Substance misuse among nurses is higher than normal

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Nurses take on many roles in their careers. They care for people when they are sick, cheer on women as they give birth, and are often the last to hold their hand during a person’s final moments. Processing these emotions is challenging and often leads to substance misuse among nurses.

Substance Use Disorder in Nursing

Although substance misuse affects people of all careers, 1 in 10 nurses misuses drugs or alcohol during their career. While nurses typically drink less than the general population, one NIH study shows they binge drink more than the general public over age 35.

Drug misuse among nurses also occurs at higher rates. This is common due to their access to prescription drugs. Nurses generally have easy access to painkillers, benzodiazepines, and stimulants.

Common ways nurses access drugs for personal use include:

  • Taking leftover drugs after a trauma
  • Taking a patients ‘as needed’ medication
  • Withholding a patient’s medications for themself
  • Giving a patient IV saline, so the patient doesn’t know.

However, these behaviors will eventually become known, and nurses face disciplinary actions or lose their license. 

Why is Substance Use Disorder in Nursing Common?

Fatigue is Common in Nursing

Nursing is a demanding career – sick, crying babies, unruly patients high on drugs, and doctors who always need help. Shifts are generally 12 hours or more, and most of them have families waiting at home. Many factors of this career increase the risk of drug misuse among nurses. 

Greater Access

Unlike the general population, nurses have easy access to controlled substances. Although the monitoring and charting of medications have improved over the years, situations such as trauma, controlled substances may not be as closely monitored. Studies show nurses with access to controlled substances misuse drugs more often than nurses without access.

Higher Stress Levels

The intense pressure of nursing is often overwhelming. Not only are nurses responsible for their patient’s well-being, but nurses are also often overworked and have a lack of support at work. A study published by the National Institute of Health states chronic stress increases the development of substance use disorder. 

Lack of Education on Substance Use Disorder in Nursing

Because most people know drugs and alcohol are addictive, nurses often receive very little training on the signs and symptoms of substance use disorder. As a result, it can be challenging to recognize substance misuse among nurses. 

Without proper education about drug misuse among nurses, many don’t understand it is a chronic disease. The lack of education also promotes the stigma about substance use disorder, which can prevent nurses from seeking help. 

Gender Can Effect Substance Use Disorder in Nursing

Women dominate the nursing field by 92 percent, according to the U.S. Department of Labor. While females typically take drugs at lower doses than males initially, their use escalates rapidly. Women also experience a recurrence of use at higher rates than males. 

Physical Pain Increases Substance Use Disorder in Nursing

Nursing is not only mentally demanding; it is also physically demanding. The constant standing, walking, and moving patients can lead to back injuries. Nurses are often prescribed pain medication. However, these medications are intended for short-term use, and taking them long-term can have severe consequences. 

Fatigue is Common in Nursing

Nurses typically work 12-hour rotating shifts. This schedule can quickly lead to burnout which can affect their overall health. Nurses commonly work on-call shifts and have to be available on short notice. 

Add in the nights, weekends, and holidays nurses often work, and it’s no wonder they are sleep-deprived. Some nurses may turn to drugs or alcohol to unwind after an exhausting day. However, this builds unhealthy coping skills and often leads to drug misuse among nurses.

Fatigue is Common in Nursing

The Risk to Patients Due to Substance Use Disorder in Nursing

A nurse’s primary focus is on the patient’s safety and well-being. But, if a nurse is struggling with substance use disorder, medical mistakes are made. For example, a patient could receive the wrong medication or the wrong dose. 

Substance use disorder in nursing can also limit their ability to assist patients. Withdrawal symptoms can cause weakness and tremors. These symptoms can cause a nurse to lose grip on a patient, resulting in the patient falling and being injured.

Substances Commonly Misused by Nurses

Nurses who struggle with substance use disorder use various drugs to cope with the stress of work. Most often, they turn to alcohol, benzodiazepines, and prescription painkillers such as fentanyl. The highest rate of drug misuse among nurses is found in nurse anesthetists. 

Common Signs of Substance Use Disorder in Nursing

Many nurses are considered high functioning, which makes it difficult to recognize substance misuse among nurses. High functioning means a person can handle their career, personal life, and substance use disorder without others noticing. 

Common signs of drug misuse among nurses include:

  • Changing jobs often
  • Volunteering to work night shift where there is less supervision
  • Falling asleep on the job
  • Offering to administer narcotics
  • Excited to work overtime
  • Takes frequent bathroom breaks
  • Misses work often
  • Smells of alcohol or tries masking the smell with mints or spray
  • Openly talks about their financial and relationship issues
  • Small pupils or glassy eyes
  • Incomplete work, repeatedly making the same mistakes

Challenges of Treating Substance Use Disorder in Nursing

At Sana Lake Behavioral Wellness Center, we offer programs designed for professionals like nurses. Treating substance use disorder in nursing is different because nurses are used to being caregivers, not patients. 

The issues that lead to substance misuse among nurses are also different than the general public. For this reason, nurses need a comprehensive treatment program that begins with medical detox. 

Since most nurses struggle with misusing benzos and painkillers, the withdrawal symptoms can often be severe. A medical detox program provides 24-hour medical care and supervision to rid the body of all toxins safely.

Another challenge in treating drug misuse among nurses is the restrictions on medication-assisted treatment or MAT. Many nurses struggling with substance use disorder choose to enter specific programs in order to keep their nursing license which adds restrictions to their treatment plans. Suboxone or buprenorphine, which is used to treat opioid use disorder, is generally not allowed because of its high risk of misuse.

What are Alternative-to-Discipline Programs?

Boards of nursing may use alternative-to-discipline to allow nurses struggling with substance use disorder to keep a clean license if they receive treatment. Nurses are provided a confidential approach with strict monitoring and random drug screens. 

Alternative-to-discipline programs are proving to be highly successful in treating substance misuse among nurses. Furthermore, long-term recovery rates of nurses who completed treatment are also high. While patients are now safe from a nurse working while using drugs or alcohol.

Inpatient vs. Outpatient Treatment for Nurses

Inpatient or residential treatment programs involve staying in the facility under 24-hour supervision. These programs are typically 30,60, or 90 days and offer the best chance at recovery. Nurses in inpatient treatment get to step away from the stress of work and their personal life and focus solely on their health and recovery. 

However, not all nurses can attend inpatient treatment. They may be single parents and have no one to help with their children. Or they may care for sick family members. In that case, outpatient treatment programs offer a variety of intensities to accommodate a person’s schedule and substance use disorder.  

Whether a nurse chooses inpatient or outpatient treatment, aspects of their treatment may include:

  • How to restore your reputation and career
  • The process of returning to work
  • Addressing licensing matters
  • How to avoid triggers at work and outside of work
  • Monitoring program participation
  • Participation in an after-care program

Holistic Therapies for Substance Use Disorder in Nursing

Holistic Therapies for Substance Use Disorder in Nursing

Holistic therapies such as yoga and meditation are beneficial in the long-term recovery of substance use disorder in nursing. While alone holistic therapies won’t treat substance use disorder, but alongside behavioral therapies, they can increase long-term recovery rates.

A healthy diet and a regular exercise program are the first steps in holistic healing. Starting healthy eating habits and exercising while in detox is crucial to begin the healing process. Physical exercise increases blood flow and promotes mental health. While yoga and acupuncture can ease pain, reducing your need for painkillers.

Meditation alongside psychotherapy and behavioral therapies promotes emotional well-being. Journaling, for example, can force you to take an honest look at yourself and heal from past trauma and substance misuse.

Spirituality is an essential aspect of treating substance use disorder. However, spirituality looks different to each person. Spirituality in treatment is not specifically about religion. It is about finding your spirituality and a better sense of self. 

Are You a Nurse Struggling With Substance Use Disorder?

If you or someone you work with are struggling with substance use disorder, you are not alone. At Sana Lake BWC, we understand the unique needs of substance misuse among nurses. Contact us today and find out how we can help you. 

References: 

https://pubmed.ncbi.nlm.nih.gov/15225894/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2732004/

https://www.ncsbn.org/substance-use-in-nursing.htm