The Rise In Substance Addiction Among Nurses

In the last year or two, studies have indicated a rise in substance abuse among nurses, especially emergency room (ER) and specialty nurses.

Drug addiction can lead to drug use on the job, which can jeopardize patient care and nurses’ careers. Encouraging treatment helps nurses get the care they need.

Prevalence Of Substance Abuse Among Nurses

Studies show a statistical difference between nurses who use or misuse illicit or prescription drugs and substance abuse rates among the general population.

A study published in the Journal of Nursing Regulation shows that 5.7% of nurses surveyed use illicit drugs and 9.9% abuse prescription drugs.

Additionally, the study shows that substance abuse rates are at 15.8% among nurses working in nursing homes and 19% among nurses working in home health and hospice.

Other studies have found that nurses in ER departments also show higher substance abuse rates than the general population.

Substances Typically Abused By Nurses

Among the substances that are typically abused by nurses, prescription drugs were high on the list, including opioids. Alcohol use was also particularly high among nurses.

Other substances abused by nurses include:

ketamine
heroin
benzodiazepines
marijuana
cocaine
methamphetamine

Some of these substances, such as prescription opioids, can be obtained by nurses while on the job.

Nursing Risk Factors That Can Lead To Substance Abuse

There are many risk factors nurses face for experiencing high levels of stress and poor mental and emotional health, which can lead to substance use.

The stress of taking care of patients day after day and ensuring their safety is just the beginning of the mental and emotional strain nurses are under.

They may have to deal with unhappy patients and their family members and pressures from doctors and other medical professionals.

Additionally, nurses may have to endure:

an excessive workload
night-shift work
travel
sleep deprivation
shortages of available nurses

Other risk factors for substance abuse may include experiencing personal or relational problems at home or enduring an injury that leads to being prescribed opioids for treatment.

These risk factors may have a cumulative effect, creating feelings of depression, anxiety, low self-esteem, or resentment.

ER And Specialty Nurses

ER and specialty nurses are often subject to even higher levels of stress because of the requirements of their particular positions.

On a daily basis, ER nurses must deal with a fast-paced environment, which includes the consequences of having to make quick decisions.

They also deal with the trauma that can come from treating patients who may have terrible pain and be suffering from fatal or near-fatal injuries.

The Effect Of The Pandemic On Substance Abuse Among Nurses

The stark reality of being a frontline worker during the COVID-19 pandemic has also contributed to increased stress and emotional strain on nurses.

It may have become more tempting during this time for some nurses to turn to alcohol or illicit drugs to alleviate the emotional toll.

Emotional Strain On Frontline Workers

During the pandemic, many of the typical stresses involved in the nursing field were amplified. This includes staffing shortages, for example. Critical care units were often overwhelmed.

The daily strain of trying to help people with a serious and potentially fatal illness was intensified by the many unknowns that COVID-19 presented, especially early on but continuing today.

Burnout

Extra work, long hours, and the intensified strain of seeing more patients suffer and, in some cases, die led to burnout for many medical professionals.

Nurses and other healthcare providers needed to take time off to tend to their mental health but were unable to do so because hospitals were overwhelmed.

Staffing Shortages

Staffing shortages meant that when more nurses were needed, there were fewer available than what was required.

Some nurses contracted COVID-19 themselves or for other reasons self-quarantined at home. Others stayed home to provide care for their children or other family members.

The reality of having many patients requiring care and too few nurses to do the job only intensified the helplessness of those who continued working.

Signs Of Substance Abuse Among Nurses

There are several signs that a nurse may be experiencing a substance use disorder, including some that are specific to this demographic because of nurses’ access to prescription drugs.

Drug Diversion

Nurses might obtain prescription drugs for their own use and cover up the “loss” of drugs in several ways.

Signs of this kind of drug diversion may include:

“corrections” on medical records to make original notations of what was used look like a mistake
altered orders for drugs
higher-than-average administration or wastage of opioids
patients complaining of poor pain relief
discrepancies involving a controlled substance

Drug diversion may be a felony but is also an indication that a nurse needs help.

Signs Of Impairment While Working

If nurses are using drugs or alcohol during work to cope with stress, it will likely show in their work.

Signs of drug use on the job may include:

disheveled appearance
constricted or dilated pupils (depending on the use of depressants or stimulants)
defensiveness
accident prone
difficulty controlling anger
fatigue
bloodshot eyes
distracted
slurred speech
unexplained nausea or vomiting
needle marks on the skin

Note that many of these can also be signs of stress and don’t necessarily indicate drug use on the job.

There are additional signs to look for when concerned that a nurse may be experiencing a drug or alcohol addiction.

Signs Of A Substance Use Disorder

A nurse who has a substance use disorder may also show signs of it at work.

These signs may include:

repeated tardiness
unexplained absences
moodiness
poor work performance
excessive sick time
leaving work early
offering to medicate patients
increased sign-outs of opioids

If a nurse you know is showing these signs, consider bringing to their attention that you have noticed this and are concerned about them.

Keep in mind that an additional sign of addiction is the inability to stop using the substance despite negative consequences.

Barriers To Diagnosis And Treatment For Nurses

While it would seem obvious that treatment needs to be made more readily available to nurses facing drug and alcohol addiction, there are barriers to that treatment.

Anecdotal evidence shows that enrollment of nurses in alternative-to-discipline programs has flatlined or, in some areas, even declined.

Stigma In The Medical Field

Studies have pointed to stigmatization in the medical field of people who use drugs. For example, one study found that nursing students were the least tolerant of people with substance use disorder when compared with people in other fields.

Another study of people who use drugs intravenously found that about 78% of participants felt stigmatized at least once in their interaction with medical professionals.

When nurses have a substance use disorder, they experience their own stigma, which can result in strong feelings of shame and guilt.

Feared Repercussions Of Seeking Treatment

There are also very real repercussions when seeking treatment. Nurses who admit to substance abuse, especially if it involves stealing and using hospital medications, could lose their jobs and have their licenses revoked.

There are stories of nurses who endured the pandemic, received substance abuse treatment, and achieved sobriety with the support of their colleagues.

But not all stories turn out that way. Some hospital administrations are less forgiving than others, focusing instead on the immediate risks to patient care involved.

Treatment For Nurses Overcoming Addiction

Treatment for substance abuse is available to nurses and other medical professionals. In fact, some addiction rehab centers offer treatment programs specifically for frontline workers.

These programs focus on trauma-informed care as a way of therapeutically helping nurses and other frontline workers deal with what they have experienced on the job.

Alternative-To-Discipline Programs

Alternative-to-discipline programs are just what their name implies: programs that offer treatment as an alternative to disciplinary action, such as being fired or losing licensure.

Often, this is what it takes for nurses to receive care. One recovery center said that 90% of nurses who seek addiction treatment with them do so only after a legal or work issue, like driving under the influence or diverting drugs.