Understand substance abuse in nurses.

ubstance dependence and abuse among healthcare workers have been studied and reported in the literature since the early 1970s (Ameri-can Medical Association, 1973; Ameri-can Nurses Association, 1984). Studies have found that physicians and nurses are not at greater risk than the general population, but their patterns of use are unique. They tend to use certain pre-scription substances more often than the general public and are more likely to have access to the drug in the workplace (Shaw, McGovern, Angres, & Rawal, 2004). PrevalenceMore than 82% (N = 14) of nurses had a single substance use disorder (nurs-es tend to use one substance only) and were significantly more likely than phy-sicians to use prescription opiates exclu-sively (Shaw et al., 2004). One study reported that the prevalence of use for all substances among nurses was 32%. Compared with nurses in wom-en’s health, pediatrics, and general prac-tice, emergency nurses were 3.5 times as likely to use marijuana or cocaine, oncol-ogy and administration nurses were twice as likely to engage in binge drinking, and psychiatric nurses were most likely to smoke. The study suggested that the high rates of binge drinking among oncol-ogy nurses could be a coping mechanism to limit the emotional pain experienced while working with patients with cancer (Trinkoff & Storr, 1998).Substance dependence and abuse have been found to compromise the delivery of quality healthcare services and impact patient safety. The problems threaten healthcare professionals’ in-tegrity and significantly impact the pro-fessionals themselves and their families (Shaw et al., 2004). ImplicationsWhen a nurse is found guilty of sub-stance abuse, the state board of nurs-ing takes immediate disciplinary action against the nurse’s license to protect the public from unsafe practices. Nurs-es experience harsher professional and work sanctions than physicians because nurses’ professional organizations often are less established. Moreover, nurses are placed on probation and sanctioned more commonly than physicians (Shaw et al., 2004). Many states have developed alterna-tive treatment programs for nurses rath-er than immediately taking their license. Thirty-nine states developed programs to channel nurses into treatment and re-covery, monitor their return to work, and protect their licenses (Clark & Farn-sworth, 2006). Nurses have an ethical responsibility to protect patient safety and the profes-sional duty to provide quality health-care services. They should be cognizant about the prevalence of substance abuse among healthcare professionals. How to Prevent AbuseNurses can use a few safeguards to prevent and address coworker sub-stance abuse. When you are asked to witness wastage of a partial dose of a narcotic drug, make sure that it is se-curely discarded. Equally, when some-one is witnessing wastage of a partial dose of a narcotic drug on your behalf, make sure the same procedure is fol-lowed. Finally, if you suspect substance abuse in a coworker in your workplace, notify your manager. In most cases, institutions have employee assistance programs that are designed to help em-ployees deal with difficult situations, including substance abuse. ✱