Prescription Drug Use Among Nurses

Being a nurse is high-pressure job, and like anyone else, nurses are not immune to addiction. They may find themselves turning to substances for coping with stress or for self-medication of pain. It is estimated that 1 in 10 nurses abuse drugs or alcohol, which is about the same rate of substance abuse in the general public.¹ There is, however, a key difference in the types of drugs that are abused.

Due to their greater access to drugs, nurses are more vulnerable to developing an addiction to prescription medications. Drugs commonly abused by nurses include benzodiazepines and opioid painkillers such as fentanyl and hydrocodone. Nurses with the easiest access are most likely to misuse prescription drugs, with the highest rates of abuses found among nurse anesthetists.²

Some of the reasons why a nurse may abuse substances include:³

• Stress
• Anxiety
• Physical pain
• Exposure to health dangers (infectious materials, radiation, chemicals)
• Conflicts with colleagues
• Lack of support and nursing staff shortage
• Emotional exhaustion
• Work overload
• Lack of task autonomy and feedback
• Reduced advancement opportunities
• Night shifts and rotating shifts
• Excessive overtime
• Fatigue
• Burnout
• Exposure to death and trauma
• Depression
• Feeling immune to negative consequences because of familiarity with drugs

In today’s evolving healthcare system, doctors are being pressured to increase the number of patients they treat. Consequently, nurses are burdened with having to perform more tasks traditionally performed by doctors, resulting in even more work-related stress. This added workload, combined with grueling schedules and easy access to addictive medications, creates the perfect storm for addiction in nurses.

Nurses and Prescription Drug Diversion

Nurses most commonly obtain prescription drugs through drug diversion, which is defined as the unlawful channeling of regulated pharmaceuticals from legal sources to the illicit marketplace.⁴ Nurses will typically divert drugs by one of the following methods:⁵

• Using the discarded portion of a drug for personal use
• Removing some of the excess drug from as-needed medications
• Not administering the drug to patients
• Administering a substitute substance (such as saline) to patients

Drug diversion jeopardizes patient care and safety and exposes hospitals and other healthcare organizations to legal issues, financial loss, and damaged reputations.5 Just recently, the Centers for Disease Control and Prevention reported that opioid drug diversion by nurses was responsible for an outbreak of hepatitis C transmission affecting several patients.⁶

Treatment

A large barrier to nurses seeking help for their addiction is fear of the consequences, including the possibility of losing their jobs, healthcare licenses, and livelihoods. Fortunately, many states have devised programs to facilitate the process of nurses seeking and receiving help for their prescription drug abuse.

Through these alternative-to-discipline programs nurses can avoid disciplinary actions, including criminal charges, if they complete adequate substance abuse at a treatment center and undergo required monitoring and periodic drug screening.

Seeking help from an addiction treatment center that specializes in treating nurses with substance abuse can be very effective in creating a successful path to sobriety.

Sources

1. Kunyk, D. (2015). Substance use disorders among registered nurses: prevalence, risks and perceptions in a disciplinary jurisdiction. Journal of Nursing Management, 22(1), 54–64.
2. American Association of Nurse Anesthetists. (2016). Addressing Substance Use Disorder for Anesthesia Professionals.
3. Moustaka, E. & Constantinidis, T.C. (2010). Sources and effects of work-related stress in nursing. Health Science Journal, 4(4), 210-216.
4. Wood, D. (20158). Drug diversion. Australian Prescriber, 38(5), 164–166.
5. Perry, J.C., & Vandenhouten, C.L. (2019). Drug diversion detection. Nursing Management, 50(2), 16-21.
6. Njuguna, H.N., Stinson, D., Montgomery, P., Turner, N., D’Angeli, M., Carr,. J, … & Moorman, A. (2019). Hepatitis C Virus Potentially Transmitted by Opioid Drug Diversion from a Nurse – Washington, August 2017-March 2018. Morbidity and Mortality Weekly Report, 68(16), 374-376.