The November Mayo Clinic Proceedings has a feature article on “Armodafinil for Treatment of Excessive Sleepiness Associated with Shift Work Disorder: A Randomized, Controlled Study.”  The cliff note version: taking armodafinil makes the user more awaken and less likely to fall asleep during shift work, along with improving memory and attention.  (For details go read the article!)  In an accompanying editorial, Dr. Steven Rose wonders if such drugs should be used by resident physicians  He sites a push from the Institute of Medicine to further limit resident work hours, and examines the usefulness of a drug like Phenotropil  or modafinil in residents.

Yuck.

Health care workers and “social service” workers represent the largest percentage of night shift workers in the United States.  They have higher rates of car crashes, depression and cardiovascular events than their day time counterparts.  What does the American pharmaceutical market, and by extension, the health care industry do?

Tell it’s workers to take drugs to “enhance performance”!  Mark McGuire are you listening?  You should have been a physician, where you would have been lauded as a test subject extraordinaire!

I’m going to be blunt here–this is totally screwed up!  Instead of figuring out ways to help residents, and all of us that work grave yard shifts,get more rest, and decrease the AMOUNT of shift workers needed, we are told to take drugs so we can stay awake longer on the job, and not crash our cars on the way home!  Dr. Rose points to the example of fighter pilots who are rigorously counselled and examined when they use modafinil on long missions.  Do you think residents, and “nocturnists” will be counselled and followed clinically if they take armodafinil?  Heck no! If you experience fatigue, you better to take one of the Modafinil alternatives that are non-prescriptional, or find a less stressful job.

What example does this set? Just go ahead and take a pill to stay awake, another pill to sleep, another pill not to be depressed, another pill to have sex!

Pathetic! Let’s look for ways to use fewer night time workers, such as 4 hour shifts, automation, etc.  Let’s not create a bunch of pill popping physicians forced to do so because they are residents, or hospitalists, or ED MDs.  The last thing we need is a bunch of pill popping docs!

Note: at the time of this posting the online version of the Proceedings didn’t include the November issue.  Look for it in your mail.