Opponents of random drug testing of doctors, as a ballot proposition on the November ballot in California would require, say it's an unnecessary intrusion on doctors' privacy. Maybe testing is necessary for pilots and truckers, they say, but not for doctors because we are not in professions that affect public safety.

As a doctor uniquely qualified to know, I say that is dead wrong.

In fact, I held patients' lives in my hands when I practiced medicine while high on narcotic drugs for 31/2 years. I made errors. My patients were lucky that I was surrounded by other doctors and nurses who politely questioned my decisions and had my back. They saw that something was wrong, but none of them confronted me.

Self-policing in the medical profession is nearly nonexistent. It's one of the reasons I so strongly support Proposition 46, which would require periodic on-the-job drug and alcohol testing of doctors.

I became addicted to prescription narcotics during my internal medicine residency and practiced medicine for years without anyone turning me in. I was taking about 100 pills a day: oxycodone, Vicodin, benzodiazepines, Valium, Xanax, Clonopin.

While high, I thought I was a better doctor. I thought I was sharper, that I didn't need sleep, that I didn't need to eat, that I could work longer hours and see more patients. I thought I was invincible, but my judgment was severely impaired.


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My colleagues knew something was wrong, that I wasn't the guy I used to be. They didn't want to hurt my livelihood. They didn't want to damage my reputation. Instead they covered for me.

Today I try to help doctors in the same situation. But we don't have the culture or ability to self-police. Nurses report to doctors. Other doctors see themselves as colleagues. There is incredible professional pressure not to snitch.

I've been sober for more than 10 years now, but there is much that I need to account for. Up to 440,000 Americans die every year to preventable medical error: It's the third-highest cause of death behind heart disease and cancer. Those physicians who are high or drunk are more likely to harm people, but we can't count the toll because of a system that so thoroughly protects the impaired.

Patients aren't the only victims of doctors' addictions. One day, I was at the bedside of a woman who had lost her liver to an overdose caused by fewer drugs than I was taking daily. I went into a bathroom and cried, more or less hoping that someone would confront me before I died.

Luckily for me, my father intervened on me. When he did, I felt like a guy who was out in the middle of the ocean and someone had come by and swung in a life raft. There's a good percentage of others out there right now that are in the same place, adrift.

Impaired physicians need that tap on the shoulder. Many are just waiting for it, as I was. Let us identify them and help them fix their lives before they go down a dark path and take innocent people with them.

I've been asked: "What if someone reads this and realizes that you might have harmed them?" It's very possible that I have, and if so, I need to be held accountable.

Bob Pack, the proponent of Proposition 46, lost his two children, Troy and Alana, due to medical negligence. I don't understand how you can look at him and what happened to his family and say we don't need to do anything. This is preventable.

As doctors, we must first do no harm. The Bible teaches us: "Physician, heal thyself." Addicted doctors can indeed heal, but not without the detection and confrontation that makes them face their demons.

Proposition 46 is the first step.

Dr. Stephen Loyd of Johnson City, Tennessee. is an associate professor of medicine at East Tennessee State University and the White House's Office of National Drug Control Policy 2014 Advocate for Action.