Throughout my career as a nurse, I’ve cared for many individuals who are addicted to opioids. When you’re a nurse caring for patients, you can kind of forget that nurses are just as likely to fall into addiction as anyone else. While nurses are no more likely than the general population to struggle with addiction, nurses have a unique situation in that we have a high-stress job with very regular access to medication.
I’d like to provide an informational post for support, encouragement, and resources to any nurse out there who may be struggling with addiction.
I had the honor of interviewing Kathy Bettinardi-Angres, APN-BC MS RN CADC. She is a Board Certified Nurse Practitioner and Certified Alcohol and Drug Counselor. She is currently the Director of Multidisciplinary Assessments, a Family Therapist and the Psychiatric Mental Health Nurse Practitioner for Positive Sobriety Institute in Chicago, Illinois.
I’m a Nurse and I’m Addicted
How common is addiction in the nursing profession?
“Addiction in the healthcare professions is the same percentage as the general population, approximately 15%. Though this is an estimate calculated in the 1980’s and I believe with the opiate epidemic it would be closer to 20% or 2 out of 10 nurses.”
I did a little research and found similar numbers calculated in the 1990’s and again in the early 2000’s that substantiated Kathy’s estimate. If 20% of the 3 million nurses in the nurses in the US is roughly 600,000 nurses struggling with addiction.
Here is a really great article that is quite comprehensive, entitled Drug addiction among nurses: confronting a quiet epidemic.
Is there a typical road to addiction with nurses you see?
“There is typically a ‘magical connection’ feeling an individual has, plus access to powerful drugs, and/or a family history and stressors in their life. Another individual would not be able to predict accurately which nurse is most susceptible, however. Also, nurses attracted to the adrenaline of ICU’s and ER’s are at higher risk.”
What does treatment look like for a nurse?
“Treatment for a nurse is optimally in a program with other healthcare professionals. In the 1980’s and 1990’s, nurses and physicians were always treated together, along with pharmacists, and so forth. Lately, nurses have not been financially able to afford professional programs, which are longer in length of stay and usually residential. 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. A lot of treatment programs say they treat nurses and are not familiar with the intricacies of reentry and monitoring.”
What is the most common barrier to treatment you see with nurses in particular?
“Money and lack of income while in treatment.”
If a nurse expresses to their employer that they are struggling with addiction, can they face legal issues?
“Yes to legal issues. Some organizations will press felony charges if the nurse diverts (see definition below). Regarding loss of licensure, if a nurse admits they have a substance use disorder, is adequately treated and monitored following treatment, the nursing boards are usually open to allowing them to keep their licenses.”
Kathy co-authored this extremely detailed article published by the Journal of Nursing Regulation entitled, Substance Use Disorders and Accessing Alternative-to-Discipline Programs which really dives deep into the disciplinary process, alternatives, treatment standards, and confidentiality.
Definition of drug diverting/drug diversion: Drug diversion is a medical and legal concept involving the transfer of any legally prescribed controlled substance from the individual for whom it was prescribed to another person for any illicit use. The term comes from the “diverting” of the drugs from their original licit medical purpose.
Have you seen nurses successfully go through treatment and be able to work at the bedside again?
“Absolutely. If their drug of choice is a narcotic, and especially if they have diverted, they are asked to not work with narcotics for a period of at least a year.”
According to this article, published in American Nurse Today, the Official Journal of the American Nurses Association,
“Currently (2011) 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. The phases include in-treatment or outpatient detoxification in a safe environment; education about the disease; group, individual, and family therapy; and most important a relapse prevention program. However, boards of nursing have a responsibility to safeguard the public, so they may suspend the nursing license of an identified impaired nurse if they suspect he or she may pose a danger to patients.”
Do you have any success stories you can share?
“Many many success stories. One that comes to mind is a nurse in school for her nurse practitioner degree, she wanted to be a nurse since pre-school. She diverted and came to treatment. She followed all recommendations and is now completing school and has several job offers.”
Kathy co-authored another amazing article which was originally published in the Journal of Nursing Regulation entitled, Nurses with Chemical Dependency: Promoting Successful Treatment and Reentry. The article states, “few reliable studies exist on nurses’ recovery success rates (abstinence after 2 years) after reentering the workplace. The California Nurse Diversion Program includes 1,000 nurses who successfully returned to work (Grauvogl, 2005). According to Diana Quinlan, MA CRNA, chairperson of the AANA peer assistance program, “programs that are put together well have an 80% recovery rate and some have a rate as high as 95%” (pg. 20, 2003)”.
What advice can you give to nurses who think their friend or coworker may be struggling with addiction who want to support them?
“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.”
If a nurse is looking for treatment options, what are things they need to consider when looking at different programs?
“Length of time treating nurses, publications, experience. Many programs will say they are professional programs and the nurse arrives for treatment and she is the only healthcare professional. Check out Physician Health Programs or National Organization of Alternative Programs, an organization that in a national resource.”
More great resources:
- What You Need to Know About Drug Diversion in Nursing from the NCSBN
- Nurse Beth wrote a great article about drug diversion in nursing.
- Kentucky Alternative Recovery Effort for Nurses brochure (even if you’re not in Kentucky, it’s helpful to see the kind of resources that are available!)
The most comprehensive resource I found:
- Peer Advocacy for Impaired Nurses – this site has a state by state list of available resources for nurses
If you are a nurse struggling with addiction, I hope this post provided some practical information for next steps. If you know someone who is struggling, check out some of these resources, support them, and encourage treatment. If you have struggled with addiction yourself and would like to share your story, please contact me.
I really want to thank Kathy for taking the time to answer these questions! To learn more about her, check out her bio on the Positive Sobriety Institute. I also want to thank the team at the Positive Sobriety Institute in Chicago, Illinois who specialize in treating healthcare providers who struggle with addiction. Your time and expertise were greatly appreciated in compiling this post.