SUBSTANCE ABUSE IN HEALTH PROFESSIONALS
Physicians, dentists, and nurses have far higher rates of dependence on controlled substances, such as opioids, stim-ulants, and sedatives, than other professionals of comparable educational achievement, such as lawyers. One reason is thought to be the ease of obtaining controlled substances (Jaffe & Anthony, 2005). Health care professionals also have higher rates of alcoholism than the general population.
The issue of reporting colleagues with suspected sub-stance abuse is an important and extremely sensitive one. It is difficult for colleagues and supervisors to report their peers for suspected abuse. Nurses may hesitate to report suspected behaviors for several reasons: They have diffi-culty believing that a trained health care professional would engage in abuse; they may feel guilty or fear falsely accusing someone; or they may simply want to avoid con-flict. Substance abuse by health professionals is very seri-ous, however, because it can endanger clients. Nurses have an ethical responsibility to report suspicious behavior to a supervisor and, in some states, a legal obligation as defined in the state’s nurse practice act. Nurses should not try to handle such situations alone by warning the coworker; this often just allows the coworker to continue to abuse the substance without suffering any repercussions.
General warning signs of abuse include poor work per-formance, frequent absenteeism, unusual behavior, slurred speech, and isolation from peers. More specific behaviors and signs that might indicate substance abuse include the following:
· Incorrect drug counts
· Excessive controlled substances listed as wasted or contaminated
Reports by clients of ineffective pain relief from medica-tions, especially if relief had been adequate previously
· Damaged or torn packaging on controlled substances
· Increased reports of “pharmacy error”
· Consistent offers to obtain controlled substances from pharmacy
· Unexplained absences from the unit
· Trips to the bathroom after contact with controlled substances
· Consistent early arrivals at or late departures from work for no apparent reason
Nurses can become involved in substance abuse just as any other person might. Nurses with abuse problems deserve the opportunity for treatment and recovery as well. Reporting suspected substance abuse could be the crucial first step toward a nurse getting the help he or she needs.