Opinion ID: 1113754
Heading Depth: 2
Heading Rank: 2

Heading: Was There Substantial Credible Evidence of Addiction or Dependency? Was the Decision of the Board of Nursing Arbitrary and Capricious?

Text: By virtue of § 73-15-29(1)(h) the Board of Nursing is empowered to revoke a nursing license upon proof that a person [i]s addicted to or dependent on alcohol or other habit-forming drugs or is a habitual user of narcotics, barbiturates, amphetamines, hallucinogens, or other drugs having similar effect, or has misappropriated any medication. The complaint in this case charged that Wilson violated subsection (h) in that he is addicted to or dependent on alcohol or other habit-forming drugs, primarily cocaine. The chancellor found, inter alia, that ... the decision of the Board of Nursing with regard to the Appellant's alleged violation of Miss. Code Ann. Section 73-15-29(1)(h) was not supported by substantial evidence and was arbitrary and capricious; ... . A review of the proceedings makes clear that the chancellor was not questioning whether Wilson is an addict in the medical sense but rather whether the statute is properly interpreted to allow the board to revoke a license based on the mere status of addiction regardless of whether the license holder is recovering and regardless of the length of time which has elapsed between the last use of the intoxicant and the revocation proceeding. The board took the position that it was within its statutory power to revoke a license even if the nurse was shown not to have used an intoxicating substance within as long as the past ten years. The proof before the board that Wilson was addicted to or dependent upon alcohol, cocaine, or other habit-forming drugs consisted of the following: (1) Wilson's admission to Investigator Carl Skidmore on August 11, 1989, that Wilson had been treated in 1988 for cocaine addiction. Skidmore testified that Wilson told him he had smoked cocaine between June and October of 1988, that he drank alcohol to come down off cocaine, and that Wilson voluntarily sought initial treatment at the Harbor House where he was an inpatient for thirty (30) days and secondary treatment at Victory Manor where he received therapy for sixty (60) days. The testimony of Skidmore was not impeached, and Wilson never denied he told Skidmore he was addicted to cocaine. (2) The testimony of Martha Collins, program coordinator for recovering nurses, that she was present during the Skidmore interview and heard Wilson tell Skidmore he used cocaine between June and September of 1988, and was drinking whiskey to come down from cocaine. (3) The statements of Thomas Milhorn, Jr., a physician certified in addiction medicine who had neither seen nor treated Wilson, that a drug addict is one who is currently or has in the past been addicted to drugs, that addiction is treatable but not curable, and addiction is forever. Dr. Milhorn had examined transcripts of prior hearings conducted on December 2, 1976; January 17, 1979; March 27, 1980; and March 26, 1981. He testified that based solely upon the content of the four (4) transcripts, Wilson has had a long history of problems with drugs. The recommended treatment for cocaine addiction was inpatient treatment for twenty-eight days, one to three months therapy at a halfway house, and two years of aftercare with random drug screening. (4) The testimony of John Wilson that he told Skidmore during the interview conducted in 1989 about some drug problem he had in 1988 and Wilson's admission during the hearing he had been treated for substance abuse. Wilson testified he used cocaine for the first time in 1975 or 1976, and for the last time between June and September of 1988. When asked if he had been treated for cocaine addiction, Wilson replied he had been treated for substance abuse. Wilson had received all the therapy recommended for addiction save for extended aftercare. (5) Wilson's testimony contained within the transcripts of the prior hearings conducted before the nursing board in 1976, 1979, 1980, and 1981, reflect that Wilson (1) had misappropriated cocaine from a hospital pharmacy in 1976, and (2) had his nursing license revoked in 1980 for being habitually intemperate with habit-forming drugs, namely demerol and morphine, which Wilson had misappropriated from the emergency room of the Delta Medical Center and had taken by injection for his own use over a period of two months. The transcripts reflect quite clearly that Wilson was acutely aware he had a serious problem with drugs and that he voluntarily sought therapy and rehabilitation for this problem. During the hearing conducted on March 27, 1980, Wilson testified he was beginning to understand more about `drug addiction', and about things that might have caused me to go to that type of activity. Wilson also testified he did not seek treatment after the initial incident involving misappropriation of cocaine because he did not understand his problem at that time. During the hearing conducted on March 26, 1981, Wilson testified his drug usage was concentrated over a period of a year and a half. (6) The treatment undertaken voluntarily by Wilson was the same treatment prescribed by Dr. Milhorn for addiction. (7) Stealing from the workplace habit-forming drugs kept under lock and key is a social dysfunction indicative of a desperate need for drugs. Wilson misappropriated from his place of employment a bottle of cocaine in 1976 and demerol and morphine in 1979-80. Although asked specifically if he could tell the board whether or not Wilson was presently a cocaine addict, Dr. Milhorn declined to answer that question, stating only that he was present for the purpose of testifying about some facts on chemical dependency. Wilson claimed he had not used drugs or alcohol in any form since 1988. A urine screen administered to Wilson on July 6, 1990, six (6) months after the hearing before the nursing board in January, was negative for habit-forming drugs. In order to justify revocation of Wilson's license, it was necessary that the Board of Nursing have before it substantial, credible evidence that Wilson was either addicted to or dependent upon alcohol, cocaine, or other habit-forming drugs. Although Wilson had been clean and sober for more than a year prior to his hearing before the Board of Nursing, the board based its revocation, at least in part, on a finding that Wilson was either addicted to or dependent upon cocaine or other habit-forming drugs. The board contends that Wilson's admissions, coupled with the transcripts of the prior hearings and the testimony of the witnesses appearing at the hearing, constitute substantial, credible evidence that Wilson is addicted to or dependent upon habit-forming drugs, primarily cocaine. Wilson, on the other hand, argues that the terms addiction and dependency as used in § 73-15-29(1)(h) mean an ongoing and continuous use of habit-forming drugs and not isolated incidents of usage similar to Wilson's which were separated in time by periods of three (3) years and eight (8) years. We agree. Because § 73-15-29 permits revocation of a nursing license, it is penal in nature and therefore must be strictly construed against the governmental agency (the Nursing Board) when attempting to revoke a license. Hogan v. Mississippi Board of Nursing, 457 So.2d 931, 934 (Miss. 1984). At least one court of appeals in one of our sister states has interpreted a similar statute to require active addiction at the time of the hearing. Colorado State Board of Nursing v. Crickenberger, 757 P.2d 1167 (Colo. App. 1988). Applying that holding that court reversed a decision that a nurse, who had not been shown to have used an intoxicating substance in six months, was addicted within the meaning of that state's license revocation law. Colorado State Board of Nursing v. Lang, 842 P.2d 1383, 1388-89 (Colo. App. 1992). We have not previously interpreted our statute. We need not follow Colorado to require active addiction at the time of the hearing. Any reasonable interpretation of the statute, however, would require some temporal proximity of active addiction to the disciplinary action. The board's stated position that it has the power to revoke a license if it finds addiction to have been active ten years in the past, even if it is in full remission, See, Lang 842 P.2d at 1388, is simply unreasonable. The facts reflect that since 1988, when Wilson finished his treatment at Harbor House and Victory Manor, he has not used drugs or alcohol of any kind. He testified that he was in after-care. The urine screen conducted in July of 1990 during the pendency of Wilson's appeal in chancery court did not detect the presence of any habit-forming drugs. In the absence of a showing that the board applied a reasonable standard, the conclusion is inescapable that the decision as to addiction is arbitrary. Arbitrary means fixed or done capriciously or at pleasure. An act is arbitrary when it is done without adequately determining principle; not done according to reason or judgment, but depending upon the will alone,  absolute in power, tyrannical, despotic, non-rational,  implying either a lack of understanding of or a disregard for the fundamental nature of things. Mississippi State Department of Health v. Southwest Mississippi Regional Medical Center, 580 So.2d 1238, 1240 (Miss. 1991).