wolfson/KFF Health News)

As addiction and overdose deaths command headlines across the nation, the Medical Board of California, which licenses MDs, is developing a new program to treat and monitor doctors with alcohol and drug problems. But a fault line has appeared over whether those who join the new program without being ordered to by the board should be subject to public disclosure.

Patient advocates note that the medical boards primary mission is to protect healthcare consumers and prevent harm, which they say trumps physician privacy.

The names of those required by the board to undergo treatment and monitoring under a disciplinary order are already made public. But addiction medicine professionals say that if the state wants troubled doctors to come forward without a board order, confidentiality is crucial.

Public disclosure would be a powerful disincentive for anybody to get help and would impede early intervention, which is key to avoiding impairment on the job that could harm patients, said Scott Hambleton, president of the Federation of State Physician Health Programs, whose core members help arrange care and monitoring of doctors for substance use disorders and mental health conditions as an alternative to discipline.

But consumer advocates argue that patients have a right to know if their doctor has an addiction. Doctors are supposed to talk to their patients about all the risks and benefits of any treatment or procedure, yet the risk of an addicted doctor is expected to remain a secret? Marian Hollingsworth, a volunteer advocate with the Patient Safety Action Network, told the medical board at a Nov. 14 hearing on the new program.

Doctors are as vulnerable to addiction as anyone else. People who work to help rehabilitate physicians say the rate of substance use disorders among them is at least as high as the rate for the general public, which the federal Substance Abuse and Mental Health Services Administration put at 17.3% in a Nov. 13 report.

Alcohol is a very common drug of choice among doctors, but their ready access to pain meds is also a particular risk.

If you have an opioid use disorder and are working in an operating room with medications like fentanyl staring you down, its a challenge and can be a trigger, said Chwen-Yuen Angie Chen, an addiction medicine doctor who chairs the Well-Being of Physicians and Physicians-in-Training Committee at Stanford Health Care. Its like someone with an alcohol use disorder working at a bar. Email Sign-Up

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From Pioneer to Lagger

California was once at the forefront of physician treatment and monitoring. In 1981, the medical board launched a program for the evaluation, treatment, and monitoring of physicians with mental illness or substance use problems. Participants were often required to take random drug tests, attend multiple group meetings a week, submit to work-site surveillance by colleagues, and stay in the program for at least five years. Doctors who voluntarily entered the program generally enjoyed confidentiality, but those ordered into it by the board as part of a disciplinary action were on the public record.

The program was terminated in 2008 after several audits found serious flaws. One such audit, conducted by Julianne DAngelo Fellmeth, a consumer interest lawyer who was chosen as an outside monitor for the board, found that doctors in the program were often able to evade the random drug tests, attendance at mandatory group therapy sessions was not accurately tracked, and participants were not properly monitored at work sites.

Today, MDs who want help with addiction can seek private treatment on their own or in many cases are referred by hospitals and other health care employers to third parties that organize treatment and surveillance. The medical board can order a doctor on probation to get treatment.

In contrast, the California licensing boards of eight other health-related professions, including osteopathic physicians, registered nurses, dentists, and pharmacists, have treatment and monitoring programs administered under one master contract by a publicly traded company called Maximus Inc. California paid Maximus about $1.6 million last fiscal year to administer those programs.

When and if the final medical board regulations are adopted, the next step would be for the board to open bidding to find a program administrator.

Fall From Grace

Morrows troubles started long after the original California program had been shut down.

The daughter of a prominent cosmetic surgeon, Morrow grew up in Palm Springs in circumstances she describes as beyond privileged. Her father, David Morrow, later became her most trusted mentor.

But her charmed life began to fall apart in 2015, when her father and mother, Linda Morrow, were indicted on federal insurance fraud charges in a well-publicized case. In 2017, the couple fled to Israel in an attempt to escape criminal prosecution, but later they were both arrested and returned to the United States to face prison sentences.

The legal woes of Morrows parents, later compounded by marital problems related to the failure of her husbands business, took a heavy toll on Morrow. She was in her early 30s when the trouble with her parents started, and she was working 16-hour days to build a private medical practice, with two small children at home. By the end of 2019, she was severely depressed and turning increasingly to alcohol. Then, the loss of her admitting privileges at a large Los Angeles hospital due to inadequate medical record-keeping shattered what remained of her self-confidence.

Morrow, reflecting on her experience, said the very strengths that propel doctors through medical school and keep them going in their careers can foster a sense of denial. We are so strong that our strength is our greatest threat. Our power is our powerlessness, she said. Morrow ignored all the flashing yellow lights and even the red light beyond which serious trouble lay: I blew through all of it, and I fell off the cliff.

By late 2020, no longer working, bedridden by depression, and drinking to excess, she realized she could no longer will her way through: I finally said to my husband, I need help. He said, I know you do.

Ultimately, she packed herself off to a private residential treatment center in Texas. Now sober for 21 months, Morrow said the privacy of the addiction treatment she chose was invaluable because it shielded her from professional scrutiny.

I didnt have to feel naked and judged, she said.

Morrow said her privacy concerns would make her reluctant to join a state program like the one being considere by the medical board.

Physician Privacy vs. Patient Protection

The proposed regulations would spare doctors in the program who were not under board discipline from public disclosure as long as they stayed sober and complied with all the requirements, generally including random drug tests, attendance at group sessions, and work-site monitoring. If the program put a restriction on a doctors medical license, it would be posted on the medical boards website, but without mentioning the doctors participation in the program.

Yet even that might compromise a doctors career since having a restricted license for unspecified reasons could have many enduring personal and professional implications, none positive, said Tracy Zemansky, a clinical psychologist and president of the Southern California division of Pacific Assistance Group, which provides support and monitoring for physicians.

Zemansky and others say doctors, just like anyone else, are entitled to medical privacy under federal law, as long as they havent caused harm.

Many who work in addiction medicine also criticized the proposed new program for not including mental health problems, which often go hand in hand with addiction and are covered by physician health programs in other states.

To forgo mental health treatment, I think, is a grave mistake, Morrow said. For her, depression and alcoholism were inseparable, and the residential program she attended treated her for both.

Another point of contention is money. Under the current proposal, doctors would bear all the costs of the program.

The initial clinical evaluation, plus the regular random drug tests, group sessions, and monitoring at their work sites could cost participants over $27,000 a year on average, according to estimates posted by the medical board. And if they were required to go for 30-day inpatient treatment, that would add an additional $40,000 plus nearly $36,000 in lost wages.

People who work in the field of addiction medicine believe that is an unfair burden. They note that most programs for physicians in other states have outside funding to reduce the cost to participants.

The cost should not be fully borne by the doctors, because there are many other people that are benefiting from this, including the board, malpractice insurers, hospitals, the medical association, said Greg Skipper, a semi-retired addiction medicine doctor who ran Alabamas state physician health program for 12 years. In Alabama, he said, those institutions contribute to the program, significantly cutting the amount doctors have to pay.

The treatment program that Morrow attended in spring of 2021, at The Menninger Clinic in Houston, cost $80,000 for a six-week stay, which was covered by a concerned family member. It saved my life, she said.

Though Morrow had difficulty maintaining her sobriety in the first year after treatment, she has now been sober since April 2, 2022. These days, Morrow regularly attends therapy and Alcoholics Anonymous and has pivoted to become an addiction medicine doctor.

I am a better doctor today because of my experience no question, Morrow said. I am proud to be a doctor whos an alcoholic in recovery.

This article was produced by KFF Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.

Bernard J. Wolfson: bwolfson@kff.org, @bjwolfson Related Topics California Health Industry Mental Health States Doctors Hospitals Substance Misuse Contact Us Submit a Story Tip

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Liverpool football star Diogo Jota killed in car crash

Published

1 hour ago

July 4, 2025

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Liverpool football star Diogo Jota killed in car crash

Liverpool star Diogo Jota has died in a car crash.

The 28-year-old Portuguese forward died in the accident in the early hours of Thursday morning near Zamora, in northwestern Spain.

His brother, Andre Silva, was also killed in the crash on the Rias Bajas Highway (A-52) near Palacios de Sanabria, heading towards Benavente.

Follow the latest updates following Diogo Jota’s death

Jota and Silva were driving to Santander to catch a ferry back to England ahead of the start of Liverpool’s pre-season training on Monday, CNN Portugal reports.

The news outlet reports that Jota was advised against flying back to England due to recent surgery.

Police said the accident happened at 12.30am when the Lamborghini the pair were travelling in veered off the road.

“A vehicle left the road and everything indicates a tyre burst while overtaking,” the Guardia Civil in Zamora told Sky Sports News in a statement.

“As a result of the accident, the car caught fire and both people were killed. Pending the completion of forensic tests, one of the deceased has been identified as Diogo Jota, a Liverpool FC player, and his brother, Andre Felipe.”

A Spanish government source told the PA news agency that police were investigating the crash as “a possible speeding incident”.

Police added that no other vehicles were involved in the incident.

Pictures of the aftermath of the crash showed debris scattered along the side of the road, including what appeared to be charred parts of the vehicle.

It comes just 10 days after the player married his long-term girlfriend, Rute Cardoso.

He had three children.

The footballer, who played as a striker for Liverpool, began his career in his native Portugal and played at Atletico Madrid in Spain before moving to England.

He joined the Merseyside club from Wolverhampton Wanderers in 2020.

Jota played an important role throughout his five years with the Reds, including scoring six times in Liverpool’s recent Premier League-winning season.

He scored a total of 47 times in 123 matches for the club. He also played 49 times for the Portugal national side, scoring 14 times.

Silva, 25, played for Penafiel, a Portuguese second division club.

Teammates and football legends pay tribute

A statement issued by Liverpool FC said the club was “devastated” by their player’s death.

“The club have been informed the 28-year-old has passed away following a road traffic accident in Spain along with his brother, Andre,” the club said in a statement.

“Liverpool FC will be making no further comment at this time and request the privacy of Diogo and Andre’s family, friends, teammates and club staff is respected as they try to come to terms with an unimaginable loss.

“We will continue to provide them with our full support.”

The Portuguese football federation said it was “utterly devastated by the deaths”.

“Far beyond being an exceptional player, with nearly 50 caps for the national team, Diogo Jota was an extraordinary person, respected by all teammates and opponents, someone with a contagious joy and a reference within his own community.

“We have lost two champions. The passing of Diogo and Andre Silva represents irreparable losses for Portuguese Football, and we will do everything to honour their legacy daily.”

The Portugal and Spain women’s teams held a minute’s silence for Jota and Silva before their match in the Women’s Euros in Switzerland on Thursday evening.

It came after Liverpool’s manager Arne Slot said in a statement: “What can anyone say at a time like this when the shock and the pain is so incredibly raw? I wish I had the words but I know I do not.

“All I have are feelings that I know so many people will share about a person and a player we loved dearly and a family we care so much about.

“My first thoughts are not those of a football manager. They are of a father, a son, a brother and an uncle and they belong to the family of Diogo and Andre Silva who have experienced such an unimaginable loss.”

Jota’s former manager at Liverpool, Jurgen Klopp, offered his thoughts in a post on Instagram.

“This is a moment where I struggle! There must be a bigger purpose, but I can’t see it,” he said.

“I’m heartbroken to hear about the passing of Diogo and his brother Andre. Diogo was not only a fantastic player, but also a great friend, a loving and caring husband and father.

“We will miss you so much. All my prayers, thoughts and power to Rute, the kids, the family, the friends and everyone who loved them.”

Liverpool captain Virgil van Dijk posted on Instagram: “What a human being, what a player, but most importantly what an unbelievable family man.

“You mean so much to all of us and you always will!”

Cristiano Ronaldo, Jota’s captain in the national team, said: “It doesn’t make sense. Just now we were together in the National Team, just now you had gotten married.

“To your family, your wife, and your children, I send my condolences and wish them all the strength in the world.

“I know you will always be with them. Rest in Peace, Diogo and Andre. We will all miss you.”

Jota’s Liverpool teammates Darwin Nunez, Cody Gakpo and Dominik Szoboszlai have also paid tribute.

Szoboszlai wrote: “Words cannot describe how heartbroken and devastated we are… Your smile, your love for the game will never be forgotten.

“We will miss you so much, but you will stay with us forever, on and off the pitch.”

Jota’s former teammates Trent Alexander-Arnold, Sadio Mane, Roberto Firmino and Thiago Alcantara have also shared messages on social media.

Mane posted a picture of himself and Jota with heartbreak emojis.

It came as Liverpool legend Kenny Dalglish wrote on X: “You feel helpless, knowing there’s so little we can do to ease the pain for his wife of just two weeks, his three beautiful children.”

Liverpool legend Steven Gerrard shared an image of Jota on Instagram and wrote: “Condolences to his family and friends during this incredibly sad time.”

Liverpool owners Billy Hogan, John Henry and Tom Werner, who are part of the Fenway Sports Group, said: “This tragic situation and the reality of it is truly shocking, devastating and has left us numb with grief.”

Football icon Lionel Messi has also paid tribute, sharing an image of Jota on Instagram with the message “QEPD” – short for the Spanish phrase ‘que en paz descanse’, which translates to “may he rest in peace'”.

European football clubs such as Barcelona and AC Milan have also shared messages, along with basketball player LeBron James and tennis icon Rafael Nadal.

Meanwhile Liverpool FC have opened a physical and digital book of condolence for supporters and members of the public to sign.

The physical book is at the club’s stadium, in the Anfield Road Stand reception area until Sunday evening.

An avid video gamer, Jota also owned an eSports team and regularly streamed on Twitch.

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