Exploring High Rates of Substance Abuse in the Nursing Community

Examining high rates of substance abuse in nursing.

As Recovery Unplugged continues to observe Nurses Week, we would be remiss if we didn’t take an opportunity to discuss the incredibly high rates of substance abuse in the nursing community, as well as its daily and long-term impact on nurses, their patients and their colleagues. Rather than cite abstract stats and faceless figures, we sat down with a nurse who has lived the nightmare of addiction and has found his way to recovery.

Jon Story has been a nurse for over 25 years. His addiction began in 2000 when he was working as an ER nurse: “In the Emergency Room, my addiction really took off. I had just come out of the closet as gay, and I was having all kinds of identity crises.” Jon began seeking acceptance outside of his career, and started doing ecstasy to escape his mental distress. “The next thing I knew, I was getting introduced to more and more drugs…the using progressed to opiates, and that’s when the diversion started to happen.”

Like many in the nursing profession who have succumbed to substance use disorder, Jon soon found a means to satisfy his addiction right in his place of business: “I began stealing drugs from the hospital where I worked.” Jon’s use became more frequent over the following years, despite several disciplinary actions the hospital had taken against him in an effort to deter his behavior. Like many nurses facing addiction, he was assigned to an IPN program, or the Intervention Project for Nurses.

What Is The IPN?

IPN is a five-year program that requires random drug screens, regular attendance at support group meetings, and mandatory quarterly reports from the employer. Although the IPN and other similar state programs have proven effective in many cases, it is often not enough for nurses in Jon’s position. “I was going to these IPN meetings, but I really wasn’t clean.” In fact, the strict requirements of the program only made him want to use more, and his attempts to disguise his addiction grew more desperate. “I was using other people’s urine to pass my drug screens, as well as anything and everything to avoid getting better.”

Unfortunately, Jon’s story isn’t uncommon in the nursing community. According to USA Today, “More than 100,000 doctors, nurses, technicians and other health professionals struggle with abuse or addiction, mostly involving narcotics such as oxycodone and fentanyl,” and the problem only seems to be getting worse. One study suggests between 14 percent and 20 percent of all RNs in the US have a problem with dependence; that means one out of every six nurses has a problem with substance abuse.

Why the High Rates of Substance Abuse in Nursing?

One theory in the nursing community is the demanding nature of the job. Various studies suggest “nurses are especially vulnerable to addiction to prescription drugs because of work-related stress” (Lippincott Nursing Center, Addiction: an Occupational Hazard in Nursing). According to a commonly cited study by The US National Library of Medicine, emergency room nurses were 3.5 times more likely to use marijuana or cocaine, while oncology nurses were twice as likely to engage in binge drinking when compared to other specialties. When asked about the link between nursing and substance abuse, Jon explains, “I think [substance abuse] is more prevalent in any stressful job…I used to believe I could get through back to back 16-hour shifts if I needed to because I numbed all feeling, so I could just work like a robot.”

The prevalence of stress and substance abuse in nursing is certainly evident, and while the amount of stress nurses endure is unquestionable, many believe it is the accessibility of the drugs that leads nurses to begin using. “If you are an ER or OR nurse, you have a ton of access. We give a lot of pain medication. You can be at the Pyxis (medication dispenser) five or six times an hour, just pulling meds. Nursing, especially in the ER and OR is incredibly fast paced,” explains Jon. “There is limited supervision, and nurses are required to be independent in their practice. This can create a very dangerous situation,” he says…”especially for a stressed out, sleep deprived nurse.” Although medication is typically monitored and counted by an automatic drug station, this does little to stop diversion.

A Systemic and Increasingly Urgent Problem

Jon knew several other nurses who were diverting drugs from the hospital where he worked, “it becomes very evident when other [nurses] around you are using”. However, the majority of nurses he knew who were using outside of his IPN program were never caught. Although the number of unreported drug diversion cases is unclear, Jon, among others, believes the number of nurses under the influence is higher than what the statistics suggest. Many hospitals fail to report drug diversion by their staff due to fear of negative publicity, fear of federal involvement and even uncertainty regarding reporting requirements. Nurses are equally afraid to report cases of abusing narcotics due to the mere severity of the disciplinary actions.

Jon explained that along with his five-year IPN requirement, he had to pay a $3,800.00 fine, complete drug screens, and had quarterly reports submitted by his employer. But Jon was lucky- if the Department of Health had decided to pursue felony charges, the punishment would have been far worse- high fines of up to $25,000.00 for both Jon as well as his employer, a revoked license and even imprisonment (up to four years). However, regardless of the severity of punishment decisions, after nurses redresses their case, the disciplinary actions remain on their license, making it virtually impossible to secure future employment in the medical field.

Jon’s Story Goes On…

Jon now has seven years of uninterrupted clean time. He completed his MS in Nursing and was promoted to director of education at his current place of employment, among a myriad of other accomplishments and awards. Though Jon has moved on and is now considered a role model by his peers, the collateral damage of his past will forever remain on his nursing license…a constant reminder of the man he used to be.