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Drug Abuse among Health Care Professionals

Healthcare workers are among the top population for drug abuse. According to the American Medical Association, “The term ‘impaired' is used to identify those members of the medical profession whose performance is adversely affected by drug abuse.”(AMA) Having an impaired heath care worker causes harm to not only them, but puts the client at a higher risk for death. Drug impaired health care workers jeopardize lives every day by working under the influence. This paper will discuss the following topics among health care professionals with drug abuse, the underlying factors, instances of harm related to drug abuse, the statistics of who abuses, and what to do if someone suspects abuse. This paper will in hope give a better view of how to lookout for substance abusers and how to help them admit they have a problem.

Drug abuse in health care professionals is an ever growing epidemic. Healthcare workers are just as likely as any other human to use substances in a manner not legal. There are many factors that persuade them into taking drugs. Drug abuse can be summarized into taking a medication without a prescription, taking more than the recommended prescribed dose, or the abuse of over the counter medications to the point of impairment. Due to the shortage of medical professionals such as nurses, the nurse to patient ratios are growing more and more as the baby boomers retire out. This is putting a substantial amount of work load on to the nurse and causing mistakes to increase. The shortage of nurses also has an increase in stress due to the amount of hours worked. Instead of the normal nurse working a 12 hour shift, it might be necessary to work a 24 hour shift to cover the shift of the night nurse that didn't come in. This increases the risk for abuse to try and stay awake or deal with the depression of not being able to go home. More nurses today are taking stimulants to stay awake to provide patient care. These stimulants put the nurse and patient at risk because of the unwanted side effects such as nervousness, being jittery or dizzy and causing seizures or respiratory depression if too much is consumed. “Substance abuse is the number one reason named by state boards of nursing for disciplinary action.”(Hrobak) In the state of Oklahoma, if a nurse is suspected of abuse, they must go before the state board in a court appearance, more than likely to have they license revoked, until otherwise proven efficient to work. Other factors to include are, a history of family drug abuse, history of domestic violence, and peer abuse, with many other factors.

There a many instances when an impaired health care worker causes harm to the patient and themselves. They can put an entire hospital at risk without even realizing what they are doing. “A string of mysterious infections at a hospital from 1998 to 1999 were traced to a most unexpected source, doctors are reporting today: a respiratory therapist who is suspected of having used a needle and syringe to steal a narcotic from the bags of intravenous medicine that were hanging by the bedsides of critically ill patients. The therapist is believed to have contaminated the medications while tapping into them.” (Grady)

Bringing in an infection to a hospital can cause everyone grief and patients a higher hospital bill for trying to rid the infection if it doesn't overtake them first. When a health care worker is under the influence many different accidents can happen. Major threats to all healthcare workers are the risk of needle stick injuries. They can inflict a disease of the patient to themselves or pass it on to other patients if not careful with “dirty” needles they use. A major risk disease that is cautiously monitored in hospitals is AIDS, HIV, and Hepatitis. Without careful monitoring of used patient supplies, more infections can be passed throughout an entire hospital without even realizing. When someone is working under the influence, they lose control of the full power of the brain and accidents are more likely to occur.

Drug abuse can happen to many other people other than nurses as well. Doctors are just as likely to do the same thing. The following is a medical malpractice case against a doctor. “A former doctor who admitted he was abusing prescription drugs agreed to settle the medical malpractice lawsuit against him in St. Louis County court this week. The patient, John W. Campbell, accused Michael Impey of putting a hole in his colon during a medical procedure in 2006. About a foot of Campbell's colon was removed as a result of the injury. Impey, who lost his medical license soon after the incident because he was abusing pain pills, agreed to settle Tuesday for an undisclosed amount.” (Malik) Without thinking of the consequences of a little abuse, it can cause professionals to lose their license and perhaps never be able to practice again. This doctor might have not been aware of the harm he was causing until it was too late to do anything. By that time, most abusers try to cover up mistakes so attention is not brought to them.

There are many different statistics used today to describe the amount of professionals relying on drugs to get through an average day of work. There are four major types of drug abuse, alcohol, nicotine, drugs, and inhalants. They can be broadened out into a bigger scope of legal and illegal drugs. Drugs are often times noted as illegal due to the fact that when the abuser deviates away from the proper use of the medication and takes it how they feel will get a better high. Herbal medicines are sometimes considered to be a drug, such as marijuana, but it has not been FDA approved so therefore takes on the name as an herb.

This following is a study conducted using physicians, According to addictionsearch.com “In a study conducted by Cicala (2003) 8% to 12% of physicians were estimated to develop a substance abuse problem.”(Cicala) This could easily be described as they have a license to dispense almost any type of medication and the readily availability of drugs. Anesthesiologists, well known for putting patients under during surgical procedures, are among the top physicians that abuse drugs. They have access to some of the most powerful narcotics and gases that are available and legal to use.

Some Dentists are also considered abusers do to the fact that they use nitrous oxide, laughing gas, during procedures, and often times huff it while alone to relax. Nitrous oxide is still considered a prescription because it has to have an order to use it and a license to buy or dispense it. The stress of taking care of another human being and being responsible for life or death choices is not a career for everyone, and they believe can be fixed by getting a high off of narcotics and other drugs. Occasional use of drugs in small dozes can eventually lead to the addiction of large quantities of drugs several times a day to get the euphoria one is seeking.

Nurses are an ever growing field with more than 2.9 million in today's society. The underlying factors associated with work stress and burn out are increasing with nurses. According to addictionsearch.com “Trinkoff and Storr (1998) conducted an investigation where substance use was studied among nurses. Thirty two percent of 4,438 respondents indicated some substance abuse.”(Tinkoff and Storr) Nurses are constantly working around narcotic and non-narcotic prescriptions on a daily basis. They are the ones who pass out routine medications to their clients and are responsible for the administration of those medications.

Often times it has been noted that those sometimes prn (as needed) medications rarely make it to the clients mouth, but to the nurses. With easy access to medication rooms on the floor the nurse is working, it is easy for some nurses to be tempted to take a few extra pills or capsules and not note it otherwise. Since many healthcare workers take on the term as a professional, it is never expected for one to abuse substances. Society views health care workers as the ones that know everything about health and how to stay healthy, so it puts that extra stress of society's view onto their daily lives.

According to The Journal of Oncology Nurses “One study reported that the prevalence of use for all substances among nurses was 32%. Compared with nurses in women's health, pediatrics, and general practice, emergency nurses were 3.5 times as likely to use marijuana or cocaine, oncology and administration nurses were twice as likely to engage in binge drinking, and psychiatric nurses were most likely to smoke.” (Tariman) Emergency nurses rate so high in abuse due to the substantial amount of stress that experience with trauma and death in the emergency room.

When someone suspects drug abuse, the worst thing one could do is not report it to the administrator or charge nurse, following the chain of command. Most healthcare workers will first go through a series of denial, not wanting to admit they have a problem until they are convinced they need help. Sometimes it is hard to recognize an impaired healthcare worker because they know how to hide the signs and symptoms, although many professionals can still detect the signs of substance abuse. Some signs of drug abuse could be volunteering extra time to work, staying late, volunteering to pass out medications to a patient not belonging to the professional, wasting more drugs than previous workers, orders to the pharmacy for large quantities of narcotics, and isolation to a confines area just to name a few of more than hundred signs available.

In today's society there are many programs available to help health professionals not abuse substances. According to an article by Straight Talk, “Many states have developed alternative treatment programs for nurses rather than immediately taking their license. Thirty-nine states developed programs to channel nurses into treatment and recovery, monitor their return to work, and protect their license.” (Tariman)

Oklahoma is one of those thirty-nine states enrolled to help nurses. The Oklahoma Board of Nursing has recently started a new program entitled Peer Assistance. “The Oklahoma Peer Assistance Program (OPAP) is a voluntary, confidential program, which assists licensed nurses whose competency may be impaired due to substance abuse and/or chemical dependency. We provide a structured, voluntary program that facilitates a recovering nurse's return to safe practice, thereby protecting the public.”(Oklahoma Peer Assistance Program) The Peer Assistance program directs individualized care focused to each participant as well as encouragement and support in hopes of persuading them into the right direction.

The Oklahoma State Department of health has incorporated a program directed towards assistance as well. The program is entitled The Oklahoma Department of Mental Health and Substance Abuse Services (ODMHSAS). “Among these programs' offerings are assessment and referral, detoxification, outpatient counseling, residential treatment, substance abuse education, transitional living, and aftercare services.” (Substance Abuse Services). They have a main target of prevention of drug abuse by giving classes to at risk abusers but can also help in the treatment of it. With all the help available to healthcare workers, substance abuse shouldn't be hid, it needs to be reported and brought to the abusers attention before things can add up and take a turn for the worse.

Healthcare professionals are among the top population for drug abuse. Frequent drug screening and accurate drug counts are just two of the many ways to help control this rising problem. No one wants an impaired practitioner helping in there healing process. It is harmful for the professional and also the patient. Drug impaired health care workers jeopardize lives every day by working under the influence.

This major problem can be stopped by having someone speak up when they notice signs of abuse. Now days many programs are available if the abuser wishes to seek help in stopping the problem before it goes too far. This paper has discussed the following topics among health care professionals with drug abuse, the underlying factors, instances of harm related to drug abuse, the statistics of who abuses, and what to do if someone suspects abuse. In describing the signs to look for, different types of treatment available, and factors leading to substance abuse, it can be up to the everyday population to help recognize these people and help them get help before it puts loved ones lives and self lives at risk.

  • Cicala, R.S. (2003). Substance abuse among physicians: What you need to know. Hospital Physician, 39(7), 39–46. http://www.addictionsearch.com/treatment_articles/article/substance -abuse-among-healthcare-professionals_49.html>
  • Denise, Grady. "Outbreak of Hospital Infection Is Tied to Worker's Drug Abuse." New York Times 16 May 2002, New York.: 16. Print. <http://www.nytimes.com/2002/05/16/us/outbreak-of-hospital-infection-is-tied-to-worker-s-drug-abuse.html>
  • Hrobak, Mandy. "Narcotic Use and Diversion in Nursing." University of Arizona College of Nursing. 06 January 2009. University of Arizona College of Nursing, Web. 3 Nov 2009. <http://www.juns.nursing.arizona.edu/articles/Fall%202002/hrobak.htm>.
  • Malik, Shezad. "Dallas Fort Worth Injury Lawyer Blog." Medical Malpractice Trial Over Addicted Doctor Begins . Dallas Fort Worth Injury Lawyer Blog , 27 July 2009. Web. 4 Nov 2009. <http://www.dallasfortworthinjurylawyer.com/2009/07/medical_malpractice_trial_over.html>.
  • "Oklahoma Peer Assistance Program." Oklahoma Board of Nursing. 2008. OBN, Web. 28 Oct 2009. <http://www.ok.gov/nursing/peer.html>.
  • "Substance Abuse Services." ODMHSAS. 20008. Oklahoma, Web. 28 Oct 2009. <http://www.odmhsas.org/subab.htm>.
  • Tariman, Joseph. "Understand Substance Abuse in Nurses." 22.8 (2007): 18.EBSCOHOST
  • TCHP, . "Substance Abuse in Health Care Professionals." TCHP Education Consortium. 2006. TCHP Education Consortium, Web. 8 Nov 2009. <http://www.tchpeducation.com/homestudies/generalinterest/substance_abuse/substanceabuse_webbook2009.pdf>.
  • Trinkoff, A.M., & Storr, C.L. (1998). Substance use among nurses: Differences between specialties. American Journal of Public Health, 88, 581–585. <http://www.addictionsearch.com/ treatment_articles/article/ substance-abuse-among-healthcare-professionals_49.html>

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