Substance abuse isn't bound by socio-economic status, race, gender, or profession, and the healthcare sector isn't immune to this problem. As nurses are trusted with the safeguarding of patients, any interference in their ability to perform their tasks compromises the entire nursing process. For over a century, substance abuse among nurses has been linked to the unique work conditions they face, which include high levels of stress and easy access to medications. However, it's critical to note that the prevalence of substance abuse among nurses is on par, if not lower, than the general population.
While statistics may suggest that less than 1% of registered nurses (RNs) are battling a known substance abuse problem or are in active treatment programs, these numbers don’t paint the entire picture. They only represent reported cases, leaving unreported or suspected cases out of consideration. The American Nurses Association states that up to 10% of RNs may be dependent on drugs or alcohol, and an alarming 14-20% may struggle with drug or alcohol abuse, indicating the potential scale of unreported cases.
When nurses suffer from addiction, the repercussions are far-reaching. Not only does this disease harm the nurse, but it also affects the patients relying on them for safe, competent care. Early detection, reporting, and intervention are crucial in protecting patients from harm and assisting affected coworkers in recovery. Furthermore, nurses battling addiction pose an additional challenge to the profession as they have access to narcotic medications, putting patient care at risk and breaching ethical standards.
Substance abuse among nurses may manifest in several ways, including consistent errors in shift count for opioids, frequent bathroom visits, isolation from colleagues, and emotional instability. If an RN’s patients consistently fail to achieve the expected level of pain relief despite receiving medication, it may be another red flag. Recognizing these signs early can potentially prevent harm to the nurse and their patients.
Substance abuse among nurses traces back to the early 1900s, with reports indicating nurses start misusing drugs before completing their education. However, recent spikes in substance misuse are often linked to easy access to drugs, job-related stress, depression, knowledge of medications, enabling coworkers, and excessive workload.
A more recent term, compassion fatigue, refers to the emotional and physical exhaustion experienced by professionals and caregivers over time. This fatigue, often a result of repetitive encounters with patient tragedies and intense involvement in patients’ grief, can lead to a decrease in care quality, increased clinical errors, and higher rates of depression, anxiety, and stress leave. Some nurses combat this fatigue with unhealthy coping mechanisms like drug and alcohol use.
Alcohol, prescription drugs, and illicit drugs like marijuana, cocaine, and heroin are commonly misused by nurses. While the use of illicit drugs is lower among nurses than the general population, alcohol consumption and prescription drug use for nonmedical purposes are higher among healthcare professionals.
Since the 1980s, the recognition of substance abuse as a disease has led to the implementation of non-disciplinary rehabilitation programs. Nurses suspected of substance use are typically placed on leave pending investigation, and findings are reported to the Board of Nursing (BON) and local authorities. These intensive rehabilitation programs allow nurses to return to work after it’s established that they are safe to practice.
While disciplinary programs focus on deterrence and public safety through punishment, ATD programs prioritize the nurse’s recovery while protecting their professional nursing licenses. Confidentiality is a key component of ATD programs, which include treatment and aftercare, resulting in a high long-term recovery rate for affected nurses.
Dealing with substance abuse can be an overwhelming task, but it’s a necessary one for the well-being of nurses and their patients. If you’re a nurse struggling with substance use, seek treatment immediately and cooperate with your BON. Understand that recovery is a lifelong commitment that benefits not just you, but also the patients in your care. Additionally, gender differences in substance use among nurses suggest that tailored approaches may be necessary for male and female nurses.
If you or someone you know in the nursing profession is grappling with a substance use disorder, Soledad House, a women’s only treatment center in San Diego, is here to help. We understand the unique needs of women in substance use treatment and offer programs addressing alcohol use disorder, prescription, and illicit drug addiction. Contact us today at 866.314.3222 to take the first step towards recovery. Your wellbeing, the safety of your patients, and your professional future hinge on this crucial decision.