DiversityNursing Blog

Nursing is a demanding field and there are many factors that put Nurses at risk for developing problems with substance abuse and addiction.

Research estimates that 10% of Nurses will misuse drugs or alcohol at some time during their career.

Many Nurses in the U.S. have had their licenses suspended or revoked because they either caused harm to a patient, diverted or misappropriated drugs, or couldn’t safely practice because of their addiction.

In the past, Nurses who had addiction problems were dismissed or charged. Now addiction is being recognized as a disease. Thankfully, there has been a shift from disciplining Nurses to helping Nurses get better.

According to the Hazelden Betty Ford Foundation, 43 states have created substance use disorder monitoring programs for Nurses called "alternative-to-discipline" (ATD) programs. Nurses with substance use disorders are three times more likely to admit their problem in states with ATD programs than in states with traditional discipline programs. ATD programs provide Nurses with a structured process for a better outcome: After completing addiction treatment, they go through monitored reintegration into the workforce.

Joan Widmer, Nurse Executive Director of the New Hampshire Nurses Association, said, "Encouraging Nurses to self-report in the early stages of addiction is critical. You want them to recognize their own problem and feel comfortable that they can come forward and address the problem without loss of licensing and a way of making a living."

An article from Kaiser Health News said, instead of revoking the license of an individual who is found to be impaired on the job, these peer-run programs try to get participants back to work with mandated treatment plans that include intensive therapy, monitoring their behavior in and out of the workplace and, of course, drug testing.

Research shows, ATD programs have been successful in treating Nurses with substance use disorders. Also the long-term recovery rate for Nurse licensees undergoing treatment in these programs is high.

“I don’t think you’re ever going to see substance use disorder disappear in the Nursing population; it’s going to be there,” Widmer said. “But if you can at least address it and find a way to do it in a non-stigmatic way, you’re going to keep patients safer, because Nurses are going to self-report."

Approximately 56 million American adults are struggling with a mental illness or substance use disorder, according to the American Psychiatric Nurses Association (APNA).

An article from mentalhealth.gov, shows the current mental health workforce shortage is projected to grow and would leave the country 250,000 professionals short by 2025.

Only 44% of adults and 20% of children in the U.S. receive the mental health and substance use care they need because there is a growing shortage of qualified professionals trained to provide timely and effective treatment.

This lack of treatment significantly contributes to one of the leading causes of death in the U.S, suicide.

According to the same mentalhealth.gov article, suicide is the 10th leading cause of death in the United States. It accounts for the loss of more than 41,000 lives each year, more than double the number of lives lost to homicide.

An article in the Journal of the American Medical Association (JAMA) discusses the increase in children under 18 going to emergency departments due to attempts of suicide or suicidal ideation.

One reason demand for mental health professionals has increased is because more Americans are gaining health coverage. It's the law per the Affordable Care Act that insurers can no longer deny coverage to people who have diagnosed mental illnesses.

Also fewer medical students are specializing in psychiatry because psychiatry jobs don't pay as well as other fields. Students facing high medical school debt are more likely to pick the jobs offering better pay.

There has also been a surge in substance use disorders and greater public awareness of mental illness. Increased public awareness means more people living with mental illness will seek treatment.

Healthcare providers and the medical community at large need to implement a more supportive environment for the psychiatry profession. There should also be increased compensation for psychiatry jobs and student loan forgiveness or free/low-cost psychiatry schooling.

Policy makers should support and enact quality mental health services that will improve public health, particularly populations who most often have no access to mental health services.

Substance Use Disorder can affect anyone regardless of age, ethnicity, gender, economic circumstance or occupation. Substance Use Disorder in Nursing is one of the most serious problems facing the profession today.

This disorder is more common in Nursing than many believe. The American Nurses Association (ANA) estimates that 6% to 8% of Nurses have a drug or alcohol problem that impairs their practice. 

Nurses are often handling powerful painkillers and other prescription drugs. This accessibility increases the temptation to use. In fact, a study showed that Nurses who handle drugs are more likely to have an addiction than Nurses who do not.

Any healthcare facility will tell you that when they have great Nurses, they want to hold onto them. Most state Nursing boards understand that addiction is a disease and Nurses should have the opportunity to pursue recovery without worrying about losing their job. 

Non-disciplinary programs are now used by a growing number of state Nursing boards. These programs provide rapid involvement in a rehabilitation or treatment program and remove him/her from providing care until safety to practice can be established and confirmed.

It is not easy for anyone with a substance abuse disorder to ask for help, and that can be especially true for Nurses. However, recognizing that there is a problem and asking for help are the two steps that can truly turn things around. If you or someone you know is struggling with SUD please use the resources below.

RESOURCES

For Nurses with SUD

The National Council of State Boards of Nursing (NCSBN) offers an Alternative to Discipline Programs for Substance Use Disorder directory here for Nurses to locate alternative to discipline programs for SUD in their state if available.

For Nurses Concerned for a Colleague 
This NCSBN online brochure, What You Need to Know About Substance Use Disorder in Nursing, informs nurses of their ethical and professional responsibilities about reporting suspected or know SUD in colleagues.

For Employers
See Chapter 6 of NCSBN’s SUBSTANCE USE DISORDER IN NURSING: A Resource Manual and Guidelines for Alternative and Disciplinary Monitoring Programs offers a comprehensive examination of SUD in the healthcare workplace, particularly for Nurse managers.

For Nursing Students
Although not specifically for Nursing students, the NIH’s National Institute of Drug Abuse College-Age & Young Adults’ webpages, contain resources for how and where to get assistance for substance abuse, as well as drug facts, infographics, and more. Currently, there is very little updated guidance for Nursing students with substance use disorder. Nursing students may want to consult their health care provider, college health center, or employee assistance program.