One state inquired about compulsive gambling and another asked whether the applicant had ever been verbally, physically, emotionally, or sexually abusive. They do not address applications relating to reciprocity or the renewal of licenses. Consider some hypothetical cases that illustrate the implications of these findings. Suppose 2 applicants had both experienced major depression 4 years earlier, with equal and significant levels of impairment during the episode. Both are currently symptom-free.
Similar implications are apparent for the questions exploring substance abuse.
With substance abuse, a dilemma arises when the question is based on the applicant's assessment of whether there is or was impairment caused by the substance use. Suppose one applicant is currently using marijuana on the weekends and does not believe that such use affects professional functioning. A second applicant abused alcohol during a discrete period 3 years earlier, during which time there was impairment of professional duties, but currently the applicant does not drink. The first applicant would have to indicate substance use in 5 states, whereas the second applicant would have to indicate a substance use problem in 23 states. Physicians with histories of emotional problems or substance abuse do have some protections.