Drug Abuse Among Medical Professionals Research Paper

DRUG ABUSE AMONG MEDICAL PROFESSIONALS 1

Drug Abuse Among Medical Professionals

Jennifer Maddox

JSU

Concepts of Chemical Dependency

Fall 2012


Abstract

Addiction is treatable disease. When thinking of those that

partake in drug abuse, people often do not stop to think that

people that are professionals that other people have entrusted

with literally with their lives. A person’s occupation does not

mask them from becoming stressed out or experiencing issues that

could lead them to turn to abusing substances. Health

professionals are still humans and still fall subject to

experiencing everyday life. These same people that perform basic

care to individuals, diagnose diseases, perform surgeries, decide

which medications you need to take to assist you with medical

issues, administer medications, etc. to you or your loved ones

still experience dilemmas in life and are not immune to having a

substance abuse addiction or issue. While there is no conclusive

evidence suggesting that the risk of addiction among medical

professionals is any more prevalent than those not associated

with the medical field, it is still very important that as a


nation, the issues involved with medical professionals and

substance abuse be evaluated. The object of this paper is to

take a look at the dynamics associate with medical professionals

and illegal drug use.

Drug Abuse Among Medical Professionals

Before looking into the dynamics of medical professionals

and drug abuse, the work that medical professionals do should be

defined. Nurses, physicians, and support staff have the

responsibility to caring for others and are trusted by the

associates of their patients to take care of their loved ones


beyond the best of their ability. These professionals have more

than likely chosen their career because they believe themselves

to be strong individuals that others can rely on to take care of

them. Most of them have a sense of compassion in their heart.

They are generally highly respected individuals. These

professionals generally work long strenuous hours and are subject

to working with those in critical condition. These long hours

and stressful work environments may lead to drug use in order to

handle the anxiety of issues occurring at work or outside of

work. Some may innocently use some drugs to stay awake while

they are at work or to give them a much needed energy abuse to

assist them with staying on top of things at work. At first,

this is looked at by the individual as simply trying to make it

through a shift. However, over time this occasional use turns

into an addiction and the person begins to feel as though he or

she cannot function at work without their drug of choice. People

find it difficult to talk about medical staff abusing substances

because they are looked upon as people that are here to take care

of others and should not be the ones that need to have someone

taking care of them.


Over time, a medical professional may have injuries and

pain from lifting patients. This can be treated with

prescription drugs that are legal and prescribed to a person.

Prescription drugs have proven to be effective, but may easily be

abused often causing people to obtain more medication than what

has been prescribed for them to take. In some circumstances, the

injuries and pain are not reported to doctors out of fear that

the individual will be forced to go on disability and not allowed

to work. In these cases, substances are used initially to blunt

the pain one is experiencing, but the medication only works for a

period of time and more medication is needed to blunt the pain.

Eventually, a person will become addicted and cannot function

without the substance.

Although rewarding in some cases, these same issues related

to the job are actually work-related stressors that may lead to a

medical professional using drugs. These professionals also have

easy access to medications. Nurses and doctors have a vast

amount of knowledge about medications and understand how they

work. People would think that this may deter an individual from

using such substances when in reality, the knowledge actually has


the professional thinking that because they understand the drug,

they can control how and when they use it. This control that an

individual thinks that they have can be quickly altered. The use

evolves into an addiction that the person does not feel they have

because they think they still have it under control. As with any

person, the individual does not generally acknowledge they have

an addiction until it is too late and severe consequences are now

in play. When an addiction sets in, signs and symptoms start to

be on display. Some of the signs that I have personally

witnessed are coming work early or staying late, patients still

remaining in pain when they are reportedly receiving pain

medication, medical staff on edge about minor issues, frequent

breaks while at work, unexplained mood swings, and as needed pain

medication that has been signed out even when the patient did not

ask for it. Some nurses may even notice that a particular

patient never complains of pain, is ordered pain medication as

needed, and seems to always get this medication only when a

particular nurse is on duty. Oddly the medical staff suffering

from an addiction will sometimes blame their behaviors blame

their behaviors on simply trying to be a good employee by coming


to work early to help others out or staying late to ensure that

they have met their patient’s needs for the day. Frequent breaks

may be blamed on a variety of ideas ranging from a urinary tract

infection to claiming they have a personal problem that needs to

be updated throughout the day.

The research on medical staff and correlation of substance

abuse is very limited. “The National Institute on Drug Abuse

estimates that 10% of U.S. adults abuse drugs during their

lifetimes” (National Institute on Drug Abuse, 2012). “The

American Nurses Association (ANA) says approximately 10% of

nurses are dependent on drugs” (The American Nurses Association,

2012). Both of these statistics show that if accurate, there is

no correlation that a medical professional is any more or less

apt to partake in drug abuse. The results are very similar. The

results of ANA’s survey basically states that “one out of ten

nurses are struggling with an addiction” (The American Nurses

Association, 2012). Chait writes that after a large study was

published in 1998, “there are an estimated 40,000 nurses in the

U.S. experiencing alcoholism” (2006). In the same article, Chait

presents that there are “higher rates of smoking among


psychiatric, critical care and emergency nurses” (2006).

Unsurprisingly, there are “lower tobacco use among oncology

(cancer) and pediatric nurses” (Chait, 2006). Other stats

mentioned were the “odds of marijuana use being 3.5 times higher

among emergency nurses, reports of higher cocaine use within the

departments of pediatrics and emergency services, and oncology

nurses reported a higher use of cocaine for all substances

combined” (Chait, 2006). The study also looked into alcohol use

and reported that “binge drinking was the highest among oncology,

emergency, and critical care nurses” (Chait, 2006). The

statistics mentioned in this subject did not find a variance

among departments and prescription drug addictions. The only

evident fluctuation discovered regarded “oncology,

rehabilitation, and psychiatric nurses reporting a tad more

prescription drug abuse than any other specialties” (Chait,

2006). “Although the study noted that drug abuse among nurses

did not vary much percentage wise from the general population,

the types of drug use did vary. Nurses were less likely than the

general population to smoke or take cocaine, more likely to abuse

prescription drugs, and had the same probability to binge drink


as the general population”(Chait, 2006). All studies are

inconclusive because of the lack of information present and

sometimes report different summaries of their findings because of

this misinformation. According to blog post where the author

displayed the name Nurse N. Recovery to remain anonymous, “the

top ten prescription drug medications abused by medical providers

are Ativan, Demerol, Dilaudid, Diprovan, Fentanyl, Morphine,

OxyContin, Percocet, Vicodin, and Xanax” (Recovery, 2011c ).

These medications fall into the categories of sedatives, opiates,

and benzodiazepines. Recovery continues to state that

“anesthesiologist abuse sedatives the most” (2011c). The

statistics on medical professionals are generally inaccurate

because medical professionals are not willing to state that they

have a problem. Medical professionals fear that if they come

forward to admit that they have an addiction, they will lose

their license as well as their career. Losing a licensure over a

drug abuse problem is a major embarrassment in any field. Issues

associated with drug abuse among employees are supposed to be

confidential. In many cases, administration will keep the issue

confidential. The problem generally lies within a staff member


telling another staff member their issue with the expectation

that the trusted staff member will not mention the issue to

others. In situations such as these, the staff member is

required to report the conversation and is not bonded to keep the

issue a secret. However, if administration is notified of the

issue, all actions taken to deal with the issue are to be

confidential. There is a fear among medical professionals that

their reputation will be ruined if the public discovers their

issue. They often not only worry about their reputation, but

malpractice suits that patients may bring forth upon learning

about their addiction. Evidence of drug abuse among medical

professionals are obtained through random drug screenings that

facilities impose on employees and by information volunteered

through medical professionals. These resources are very limited

due to previously mentioned statements regarding reasons why the

substance abuse is hidden and the epidemic that some medical

facilities and practice do not participate in random drug

screenings. Ethics require medical professionals to seek

treatment and to report any suspected substance abuse by a

colleague. Some cases are not reported by co-workers regardless


of what ethics state under the state licensure board. Colleagues

often do not report suspicions of drug abuse because they feel it

creates “friendship issues, guilt, loyalty issues, and they fear

that it will jeopardize their colleague’s nursing license”

(Recovery, 2011a). Colleagues know first-hand how hard it is to

obtain a medical license and often place themselves in the

situation of imagining how it would feel if they lost their

medical license. This makes it very difficult to risk seeing

your colleague’s license potentially being revoked. Other than

the risk of watching a colleague’s career be disposed of, very

few people want to see another person unemployed because of

something that they told administration about. However, ethical

practices expound on viewing the well-being and health of the

patient over any other issue when considering the decision of

reporting a colleague that is addicted to a substance. When a

person suspects a person is suffering from an addiction, “they

should talk to the person in private about the issue in a non-

confrontational manner. A colleague should express to the

addicted colleague their concerns about patient safety and

express their concerns about the well-being of the medical staff


suffering from a possible addiction” (Recovery, 2011a). If a

person admits that they have a problem, this does not mean that

the problem is solved and the person has no further duties to

accomplish to ensure the person seeks treatment. The person may

admit that they have a problem, but still not admit it to others

or seek treatment. It is a “colleague’s responsibility to report

the issue to the proper staff and ensure that the medical staff

with the issue gets the help that he or she needs because a

patient’s life could depend on it” (Recovery, 2011a).

The negative consequences of an addict are great within the

general population. The negative consequences increase when

medical staff is involved. Chait explains that drug abuse can

cause “patient mistreatment, including basic care, medication

errors, and abuse” (2006). In some cases, patient death has

occurred because a medical professional was under the influence

while caring for an individual. Other negative consequences

mentioned by Chait (2006) are “higher hospital or clinic costs

associated with the legalities of patient mistreatment, stolen

drugs, lost wages, training, and rehiring” occur because of drug

abuse within employees in a medical facility. “Nurses may lose


time due to receiving treatment, thus receive lower wages”

(Chait, 2006). “Nurses and physicians can lose their job and

entire career depending on the damage substance abuse has created

in their life”(Chait,2006). Emotional factors also come into

play when discussing the negative consequences of drug abuse.

The impact of this factor is not easily estimated, but occur in

great amounts. Patients may overcome the physical

characteristics of physical abuse, but their emotional state is

one that is not easily corrected if ever corrected. The loved

ones that already have a great deal of guilt when they have no

other choice but to place their loved one in the care of another

has even more emotional distress when they discover that their

loved one has been abused. They begin to feel as though the

abuse would have never have happened if they had just found

another way to care for their loved one rather than trusting

medical staff to do the job. When in reality, if the medical

staff were not suffering from an addiction, the patient may not

have been abused. Addiction leads to short-comings of medical

professionals causing the victims of the issue to no longer trust

other medical professionals to assist them in the future. Some


patients end up being overly medicated due to the addictions of

medical staff. For example, a nurse communicates in medical

records that a patient is given a low dosage of morphine for

pain. The next nurse comes on shift and reports that the patient

is still in pain. The physician believes that the medication is

not enough to handle the pain the patient is in. The medication

is increased to a higher dosage. The medication is administered

and the patient is sedated because they are receiving a higher

dosage than what is needed.

There are also inconclusive arguments between whether or not

physicians use substances more than nurses, etc. This

information is inconclusive because a physician has the primary

tool needed for obtaining medication. These physicians are

equipped with a prescription pad and can write any prescription

they want. Warranted they are smart enough to not go on a

prescription frenzy for themselves and have their own methods to

get what they are yearning for. Physicians generally work for

themselves and have very few people shadowing them closely enough

to pick up on an addiction symptom. The people that do work by

their side are generally colleagues that would also neglect


reporting the issue to the licensure board because of the same

reasons mentioned previously. Other co-workers would also not

report the issue if the physician happened to be their boss.

These workers would not want to risk losing their own job due to

retaliation or having the business close down because the

physician was no longer able to practice. The oath is taken to

always keep a patient’s well-being first, but this is not always

the case. Physicians are also less likely to be drug tested

because they are self-employed.

Not all medical staff that admit to having an issue with

drug abuse have a negative outcome. Colleagues and

administration are apt to look more highly of a person that

admits to having a problem voluntarily and actively wanting to

seek help. There are some success stories that entail a person

seeking therapy for their issue and eventually returning to work.

Most medical boards have adopted policies that require you to

seek treatment or spend time in jail under a set guideline of

circumstances. Medical organizations have acknowledged that a

person’s profession does not make them exempt from experiencing

the same issues as people that are not in the medical field.


Most honor the fact that an addiction influences the health of

people and these people need treatment. The organizations

believe that the person should have some type of consequences,

but do not believe that jail time is going to correct the issue

because jail generally does not provide any type of

rehabilitation. Therefore, a person that is sentenced jail time

for something involving substance abuse still has a serious

problem when released because the problem has not been addressed.

“Workplace resources include employee assistance programs,

employee health services, and human resources departments. Union

representatives and nurse manages can also support nurses

recovering from addiction. Legal consultation, behavioral

treatment, peer support groups, and the meetings of 12-step

programs” are available for most medical staff” (Maher-Brisen,

2007). “Caduceus is a program open only to healthcare

professionals for assistance” (Maher-Brisen). Every state board

has different guidelines for approaching addictions among medical

workers. Maher-Brisen (2007) also states that “approximately 40

states have alternatives to disciplinary action, including peer

assistance and recovery monitoring programs.”


Discussion

No matter what profession one chooses, the profession does

not make a person immune to an addiction. Addiction occurs

within even the most intelligent physicians and medical staff.

Being that the expectations are so high of a well-respected

medical staff and circumstances of being caught abusing drugs are

so extreme, the information available on this subject is limited.

No one wants to be sick and worry if the person that is taking

care of them is capable of doing so because they have a problem

themselves. Although society should trust that medical

professionals are going to do the best of their ability to take

care of them because that is what they have taken an oath to do,

they seem to forget that these same medical professionals are


human as well. These medical professionals have every capability

of falling victim to addiction just as well as a person that is

not involved in the medical field. Learning the signs of

addiction may possibly save a life one day. Even suspicion is to

be reported immediately. As a patient, if at any time a patient

is not comfortable with the care they are receiving, arrangements

can be made toward which individuals are involved on the

treatment team. Addiction is a serious issue within any person.

However, the parameters involved with medical staff and

addictions are extremely dangerous and individuals should strive

to conduct more research on this issue to possibly save lives in

the future.

References


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from http://www.jaxtherapists.com/substance-abuse-among-nurses.html

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http://addiction.lovetoknow.com/wiki/Drug_Abuse_among_Nurses

Copp, Mary Ann B. (April, 2009). Drug Addiction Among Nurses: Confronting a Quiet

Epidemic. Retrieved from

http://www.modernmedicine.com/modernmedicine/article/articleDetail.jsp?id=592623

Maher-Brisen MSN, APRN, BC, P. (August 2007). Addiction: An occupational hazard in

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