In an article by Daniel Angres, M.D., et al. titled, “Nurses with Chemical Dependency: Promoting Successful Treatment and Reentry” (published in The Journal of Nursing Regulation), the authors state the literature on chemical dependency in nurses lags far behind that for other health-care professionals, particularly physicians. “However,” they point out, “with nurses on the front lines of patient care, it stands to reason that their risk of chemical dependence is at least as high as that of other health-care professionals.”
So the question arises, how often does addiction occur in the nursing profession? Kathy Bettinardi-Angres, APN-BC MS RN CADC, a Board-Certified Nurse Practitioner and Certified Alcohol and Drug Counselor, says it’s more often than one might imagine.
“Addiction in the healthcare professions is the same percentage as the general population, approximately 15%… (however) I believe with the opiate epidemic, it would be closer to 20% or 2 out of 10 nurses.”
Given there are an estimated 3 million nurses employed in the U.S., that means approximately 600,000 nurses are afflicted with a substance use disorder.
And while it’s clear that nurses with chemical dependency are endangering the safety of their patients, as well as their own health—not to mention the reputation of their employers and the nursing profession as a whole—the “solution,” according to Angres, et al., to achieve the best possible outcomes for all involved, is to “promptly identify, appropriately treat and, when appropriate, allow (them) to reenter the workplace with stringent monitoring.”
And what, you may ask, is the treatment protocol for a nurse?
Ms. Bettinardi-Angres says, “Treatment for a nurse is optimally in a program with other healthcare professionals. A typical treatment course for a nurse is 6-12 weeks, depending on the severity of the addiction and dual diagnoses, such as anxiety disorder, depression, and so forth.” She adds that the treatment program be “familiar with the intricacies of reentry and monitoring.”
Commonly cited obstacles to treatment with nurses include money and lack of income while in treatment, as well as the fear of legal issues and loss of licensure.
It should be noted, however, according to Bettinardi-Angres, that when “adequately treated and monitored following treatment, the nursing boards are usually open to allowing them to keep their licenses.”
And how possible is it to see nurses with substance use disorders to successfully go through treatment and be able to work in their profession again?
According to an article in American Nurse Today (the official journal of the American Nurses Association):
“…(at least) 37 states offer some form of a substance abuse treatment program to direct nurses to treatment, monitor their reentry to work, and continue their license according to the National Council of State Boards of Nursing. Alternative programs monitor and support the recovering nurse for safe practice. Strong recovery programs offer a comprehensive, bio-behavioral, individualized treatment plan (with) phases including in-treatment or outpatient detoxification in a safe environment; education about the disease; group, individual, and family therapy; and most importantly a relapse prevention program.”
The good news, according to Diana Quinlan, MA CRNA, chairperson of the AANA peer assistance program, “(Treatment) programs that are put together will have an 80% recovery rate and some have a rate as high as 95%.”
Bettinardi-Angres’s advice for nurses who think their friend or coworker may be struggling with addiction, or for anyone who wants to best support them, is this:
“In a nutshell, say something, because death from overdose is a real possibility. Talk to the nurse first, and tell him or her you will accompany them to administration to ask for help.”