This blog is based on a recent episode of the Med School Minutes podcast, where Dr. Jason Giles shares his deeply personal journey through addiction, recovery, and transformation.
Addiction doesn’t discriminate. It doesn’t care if you wear a white coat or hold a prescription pad. It finds its way into lives often masked by high performance, ambition, and service to others. Among physicians, the pressure to maintain an image of composure, competence, and strength can make it even harder to acknowledge the cracks beneath the surface. But healing begins where honesty starts.
Dr. Jason Giles’s story is a powerful testament to this truth.
While training in general surgery and later anesthesiology, Dr. Giles found himself deeply immersed in the high-stakes, high-pressure world of medicine. He loved the work—its pace, variety, and intellectual challenge. But what remained hidden, even from himself, was a “lurking” addiction that began to grow stronger the moment things slowed down.
For many medical students and physicians, the pathway to addiction isn’t lined with chaos but with silence. Long hours, isolation, and a culture that discourages emotional vulnerability all contribute. Dr. Giles didn’t begin using fentanyl as an escape from pain, but out of curiosity—and it worked. There were no immediate consequences. No catastrophes. Just a momentary tool to manage anxiety, boredom, and imposter syndrome.
And that’s how it often starts: rarely, then occasionally, then frequently, then daily.
Addiction, particularly among medical professionals, often takes on the form of high-functioning dependency. Dr. Giles was not only working full-time—he was excelling. His schedule left little room for reflection or collapse. As he explains, “If I was awake, I was probably at work.” The long hours, emotionally intense cases, and life-or-death decisions masked the growing psychological strain.
Eventually, it caught up with him.
A discrepancy in fentanyl inventory led to a call from his department chair. The request was simple: return the medication. But it was also the intervention that started his recovery. With support from colleagues who had seen this path before, Dr. Giles was sent to treatment—not punished, but believed in. “We expect you to get well,” they told him. And he did.
The recovery wasn’t just about quitting a substance. It was about redefining identity—from a doctor with a secret to a doctor who could help others find their way out of the same darkness. Dr. Giles returned to finish his training in anesthesiology and pain management but ultimately found his calling in addiction medicine. The very thing that had once threatened his life became the lens through which he could help others reclaim theirs.
Today, he leads a team offering telemedicine-based addiction treatment, reaching more people than ever. He emphasizes the critical role of support systems—not only during recovery but throughout medical training and practice. A good support system, he explains, isn’t something you call upon only when in crisis. It’s something you build and nurture consistently: honest, open, and present relationships that catch you before you fall.
Importantly, Dr. Giles challenges the illusion that doctors should be immune to vulnerability. “Just because you’re a doctor doesn’t mean you can’t be a patient,” he says. This truth is especially crucial in a culture that still associates medical professionalism with emotional detachment. The reality is: physicians suffer. Physicians need help. And when they receive it, they not only survive—they lead.
Dr. Giles’s experience also shines a light on broader issues: the culture of overwork, the stigma surrounding addiction, and the lack of open dialogue in medicine. He introduces concepts like “moral injury”—the emotional toll of bearing witness to suffering—and emphasizes the need for safe spaces to process that trauma.
He also wrote books to offer practical tools and relatable guidance, not just for those in treatment but for anyone questioning their relationship with substances. His message is clear: recovery is possible, and it’s never too early to ask yourself hard questions.
For those in training, Dr. Giles offers one more piece of advice: seek honest conversations with physicians in the fields you’re considering. Understand the real day-to-day experience, the emotional labor, and the parts of the job that don’t appear in textbooks. “You’re the prize,” he says. “The job needs you more than you need the job.”
Medicine, at its core, is about helping people. But to do that well, we must also learn how to help ourselves—and each other.
Watch the full interview with Dr. Giles on our YouTube channel and learn more about our commitment to empowering future physicians at www.sjsm.org.