What ‘The Pitt’ Got Right About Addicted Medical Professionals

Written by Emma Nagle, LCSW | May 21, 2025

The character of confident, playful, senior resident Dr. Langdon in HBO Max’s The Pitt, offers a rare, honest glimpse into the hidden struggles of medical professionals dealing with addiction.

While fictional, Dr. Langdon’s story reflects a reality that I’ve encountered many times in my work as an LCSW and Clinical Supervisor in an New York outpatient substance use and mental health treatment clinic.

Over the years (and particularly since the COVID-19 pandemic) I’ve seen a notable rise in professionals, especially those in healthcare, getting connected to treatment. As The Pitt demonstrates, doctors, nurses, and other licensed clinicians carry immense responsibility and are routinely exposed to trauma, high-stakes decision-making, and chronic sleep deprivation. The culture of medicine often demands stoicism and self-sacrifice, leaving little room to tend to one’s own mental health. The show also explores a less talked-about dynamic: the pride that comes from 'doing the most.' There is a sense of validation and identity that can form around being the one who saves lives or works the longest shift, no matter the personal cost. As Langdon describes it, he is connected to the identify of being one of  “the bees protecting the hive.”

It’s no surprise that burnout, depression, and substance use disorders are common among this group. Yet, seeking help can be incredibly complicated. Medical professionals not only fear stigma, they fear career consequences. Many face mandatory reporting, disciplinary action including license revocation, or professional monitoring. In New York City’s public hospital systems, the pressure to keep functioning under high patient volumes, staffing shortages, and institutional strain only amplifies this tension, much like The Pitt exposes.

What The Pitt gets right is the complexity. Dr. Langdon isn’t portrayed as reckless or weak. He’s a skilled, committed, senior resident, and quietly unraveling under the weight of his work and unprocessed pain. It mirrors what I’ve seen in real life: professionals who are high-performing, deeply caring, and profoundly isolated in their suffering. In fact, The American Association of Nurse Anesthetists (AANA) reports that approximately 10% to 15% of all clinicians will misuse alcohol or other drugs during their careers. While support exists for these individuals, Caduceus meetings are not enough support and do not encompass all the different types of medical licensure out there and are reserved strictly for doctoral healthcare professionals. 

It should be noted that the concept of staff members diverting medication is not unfamiliar.

Roughly 10% of all healthcare workers will steal opioids and other substances from patients and hospitals at some point in their career. 

The Pitt taught us how inconspicuous someone’s addiction can be, even for doctors in an emergency room environment where professionals have a trained eye. The discovery of Dr. Langdon’s diversion of benzodiazepines was an accurate depiction in that a colleague suspected him. Like many other professionals misusing substances, it required a colleague or supervisor reporting them for confrontation about their addiction to occur. The moment Dr. Langdon is cornered about his diversion of a controlled substance, he begins to unravel. He clearly fears not only for his job at Pittsburgh’s Trauma Medical Center, but for his license as a doctor that he has spent a minimum of eight years working towards.  

What we don’t see in The Pitt series is what the attending, Dr. Robby, chooses to do with the knowledge that one of his supervisees is stealing medication and appears to be addicted to pills. We heard him threaten Dr. Langdon by reporting him, which leads to:

“30 day inpatient treatment program. Followed by random urine tests - 50-60 a year. Followed by mandatory NA meetings. Three to four times a week for the first three years… Of a five year program.” 

This may sound excessive, but it is comparable to the types of consequences medical professionals might face and the process they go through. A medical professional who is caught on the job under the influence, diverting narcotics, or, chooses to surrender their license and seek help, will be connected to their respective Employee Assistance Program (EAP). The Committee for Physician Health (CPH), Professional Assistance Program (PAP) and Office of Professional Misconduct (OPMC) are just a few monitoring sources that become involved depending on the type of licensure.

Given the stigma that exists around addiction, plus the consequences of losing a job and temporarily a license, and five years of intense monitoring, medical professionals are not inclined to seek out help.

Despite awareness of and access to resources, concerns for confidentiality and the impact treatment might have on employment or other responsibilities hinders workers from seeking care before their substance use and mental health issues have progressed and become unmanageable.  

The Pitt doesn't offer a full resolution to Dr. Langdon’s story, but perhaps there is more to revealed in Season 2. This show captures how the demanding work in the healthcare field and issues like chronic pain can cultivate addictions to medications. It highlights that addiction does not discriminate. It also exposes the difficult truth that addiction among medical professionals often goes unseen until a crisis forces it into the light. And even then, the path to recovery is long, complicated, and shadowed by professional risk.

In my own work, I’ve seen how deeply rooted the fear of losing one’s identity, license, or livelihood can be for healthcare workers struggling with substance use. The systems meant to protect patient safety often unintentionally deter providers from getting the help they need until their suffering becomes too visible to ignore.

My experience facilitating an “Impaired Professionals” group shed light on just how prevalent addiction and barriers to treatment, really are among professionals. This also includes those not in the healthcare field, such as lawyers and pilots who also risk losing licensure. For better or for worse, many of these professionals found their way to care because they were reported. As part of their healing process, therapy often includes looking at their relationship to their job and discovering their identity outside of their profession. Those that successfully make it back into practicing in the field are required to learn healthier boundaries in the workplace to be able to maintain recovery gains.

Ultimately, what The Pitt gets right are the intricacies of addiction in high-functioning professionals. It doesn’t sensationalize the downfall and thus far, doesn’t simplify the recovery. It shows us how the very qualities that make someone excellent at their job—drive, endurance, perfectionism—can also mask the symptoms of burnout and dependence. And while it leaves us wondering what will happen to Dr. Langdon, it offers an opening for an important conversation about how we, as providers, supervisors, and peers, can better support one another before the unraveling begins.

Surfing the Urge

Cravings and big emotions can feel like overwhelming waves, but remember: you don’t have to drown in them. With urge surfing, you can ride through each swell with awareness, knowing it will pass.

Ready to learn how to stay steady when the wave hits? Let’s dive in.

Written by Emma Nagle, LCSW | April 23, 2025

“I am not afraid of storms,

for I am learning how to sail my ship.”

--  Louisa May Alcott, Little Women

 

Urge surfing is a mindfulness technique that helps you manage unwanted behaviors by acknowledging and accepting urges without judging or acting on them.

Use the steps below as a guide to surfing the wave:

1. Identify the physical sensation of the urge

2. Visualize the urge as a wave that builds up, peaks, and then subsides

3. Observe the urge without fighting it

4. Ride out the urge until it passes...

Like real waves, urges rise and fall—they don’t last forever. The more you practice observing rather than reacting, the more your nervous system learns that you’re safe, even in discomfort. Urge surfing isn’t about willpower or resistance—it’s about building awareness, staying present, and trusting the temporary nature of emotional and physical impulses.

With time, urge surfing strengthens your ability to pause, reflect, and choose responses that align with your long-term values rather than short-term relief. For example, someone with an addiction might use this technique to sit with the discomfort of a drug craving—observing the urge without reacting or using, and instead, allowing it to pass. This practice not only helps prevent relapse, but also builds self-trust and reinforces the recovery process.

Each time you choose to ride the wave instead of reacting to it, you're practicing a new kind of resilience. Be patient and curious with yourself. Don’t judge your urges. Every urge you surf is a step toward greater self-regulation, freedom, and trust in your own inner stability.

How to Support a Loved One with Addiction

A CRAFT-Based Guide to Staying Connected Without Enabling

Written by Emma Nagle, LCSW | April 23, 2025

 

When someone you care about is struggling with substance use, it’s natural to feel helpless, scared, and unsure of what to do. You want to help—but you don’t want to enable. You want to set boundaries—but you don’t want to push them away. It’s a painful and confusing space to be in.

That’s where the CRAFT model comes in.

CRAFT stands for Community Reinforcement and Family Training. It’s a research-backed approach designed to help family members and close support systems learn how to effectively encourage a loved one toward treatment—without ultimatums, guilt-tripping, or cutting them off.

As a therapist, I’ve seen CRAFT empower families and partners with tools that are not only compassionate and practical—but actually work.

 

Here’s a guide of how it works:

1. Understand What You’re Dealing With

CRAFT starts by educating loved ones on what addiction is—not just a series of bad decisions, but a complicated behavioral pattern shaped by reward, habit, and pain systems in the brain.

Knowing this helps shift the mindset from:

“Why won’t they just stop?” to “What’s reinforcing this behavior, and how can we shift that?”

2. Notice What is Reinforcing the Substance Use

CRAFT teaches that people keep using substances because something about it “works” for them—whether it’s escaping stress, numbing pain, or just feeling normal for a moment. Their substance of choice should give insight into what they may be “treating” within themselves.

Your job isn’t to fix them—but to start recognizing how your responses might be (unintentionally) supporting the behavior.

Examples:

• Are you giving money when they’re short because they spent it on substances?

• Are you cleaning up their messes so they don’t face consequences?

This isn’t about blame—it’s about becoming more conscious of what’s keeping the cycle going.

3. Use Positive Reinforcement for Healthy Behavior

Here’s something refreshing: CRAFT isn’t about punishment. It’s about learning how to reinforce positive change, even in small doses.

Did they come home sober one night? Keep a therapy appointment? Go 24 hours without using?

Notice it.

Name it.

Appreciate it.

When you consistently reward healthier choices (with time, attention, calm conversation), you’re giving their brain a reason to keep trying.

4. Improve Communication Without Fighting

CRAFT encourages clear, kind, and assertive communication. That means less yelling, fewer power struggles, and no more walking on eggshells. Try using “I” statements and avoid blaming language. 

Instead of saying:

“You’re ruining your life!”

You might try:

“I care about you, and I get scared when I see how much you’re using. I’d love to talk when you’re ready.”

This approach respects both your boundaries and their autonomy—two things that are crucial when trying to keep connection without enabling.

5. Support Treatment—But Let It Be Their Choice

A major goal of CRAFT is helping loved ones be more likely to accept help—without being forced. CRAFT has been shown to be more effective than interventions that rely on confrontation or cutting people off.

You’re not trying to control their timeline. You’re helping create an environment where choosing help feels safe and supported. When they are ready to accept help, be ready to help. Have resources available or someone for your loved one to speak to further about their addiction.

 

final thoughts

Supporting someone through addiction is emotionally exhausting—but you don’t have to choose between doing everything and doing nothing.

CRAFT offers a third option: Stay connected. Set boundaries. Reinforce hope. All while taking care of yourself, too.

If you’re navigating this with someone you love, consider finding a therapist or support group to help ensure you are prioritizing your own emotional needs. Al Anon is one commonly sought out mutual aid resource for family and friends who have been affected by a loved one’s addiction. Support groups are a helpful reminder that you are not alone in this struggle. With the right tools, it is possible to make meaningful change—without losing your sanity, your compassion, or your connection.

 

 

Want a printable version of this guide? See below: