Drug-addicted nurses ‘should be treated not punished’, say us nursing bodies

Specialised treatment and a pathway for return to practice should be favoured over discipline for nurses that have been found to have substance and alcohol use disorders, according to US

experts. Famously and controversially, the lead character in US comedy-drama serious _Nurse Jackie_, which ran from 2009-15, took prescription painkillers and benzodiazepines, bringing the

issue to the attention of the public. > “Treatment outcomes for substance use disorders are comparable to > those of other diseases” >  > Position statement Now a new position

statement from the International Nurses Society on Addictions and the US Emergency Nurses Association has stated that substance use is a “serious problem” in the profession. It acknowledged

the heightened risk from alcohol and other substance use by nurses, as it “potentially places patients, the public, and nurses themselves at risk for serious injury or death”. However, it

noted that traditional disciplinary approaches to nurses with substance use disorders often resulted in “harsh penalties”, especially when prescription medications were involved. For

example, nurses may lose their job and their registration, and possibly face criminal charges, while students may be expelled from school, without appropriate treatment or follow-up. In

contrast to this “moral or criminal model”, the two organisations argued that substance addictions should be viewed as long-term conditions and treated as such. “When viewed and treated as a

chronic medical illness, treatment outcomes for substance use disorders are comparable to those of other diseases…and can result in lasting benefits,” said the authors in the _Journal of

Addictions Nursing_. They suggested drug use for personal reasons should be “viewed as a symptom of a serious and treatable disorder, and not exclusively as a crime”, emphasising

“alternative-to-discipline” approaches. > “Patient safety is of paramount importance” >  > Stephen Strobbe They called on healthcare facilities and nursing schools to adopt such

approaches to help affected nurses and nursing students through the use of “stated goals of retention, rehabilitation, and re-entry into safe, professional practice”. They also recommended

that nurses with substance use disorders refrain from practice for some time, while undergoing specialist treatment to establish “sobriety” and a programme of recovery. Treatment may include

residential or intensive outpatient programmes, individual and group therapy, urine drug testing, and support group attendance, they suggested. Meanwhile, return-to-work agreements might

include restrictions of work hours and assignments, with continued treatment and monitoring for periods of up to three to five years. Drug-addicted nurses ‘should be supported not punished’

Stephen Strobbe The position paper, which has been endorsed by the American Nurses Association, added that employers should provide education and policies promoting a “safe, supportive, and

drug-free workplace”. Nurses and nursing students should be made aware of the risks associated with substance use, and the responsibility to report suspected concerns, it highlighted. The

joint statement was co-written by the society’s president Dr Stephen Strobbe, clinical associate professor at the University of Michigan school of nursing. He said: “Patient safety is of

paramount importance, and one of the best ways to achieve this is through effective prevention, intervention, treatment and recovery, and professional monitoring of nurses and nursing

students with substance use disorders.”