Introduction

Substance abuse among nurses has not been heavily studied. But it is estimated that approximately 10% of the current nursing population is addicted to some form of drugs and/or alcohol. About 6-8% of these nurses have a problem that is serious enough that it has started to interfere with job performance and patient safety.

Nurses, as a group, seem to be more vulnerable to prescription medication than any other substance, especially when compared to the general population. Most likely this is due to the close proximity of nurses and narcotics. Many nurses have access to a hospital's supply of pharmaceuticals. It is important to note that nurses are much more likely to remain sober and to avoid relapse or return to abuse when compared with the statistics resulting from the general population.

What causes substance abuse among nurses?

Nurses tend to be highly caring individuals by nature. They have chosen to devote their lives to caretaking which often requires highly stressful and emotional situations. This type of profession and atmosphere would have a unique draw for those people who are already predisposed to addiction and dysfunction. Many people who grew up in a home with active addiction tend to take the superhero role in their families. They take care of their younger siblings, cook dinner, clean and maintain the status quo while their parents are caught up in the drama of dysfunction. While the skills developed in this chaotic situation are valuable to the nursing profession, it also results in lack of self esteem, over-achieving, spreading yourself too thin and lack of healthy boundaries. To further illustrate this point, one study has shown that up to 80% of nurses come from families with at least one alcoholic member.

People who come from homes afflicted with addiction are more likely to perpetuate the cycle. They have the burden of carrying around old pain and they continue to pile more and more on top. The stressful hospital environment may prove to max out their survival capabilities. In such instances, they may turn to substances that can momentarily dull the pain. Once they feel this release, it's not easy to resist. However, the initial amount will soon prove ineffective and the dependence will begin to take hold of their lives.

Environmental factors on the job

Any profession within the healthcare system proves to be particularly conducive for addiction. Long work days, fatigue, problems balancing career and family, emotional patients and low self esteem all help to pave the way to active addiction. Death and illness are ever present and emotionally and physically taxing. Also, with staff shortages come mandatory overtime, adding to the already unnatural work shift. Nursing also has an added disadvantage to drug addiction not present in other non-healthcare professions, because prescription medications are readily available on the job site and as part of the job itself.

Most importantly, one of the main duties a nurse is responsible for is handling and dispensing. And because nurses are so familiar with drugs, they may think that their expertise gives them the ability to self-medicate without becoming addicted. Most of us do not have a supply of diazepam readily available when we go to work. This makes it that much harder to stop the cycle of addiction once it has started.

Prevention and Treatment

Nurses are legally bound and ethically required to report colleagues they suspect may have an abuse problem. There are many obvious reasons why this has been put in place. First, of course, is that the patients are entitled to effective and "sober" care by and medical health professional. They are also expected to receive the full and proper dosage of the medications they need to manage their own pain. Nurses who abuse drugs often "short" patient dosages and then give themselves the excess. Second, nurses who are under the influence may make hazardous mistakes that are may prove to be life-threatening. Finally, it is imperative that any professional suffering with substance abuse receive adequate care and the chance to live a fulfilling life.

Although still a problem to some extent, administrators and other officials are increasingly NOT turning a blind eye to the problems of abuse and are getting them addressed. This is contrary to previous nursing culture, which often had an unspoken "don't talk" rule when it came to notifying others about drug abusing colleagues' behavior.

Finally, drugs themselves are much more carefully kept track of and monitored than they were previously. Most often, they're kept under lock and key and strict records are maintained so that if any shortages should occur, they are immediately noticed and the reason for the shortage is found. If it is because someone on the nursing staff has been taking it for his or her own use, measures are put in place to address the problem through intervention and help, and if necessary to remove the nurse from his or her job.