Concerned Colorado Dentists (CCD) provides colleague interventions to dentists about whom concerned others have described verifiable observations that indicate a likely substance abuse problem. Such interventions are empathetic and caring requests that the subject dentist voluntarily seek an assessment from, and enter into any recommended treatment agreement with, the Dentist Peer Assistance Program (DPAP) before someone else decides to make a complaint to the dental board. We present the observations described to us in as objective, nonjudgmental way as possible. CCD does not threaten to go to the board, does not demand anything of the dentist, and does not proclaim him or her to be an addict. We do tell the dentist that the people who have expressed concerns are waiting to hear from us regarding the outcome of the meeting. We tell the dentist we want to be able to tell the concerned ones that the problem is being addressed, and that they need not pursue further action. We describe voluntary DPAP entry into recovery as a way out with dignity.
About 70% of the time, the dentist agrees to a voluntary assessment through PAS at that time. The others sometimes call back later for further information or an assessment. The rest can often be helped by other means, which we explain to the people who have espressed concern to us.
The importance of intervention in arresting chemical dependency stems from denial, a peculiar and powerful characteristic of the disorder. Denial is such a pervasive aspect of addiction that it in part defines the disease. Addiction is unique among diseases in that it convinces the person who has it that nothing is wrong.
The American Society of Addiction Medicine (ASAM) defines alcoholism in the following manner. It is important to realize that chemical dependency is the same disease whether its victim is using alcohol, opiate pain pills, cocaine, marijuana, or any other addictive substance. Thus denial is part of the disease process regardless of the drug being used:
Alcoholism is a primary, chronic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations. The disease is often progressive and fatal. It is characterized by continuous or periodic: impaired control over drinking, preoccupation with the drug alcohol, use of alcohol despite adverse consequences, and distortions in thinking, most notably denial.
The ASAM definition goes on to say:
Denial is used here not only in the psychoanalytic sense of a single psychological defense mechanism disavowing the significance of events, but more broadly to include a range of psychological maneuvers designed to reduce awareness of the fact that alcohol use is the cause of an individual's problems rather than a solution to those problems. Denial becomes an integral part of the disease and a major obstacle to recovery.
A person afflicted with a disease characterized by such a deeply seated delusional belief that nothing is wrong will rarely seek help on his or her own. It sometimes happens, but to assume that the bulk of dentists afflicted with chemical dependency will experience spontaneous self-realization is itself delusional thinking.
As explained by Linda Crosby and LeClair Bissel in "To Care Enough - Intervention With Chemically Dependent Colleagues":
Our challenge is to get help to those who don't believe they need it, don't want it, and therefore rarely seek it on their own…
Without outside intervention, some impaired colleagues will continue to function in professional roles, sometimes seemingly successful, but often increasingly falling below safe standards of practice. Finally their problem may become so blatant that complaints are filed with licensing boards, legal action is taken, or a myriad of other punitive procedures ensue…
A knowledgeable colleague may be the only realistic hope for an impaired professional. As colleague and co-worker you possess the reality base, the specific data necessary for action.
John and Pat O'Neill describe the empathetic caring tone of such a meeting in "Concerned Intervention - When Your Loved One Won't Quit Alcohol Or Drugs":
The goal of intervention is to break through the wall of delusion surrounding the CD person long enough to get him or her to accept help. To repeat, intervention is a win-win, non-antagonistic effort with an absence of judgment and packaged in concern. There is no labeling, generalizing, attacking, or moralizing.