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Historical Background

Since its establishment in 1993, the Student Counseling Service (SCS) has provided confidential help to students with a whole range of psychosocial problems, including problems relating to substance abuse. These services have been available without charge to students of the four colleges of SUNY Downstate Medical Center at Brooklyn.

Christine Saunders-Fields, Ph.D., Director of the SCS, recognizes that additional services directed specifically to students with substance abuse disorders are desirable. She supports and contributes to a comprehensive substance abuse program for students.

On November 6, 1995, Jennifer Timbrook, a third-year medical student at SUNY Downstate who had distinguished herself in both curricular and extra-curricular activities, died of a drug overdose. Her death aroused widespread consternation and dismay, for it represented the tragic loss of an extremely promising young physician and a very special human being. When it emerged that several people on campus had known of her drug problems before her death, but had been unable to intervene effectively, in spite of their conscientious effort, the pervasive sense of loss was compounded by feelings of frustration and helplessness. It was recognized that SUNY Downstate did not yet have a coordinated, comprehensive substance abuse program for our students, and that this deficiency represented both insufficient caring for our students, and inadequate attention to their education as healthcare professionals.

In response to Jennifer Timbrook's death, Jordan J. Cohen, MD, president, Association of American Medical Colleges, wrote in Academic Medicine, speaking to all medical schools:

"Failing to recognize, acknowledge, and deal effectively with an impaired colleague not only forfeits an opportunity for rehabilitation, it is an abdication of public trust… Medical schools…must not only be alert to the possible presence of impaired students…; they have the added burden of ensuring that students and residents be schooled sufficiently in the tenets of medical professionalism to exercise their responsibility to the profession and to the public in case they discover that one of their own is impaired… Students must be taught how to detect the various forms of physician impairment (especially at their earliest stages) as well as how best to intervene;…students must be taught to recognize and banish easy excuses and comforting rationalizations for inaction when they suspect a colleague is impaired;… (and) students themselves must be persuaded that the identification of impairment in a colleague is not a betrayal of a friend but an affirmation of concern."

We take Dr. Cohen's message seriously. Furthermore, we believe that everything he said applies equally to nursing students and to students of other healthcare professions.

Healthcare professionals must be well educated about the diagnosis and treatment of substance abuse disorders, not only so as to be able to intervene effectively when one of their peers is impaired, but also to provide good care to their patients.

Apart from the responsibility which medical schools have to society, including the future patients of their students, they also should insure appropriate care for those students who are impaired due to substance abuse. To this end, the Association of American Colleges encourages all medical schools to:

"promote student wellness through professional educational and prevention programs...; recognize that chemical dependency (including alcoholism) is a treatable disease that affects all of society; develop an appropriate program to assist students who are impaired due to chemical abuse...; ...insure appropriate levels of confidentiality…; and provide an environment in which recovering impaired students are able to continue their education without stigma…"

Again, these recommendations are just as important for nursing schools and colleges of other healthcare disciplines as for medical schools.

Several months after Jennifer Timbrook's death, Eugene B. Feigelson, MD, Senior Vice President for Biomedical Education and Research and Dean, College of Medicine, SUNY Downstate, appointed an Ad Hoc Substance Abuse Committee, chaired by Cavin P. Leeman, MD, Clinical Professor of Psychiatry, "to develop substance abuse procedures for students and recommendations for programs which will assist the students of our campus."

After meeting throughout the fall semester of 1996, the Ad Hoc Committee issued its final report in February 1997. Dean Feigelson accepted the report and appointed a standing Substance Abuse Committee (SAC), co-chaired by Audree Bendo, MD, Associate Professor of Anesthesiology, and Dr. Leeman, to implement and monitor its recommendations, which included the inauguration of a new Substance Abuse Program for Students, as well as expanded coverage of substance abuse in the curricula of the four colleges on our campus and the development of an active program of extracurricular education and outreach, to inform the campus community about substance abuse and the Substance Abuse Program for Students.

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