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Addiction Treatment for Nurses

Addiction Treatment for Nurses


WHAT THIS ARTICLE COVERS: Nurses develop substance use disorders at generally the same rate as others. However, addiction is treated differently for nurses. What practices are most effective? We explore here.  Then, we invite your questions related to nursing and treatment at the end.


TABLE OF CONTENTS: 


The Need

Although most nurses understand the dangers of addiction, drug abuse and addiction can quickly develop in this population. Why? Two of the biggest reasons for this seem to be a high-stress work environment and ease of access. Addicted nurses may use alcohol or drugs to cope with the anxiety of their often difficult and fast-paced career. And in a medical setting, prescription drugs are often very easy to come by.

Unfortunately, addicted nurses not only put themselves in danger, but also put their patients and co-workers in danger. When it comes to nurses and addiction, treatment is absolutely essential. However, due to the nature of their work, many physicians and medical professionals , as well as nurses may not be willing to seek addiction treatment. They may recognize a substance abuse problem in themselves or may be worried about losing their jobs if anyone finds out they have an addiction.

In order to be effective, addiction treatment programs for nurses should include some of the following important aspects.

  • Addiction education
  • Aftercare
  • Intensive treatment
  • Peer-to-peer support
  • Privacy
  • Workplace re-entry plan

Around 1 in 10 nurses is likely to struggle with addiction.


The Numbers

So, how many nurses are facing a problem with drug use or problem drinking?

It seems to depend on where you work. A recent study published in American Journal of Public Health found that emergency nurses were 3.5 times as likely to use marijuana or cocaine when compared with nurses in women’s health, pediatrics, and general practice, while oncology and administration nurses were twice likely to engage in binge drinking, and nurses in psychiatry practice were most likely to smoke.

The American Nurses Association (ANA) reported that 6 to 8% of nurses use substances to an extent that is adequate to impair professional work. Moreover, the National Council of State Boards of Nursing (NCSBN) reported research that synthesized several sources estimated that between 14% and 20% of nurses practicing in the U.S. suffer from addiction.According to these statistics reported in the book, Issues and Trends in Nursing , nurses generally misuse substances at the same rate as the rest of the population, 10 – 15%.

This means that 1 in 10 nurses is likely to be struggling with substance use disorder.

To conclude, nurses have a lot on their shoulders. Easy access to medications, high stress workplaces, and little rest can create the perfect storm for a problem. Still, don’t wait to seek help. Addiction responds with treatment!

Specialized Treatment

Individualized and evidence-based addiction treatment practices are the best solution for treating anyone diagnosed with substance abuse disorders. According to NIDA, a variety of addiction treatment services should be tailored to meet your needs. Furthermore, reputable program should address specific:

  • Cognitive issues
  • Emotional issues
  • Neurochemical issues.
  • Physical issues
  • Social issues

Because nurses can be somewhat sensitive, program should also be based on prevention and trigger elimination. How do professional certification organizations weigh in? Position statements exist from the:

These organizations have actively promoted nonpunitive substance abuse policies, and many states have adopted alternative-to-discipline (ATD) programs. According to a study published in the Journal of Psychosocial Nursing and Mental Health Services, medical practices that have moved from disciplinary and suspension punishments to ATD programs have good retention rates. Moreover, nurses who complete ATD addiction rehab programs have fewer criminal convictions and are able to retain their nursing licenses and maintain successful careers in nursing.

What To Expect?

While nurse addiction treatment does differ slightly from addiction treatment for non-medical professionals, it typically follows the same basic steps.

1. Evaluation and assessment

Addicted nurses should be evaluated before entering any addiction treatment program. During this evaluation, an addiction specialist will be able to assess their needs, diagnose mental health disorders, and create an addiction treatment plan.

2. Detox or withdrawal

Detox is highly recommended for addicted nurses before they enter treatment. While in a detox program, nurses can safely go through withdrawal from drugs or alcohol. There is also a much smaller risk of relapse while in a detox facility, since access to drugs or alcohol is non-existent.

3. Psychological addiction treatment therapies

Treatment options for nurses can include residential inpatient treatment, partial inpatient treatment, and intensive outpatient treatment. While in an addiction treatment program, nurses will usually undergo individual behavior therapy, group therapy, and addiction education classes. In some cases, pharmacotherapy may also be used.

4. Aftercare

Aftercare is an extremely important part of nurse addiction treatment programs. Nurses recovering from addiction will typically need to continue going to outpatient therapy programs as well as group therapy sessions. Most employers will also require nurses recovering from addiction to sign a last-chance contract, which stipulates that a nurse will be terminated in certain situations. For example, they may be terminated if medications are missing during their shift or they fail a drug test.

Is It For Me?

If you are asking yourself whether you have an addiction problem, first get honest with yourself. Then, check out this Diagnostic and Statistical Manual of Mental Disorders (DSM–5) that lists 11 criteria to diagnose addictive behavior:

1. Take the drug in larger amounts or longer than intended.
2. Want to cut down or stop using drug but fail to succeed.
3. Spend a lot of time obtaining, using, or recovering from the use.
4. Experience cravings and an uncontrollable need to use the drug.
5. Fail to perform normally at work, home, or at school due to drug use.
6. Continue to use, even when it causes problems in relationships with family, friends, and partners.
7. Give up important social, occupational or recreational activities because of use.
8. Use the drug again and again, despite being aware of harmful risks and side effects.
9. Continue to use despite the risk of developing health problems or worsen physical or physiological condition.
10. Need more drug to get the desired effect (tolerance).
11. Experience withdrawal symptoms which can be relieved by taking higher dose (dependence).

Moreover, the severity of any addiction is diagnosed based on the number of criteria you meet.

2-3 Criteria = mild addiction disorder.
4-5 Criteria= moderate addiction disorder.
>6 Criteria = severe addiction disorder.

Still not sure? Check out this NIDA online drug screening tool, and seek help from a certified addiction specialist.

Keep in mind that you can always call SAMHSA hotline 1-800-662-HELP (4357). It is a confidential, free, 24/7 service for individuals and family members dealing with substance use problems.

Treatment Barriers

Not surprisingly, nurses face a number of barriers before, during, and after treatment. This includes general barriers, such as family and career responsibilities, as well as more profession-specific barriers.

Some common nurse addiction treatment barriers include:

  • Ease of access to drug(s) of choice.
  • Fear of judgment by peers and coworkers.
  • Fear of ruining a career.
  • Need for staying alert on the job or relaxing afterwards.

Where To Find Help

Since nurses are health care providers, they often believe that they are able to handle their substance use disorders by themselves. But, although you may be hesitant about asking for help, this need not be the case. Many employers will be glad to help, as someone using drugs or drinking on the job is a danger and a liability.

You can speak with your human resources office, employer health services, or even a fellow co-worker that you trust. You can also speak with your own primary physician or an addiction specialist. Anonymous addiction hotlines are another great resource when looking for help, as is your state’s Board of Nursing.

Your Questions

Struggling with an addiction is a stressful and difficult time, especially if you believe your career is in jeopardy. If you or a loved one is a nurse and in need of addiction treatment, feel free to leave any questions or concerns about your situation in the comments section below.

We look forward to helping all of our readers get started on the path to recovery, and you can rest assured that your privacy is our utmost concern.

Reference Sources: The Addiction Recovery Guide: Nurse Addict
Carle: Addiction Recovery Center
Lippincott’s Nursing Center: Addiction: An Occupational Hazard in Nursing
Resurrection Health Care: Nurses with Chemical Dependency: Promoting Successful Treatment and Reentry
HAZELDEN: Nurses overcome barriers to addiction care

Leave a Reply

15 Responses to “Addiction Treatment for Nurses
Julia
6:21 pm August 9th, 2015

I am a former oncology RN. I was a nurse long before the development of safety devices to help move and transfer patients. As a result, I injured my back many years ago and suffered from chronic lower back pain. In order to function, I took prescribed pain medications which I ultimately became addicted to. Out of desperation and fear of disclosing my addiction, last year I diverted a narcotic from a patient’s PCA machine. I confessed this to my employer and sought help. The outcome was 50 days in jail, a felony conviction, loss of my nursing license and 5 years felony probation. Prior to this event, I had never had so much as a traffic ticket. I was the poster child of nursing, a seasoned oncology nurse who had practiced for over 12 years and touched thousands of lives. I was a charge nurse and a preceptor to new nurses. No one, myself included, ever saw this coming. Nursing drug diversion is an unspoken epidemic problem in the healthcare facility. It caused me to lose everything. However, I have to believe there is a reason why this tragedy befell my life. I am also offering my experience in anyway I can to help those advocating for drug diversion awareness and policy reform. Perhaps getting an inside look at how easy it is for this to occur undetected can help policy makers create functional changes in the healthcare community. Thank you for all you are doing for this pervasive issue.

Joanne
11:51 pm January 7th, 2016

I was a nurse and midwife in the UK. I had a riding accident and was prescribed opiates. For years I took them as prescribed but then depression hit and I started using opiates for mental pain too until I was terribly addicted. I took drugs from work and rather than getting help ended up being struck off and having a breakdown which lead to further criminal activity as I didn’t care anymore- I even tried ending my life. I am now in recovery and have 2 beautiful kids which are my whole world and reason to get up each morning. I have read that a possible 1 in 10 nurses are suffering from addiction. It seems when doctors abuse drugs they can still practice so why come down so hard on nurses??? If help was available more nurses would seek help and be in recovery but they are terrified of coming forward because of what happened to me. Is it possible for a nurse having suffered from addiction in the UK to resume their career??? I think not.

Lydia @ Addiction Blog
4:29 pm January 14th, 2016

Hi, Joanne. I’m really sorry that you’ve experienced all that. And, I totally agree with you about taking away nurses’ practice while doctors can still work. It’s not fair! I’d suggest you consult somebody who is familiar whit case like yours. Maybe, you can find lawyer or carrier consultant to answer your concern.

Angel
2:44 pm February 2nd, 2016

It has come to our attention that a CNA is a regular user of marijuana and has been smoking pot to control her symptoms of morning sickness. She is pregnant with twins. Any advice on how to proceed?

Lydia @ Addiction Blog
8:47 pm February 16th, 2016

Hi, Angel. That’s harsh… I suggest that you look into the CRAFT model for families and interventions. One NGO called Allies in Recovery has some online reading that can help: http://alliesinrecovery.net/about-craft/

Cheryl
12:30 am April 10th, 2016

I lost everything . I was primary bread winner in my family. I admitted to my employer that I had diverted pecocet from a script a patient brought to the ED and was admitted. I had had treatment twice before and established long periods of sobriety but my fibromyalgia and back pain due to work injur became unbearable. They convinced me to resign and allowed me to self report to the board. I was not able to get my short term or long term disability which I had paid for years. So social security became my only option. Of course that involved a very long wait during which I became unable to afford the urine drug screens the board required for continued licensure so I had to surrender my license . My husband was already on social security. He had been a contractor all his life so he only qualified for 650$ a month so we lost our home we had built as well as a lot of friends. We ended up in a one bedroom apartment with a very small kitchen and bathroom with just a shower. No more warm soaks for me! It was embarrassing and humiliating. It affected everyone in my family negatively. I never did get to go back to nursing. I work 15 hours a week for ten dollars an hour helping elderly and disabled people with their activities of daily living, it is not always a good situation . Though at least I avoided conviction and legal troubles except for bankruptcy . Think long and hard about reporting to your employer unless you know they have a program in place to treat addicted nurses. Doctors in my state do not lose the ability to practice. It is so unfair .

Jodie
3:42 pm January 5th, 2017

I’m a registered nurse in the UK and am currently in recovery on a methadone programme for opiate addiction. Like many other people, my problem developed from using codeine for back pain, initially prescribed for me and ended up 4 years later a raging addict. I stole drugs from work and had to resign whilst under suspicion, iv wrecked my career, I cannot work and am so ashamed that iv ruined not just mine but my families life. I agree with Joanne in that there is no support system in place in the UK to help nurses with this problem. We are just hung out to dry, its a very lonely state

Carol
2:54 am February 21st, 2017

I have been an RN in California for 10 years. I have always been a heavy drinker and recreational drug user. I have never stolen drugs from work nor been intoxicated at work either. However, I feel that my lifestyle of drinking and partying (on my days off) is getting old and want to seek treatment. My only concern is that I’d potentially be reported to the CABRN as a “threat to public health.” Would that happen or could I seek treatment from a psychiatrist or 12-step meetings and not be reported due to HIPPA and confidentiality rules.

Lydia @ Addiction Blog
3:11 pm March 31st, 2017

Hi Carol. I suggest that you call the helpline on the website to speak with a trusted treatment consultant.

Melanie
7:47 pm July 6th, 2017

Hi, I feel like I have many addictions , Alcohol, relationships, benadryl, yes benadryl and now meth. I became involved in a very toxic relationship , he was an active drug user I am an LPN, it began sniffing the meth then I realized he was also doing pain pills and xanax, I tried the pill but made me sick, so I strictly stayed with meth. While I was at work he would text me to bring him home stuff . I guess because I wanted him to love me I would sneak out pills for him . I became heavy in the meth began to shoot it. And because of the come downs I would get sick also … I couldn’t function at work. Felt like I was going crazy with the emotional rollercoaster, I last used on Saturday, he left me .. I’m figuring because I had no more access to the pills. And no more money to pay his bills and habit also. So here I am Alone. Going threw withdrawals if both him and the meth. No job. About to lose my apartment. I let my life spiral away from me. So fast . I’m lost.

Lydia @ Addiction Blog
5:29 pm July 20th, 2017

Hi Melanie. Call the helpline you see on the website to speak with a trusted treatment consultant.

Alyson
4:10 pm October 3rd, 2017

If health insurance is used to pay for treatment, will my employer, a major hospital system, be able to see that I am in treatment? Will I be in jeopardy of losing my job or be subjected to a drug test if they see that I have an addiction issue based on treatment that I’m seeking?

Lydia @ Addiction Blog
3:26 pm October 20th, 2017

Hi Alyson. I suggest that you consult with a person from your health insurance company about your concerns.

Deborah
7:54 pm February 12th, 2018

Please help me with my problem.

Lydia @ Addiction Blog
1:26 pm February 13th, 2018

Hi Deborah. If you have questions about addiction treatment and your options, immediate assistance is available. Call our free hotline to speak with a trusted treatment consultant.

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