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Nurses and Substance Abuse

Last Updated 3 16, 2012

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By: Sue Heacock

Nursing is a high-esteemed profession but still with its negative aspects. Because of the demanding and stressful nature of the job, many nurses have fallen in the traps of substance abuse. On shows like 'Nurse Jackie', this unfortunate truth is made known to the public but the problem is more prevalent than most poeple realize:

"It has been estimated that 10 to 15 percent of all nurses in the United States are addicted to some type of illegal or controlled substance, explained Art Zwerling, MS, MSN, CRNA, FAAN, a nurse anesthetist educator and member of the peer assistance program at the American Association of Nurse Anesthetists(AANA). While the risk of addiction is not limited to any one specialty, the specialties with the highest prevalence of substance abuse uses are ICU, ER, OR, and anesthesia.

There are several reasons that can potentiate this issue in our profession:

Job stress. Long hours/stress related to caring for the sick/dying.
Job work area. You will notice in the above quote that nurses working in ICU, ER, OR, or anesthesia have the highest prevalence of substance abuse. These are considered VERY high stress work settings.
Easy access to medications.
Workaholic personality leads to other addictions.
In general, nurses take care of others first and themselves last. This leads to addiction to "hide" personal needs and tend to the needs of the patients.

What can I do as a nurse if I suspect a co-worker is addicted to drugs or alcohol?

The worse you can do is nothing.
Approaching the nurse directly will likely meet with resistance and denial.
Report your suspicions to management. This will lead to the nurse getting help. Most employers offer drug/alcohol treatment programs. An employer would rather treat a nurse and get her back to work than to have to invest/train in a new nurse.
Do not feel guilty about reporting your suspicions. If you are wrong, no harm done. But if your suspicions are correct, you have helped a fellow nurse get his/her life back on track, have contributed to patient safety, and have promoted the positives of the nursing profession.
Speaking of patient safety: "Statistics indicate that employed people who abuse substances are unreliable on the jobs". (Recoveringnurses.org) Without going into more detail, this statement says it all. You owe it to your patients to give them reliable care. If you are working with an addicted nurse, you are not being fair to your patients.
Need another example? "Compared to nonusers, alcohol and illicit drug users are more likely to have been involved in a workplace accident in the past year." (Recoveringnurses.org) Again, think about the safety of the potentially addicted nurse, your patients, coworkers, and yes, yourself!

What if I am a nurse and think I am addicted to drugs or alcohol?

Ask for help. Addiction is an illness. You need help in recovery. There are organizations that can help, but not if you don't ask.
Don't wait until you resort to stealing, cheating, or lying to feed your addiction. Get help early. Your supervisors and peers will respect you for your efforts.
Protect your nursing license. By getting help and staying clean, you protect what you have worked so hard to earn, in a profession you are proud to be in!
Become an advocate. Help other nurses in your community with addiction issues. As stated above, over 10% of nurses are addicted to drugs or alcohol.

Nurses, have you ever been through an experience with a co-worker who developed a substance abuse problem? What did you do about the situation to help?

About the Author: Sue Heacock, RN, MBA, COHN-S is the author of Inspiring the Inspirational: Words of Hope From Nurses to Nurses. Sue is a Certified Occupational Health Nurse Specialist and has worked in a variety of areas of nursing including pediatrics and research. Before entering the nursing profession, Sue worked in human resources and equal employment opportunity.

Click here to read more on Sue Heacock.

Nurses, if you enjoy writing on nursing career, education or lifestyle related issues and are interested in becoming a NurseTogether.com contributor, please click here.

Tags:communication in nursing, nurse leadership, Nurse Manager, nurses and addiction, nurses and substance abuse, nursing career, nursing profession, patient care, professionalism in nursing

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Recent Comments (there are 18 comments)

My first job out of college was working as a external PRN staffing recruiter for a hosptial in Southeast Texas. I hired a nurse who admitted to having a meth problem in the past, but had gone through rehab and was supposedly clean. She told me a story about being on a 7 day meth binge and working in the ER. I'll spare you the details, but it was CRAZY. Several months later this nurse broke up with her boyfriend and for revenge he called all of the hospitals in town to report that she had stolen morphine from their pharmacies for both of them to use. (She was very sneaky, too. If he hadn't called no one would have ever known who stole it.) Unfortunately, drug use is out there. And not reporting it really is the worst thing you can do. Tommy Mitchell thomas@aprx.net 888.812.3452 x714 www.advancedpracticerecruiters.com

Posted By: Tommy M on 7 01, 2011

There are a few warning signs that may indicate a problem: mood swings, angry outbursts, tardiness, and changes in personal appearance. It is very difficult to be attuned to your co-workers when decreased staffing and increasing workloads remain issues.

Posted By: Cathy O on 7 11, 2011

People do really ugly things in revenge (such as the boyfriend???) Did anyone have hard core proof? I'm just saying...accusing or so called "reporting" in this very cut throat profession can often start a nightmare for persons actually clean but maybe going through some personal issues etc. BE very careful throwing your stones...they may come back to break your window.

Posted By: Angie Z on 7 12, 2011

There should not be "illegal drugs" or "controlled substances." Adults should have ez access to whatever they want. Likewise, employers should be able to place whatever restrictions or drug testing they desire on employees. I don't care what adults do. That is their business. You can't legislate morality or outlaw stupidity. On the other hand, I would never employ a druggie myself.

Posted By: William H on 7 12, 2011

I have been an R.N. all my life, but after my retirement, I became an alcoholic, due to some severe stressors in my life. I am now in recovery for 5 yrs. I know of many nurses in my program, who have had this problem, and they sought help. I never had a pill/drug addiction, but it's all the same at the end of the day. I can really identify, as this can happen to anyone, no matter WHO they are!

Posted By: Barbara S on 7 13, 2011

I am a Nurse and a alcoholic. I've been rehabilitated, medicated and have done AA. i currently work for the department of corrections and it kills me seeing how other nurses view addicts and alcoholic. Not knowing that the nurse next to them is and addict as well. i'm not proud of what i am but as a nurse it gives me the drive to do my job twice as hard. i have experianced pain and suffering which helps me react to patients pain better. people tend to forget the human element, nurses are human with the same flaws and shortcomings that their patients have. but in all honesty the nurse who is an addict should be viewed like a patient... some can be saved and some can't.

Posted By: nurse P on 7 17, 2011

I was a hospice nurse accused by a family member of stealing lorazepam. Fortunately, the accuser had used up all her cred and my managers had absolute faith in me. I got out of all face-to-face contact and hope never to be in the presence of a client again. People lie, mud makes good paint. Don't judge, show some compassion

Posted By: Raymond H on 7 17, 2011

I am an RN who is also a recovering addict/alcoholic. I am very grateful that someone confronted me so I could get the help I desperately needed but was too shamed to admit. I have been sober for 7 years now and have spent the last 4 of them working in addiction medicine. I can tell you that the statistics listed here are right on, if not a little low for whats in the field. It's staggering and it does not discriminate. It is not a morality issue, its an illness. Check it out with AMA.

Posted By: Druggie a on 7 16, 2011

I can say that, high stressors and inadequate coping skills can truly make it easy for a nurse to become an addict. I had a drug problem in the past and I am not afraid to say it and of course I know that I will always be an addict. God blessed me with the ability and strength to become clean and to keep my nursing license without ruining my life or anyone elses' in the process. I now have the tools I lacked in the past and truly being through all I went through has made me become a more understanding and tolerant nurse and person. Everyone has made mistakes and we just need to keep moving forward and not look back. For anyone in this situation at this time. There is hope and you can overcome. God Bless.

Posted By: Rebecca H on 7 15, 2011

I am a nurse with 31 years in recovery. I was stealing narcotics from the hospital and using heroin. I went to a nurse support group and many AA and NA meetings. I also used Naltrexone for a year. During my sober career I was the manager of the drug free work place. I intervened on many hospital employees and nurses. All but one of them returned to their job after a 28 day treatment program. The one nurse is continuing to use alcohol. I have found that if you suspect drug abuse your are correct. Because thinking someone is a drug or alcohol addict is not the first thing that comes to your mind. So if you suspect do intervene even though most of the time they will deny it. Recovery is possible. In California they found that nurses who were loosing their licenses jumped off the golden gate bridge so the initiated a diversion program for nurses which has been very successful. We need compassion and treatment for our nurses who are suffering with addiction not jail time.

Posted By: Ann J on 7 15, 2011

I'm in nursing school now and I think I'm already an addict. It happened without me realizing it. I will soon graduate and keep telling myself I can hold on until I graduate. But reading all these posts, I realize that my judgement may be impaired. However, I do think that it makes you a more compassionate nurse. Where I used to work, I watched a lot of nurses and doctors stereotype people the minute they came in the door. The economy has forced many people to use the ER like they would have doctor offices before. I'm just terrified that any future employers will find out I went through a recovery program and won't hire me. I'm researching outpatient clinics for help now. I realize now that I will need lifetime counseling to overcome the things in my life that I've suffered and continue to deal with.

Posted By: hoping N on 7 17, 2011

I have been an RN for 21 yrs and and never did I wish to be able to have adequate access to narcotics, a nightmare. I went through rehab twice and when I felt myself slipping away, I temporarily retired until I get it all back together again...my heart goes out to us addicts.(not something we had in mind) We can do it...we can overcome...but I will not return to nursing until I feel very confindent in doint so like I did when I started in 1990.

Posted By: Arturo M on 7 19, 2011

Been in SARP :) could not have stopped w/o intervention. It sux to be caught, but being free from the drugs is worth it.

Posted By: matthew d on 7 21, 2011

SARP,,;),,nuff said

Posted By: matt d on 7 21, 2011

To the nurse who works in corrections. I know how you feel. I'm a nurse in a psych unit. We see many addicts. I hate the way my co owrkers view them. I have a son with a heroin addiction, which began with Oxycontin. His addiction is what drove me to work in psych.

Posted By: Leigh S on 8 13, 2011

i realize the importance of gettting help for an addicted peer, but who makes the call? at my place of employment, one of the nurses called our program director and relayed her suspicions about a peer, who was drug-tested and found to be clean! the accused nurse was humiliated; now most of us feel like we do not want to work with the accuser and the atmosphere at work is almost like that of a witch-hunt. i don't agree that "there was no harm done." illegal drug use is a very serious accusation among professionals and i feel the accusing nurse should now be made to apoligize to her peer.

Posted By: maria y on 8 30, 2011

I too am in recovery. I think my past gives me strength to do the right thing. I do not hide who I am. I can't. I was arrested from my job and escorted out of the hospital in handcuffs. I have returned to work and am currently an advocate. I am not proud of my history, but I am living proof that things can change and you don't have to be a statistic. I am now a nurse manager at the same hospital I was escorted from. It was in 2004 and I went to a two year fairly extensive rehab process. It is not for the weak but the results are amazing. Freedom from my own personal hell (Priceless) Thank God for the day I was caught!

Posted By: Anna C on 10 21, 2011

I have been an ER nurse for 6 years, and an alcoholic my whole life. My family and husband were so proud when I decided to become a nurse and actually graduated later in life. Six years later I find a letter in the mail from the BON. I will need to enter the diversion program. I am elated, scared, angry, relieved, all of the above. Don't know what will happen. I started taking the "waste" with narcs after a few years on the job then started to downright fudge charts and actually just steal narcs. Originally stole them for hubby who had quit drinking..I felt bad for STILL drinking and started stealing the drugs for him so he could "feel good" too...then I started taking the drugs...sick I know...looking forward to help actually...don't know if I want to be a nurse anyway...so confused...please pray for me. I was a very good nurse by the way.

Posted By: jay p on 10 30, 2011