Magazine article Addiction Professional

Nurses Fighting an Opioid Crisis from Within: With Easy Access to Potent Drugs, Autonomy and High-Stress Work, Nurses Face Temptation to Abuse or Divert Medications

Magazine article Addiction Professional

Nurses Fighting an Opioid Crisis from Within: With Easy Access to Potent Drugs, Autonomy and High-Stress Work, Nurses Face Temptation to Abuse or Divert Medications

Article excerpt

While nurses join other healthcare providers in battling the opioid epidemic on the front lines by caring for patients with overdoses or chronic substance use, they also are fighting a more private struggle.

With easy access to potent drugs and the autonomy to practice with minimal supervision, coupled with the realities of a highly demanding and stressful job, nurses might be tempted to abuse or divert the medications they steward for their patients. What's worse is that with so much to lose, nurses might not get help until the problem hurts their patients or themselves.

In these cases, state boards of nursing are tasked with regulating licenses and addressing problems such as substance use when they occur. Nursing boards typically take a non-punitive stance in cases of problematic substance use, offering nurses an opportunity to get treatment for their disorder and retain their license. However, criminal charges can be filed by hospitals, employers or patients for neglect, theft or other issues associated with substance use or diversion among nurses.

EXTENT OF PROBLEM

The American Nurses Association estimates that as many as 15 % of registered nurses may be fighting a substance use problem or are in recovery. While substance use problems aren't necessarily more prevalent among nurses than in the general population, the issue takes on a different form among nurses because of how accessible controlled substances are to the profession.

A 2015 report published in Substance Abuse revealed that out of300 nurses participating in a health assistance program, almost half admitted in an anonymous poll to drug or alcohol use at work, with 40% acknowledging that the use affected their professional competency.

In addition, about 60% of respondents said their problem could have been detected earlier, and that they didn't seek help out of embarrassment and fear over losing their nursing license.

Finding ways to improve early detection and intervention is the goal of the Missouri State Board of Nursing. Mariea Snell, assistant professor and faculty coordinator of nursing at Maryville University and vice president of the state nursing board, is working to move beyond the traditionally reactive way of handling substance use problems among nurses.

Missouri has been collecting data on how and when substance use-related infractions among nurses occur, Snell says, and is working to provide analysis that will help identify trends and potential prevention and treatment interventions.

"There's the thought that we're seeing this more only because we're able to detect it more," says Snell. "This kind of problem is a combination of things. We have more opioids on the market and more access to them. And we have the technology now that detects them more frequently. I don't believe necessarily that this is a new phenomenon. It's just sort of a perfect storm of access and ability to detect."

A nurse's problems with substance use or diversion are already in full swing by the time they reach the attention of the state board, Snell says. While states have been collecting data on numerical trends, little has been done on what factors might contribute to substance abuse and diversion among nurses, and what preventive measures might be taken. …

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