CRNA Drug Addiction

  1. I have heard from alot of sources that the addiction rate among CRNA's is higher than other nursing specialities. Why is this? I realize availability of drugs, etc. plays a part, but in short I guess what my real question is. If nurse anesthesia is such a great job then why is the addiction rate so high?? When they talk about high job stress as a CRNA, what exactly are they referring to, (having someone's life in your hands)??
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  2. 37 Comments

  3. by   jfpruitt
    I have read this also and was wondering the same. There was a whole article about that in my local paper a few months back. I realize you have access to potent drugs, but doesnt the hospital have the checks and balances where you really couldnt take them without being caught?
  4. by   meandragonbrett
    The reason the job is so stressful, as i've been told, is that the anesthetist is the one that holds the life of the patient in their hands, not the surgeon. More than likely if anything goes wrong in the case, they family is not only oging to go after the surgon but also after anesthesia. I haven't heard that about drug addiction rates being high for CRNAs. THat's interesting to hear. I don't really know much about drug addiction. Kevin might be able to offer some insight to both of the issues about the drugs and the stress.

    Brett
  5. by   WntrMute2
    There are 11 in my class, and statistically, 1 of us will abuse drugs. Nice thought. I don't think the addiction rate is different for anesthesiologists. Just consider a standard pack of drugs for the day is 50 mls of fentanyl (50 mcg/ml) , 10 mls of versed (2mg.ml), 20mg morphine, and 500 of ketamine, also you pick up a gram of pentathal. Once drawn up there is no way for someone to know how much of what someone got. Responsibility comes with the job.
  6. by   lgcv
    One theory is that we give drugs to people everyday to relieve their pain and anxiety. We believe that we have full command of the drugs and therefore could "relieve" our own pain or anxiety with them....without any real consequence. skip forward, time determined by drug chosen (sufentanil addiction time is just a few days) and you have an addict.

    Most of the CRNAs who openly discuss their previous addiction problems, state that it started with a stressful event in their life, usually not work related stress.
  7. by   jfpruitt
    Being just in nursing school, maybe I'm confused. But in the hospital, don't you have to document that you drew up 50mg's of say Morphine for a patient? Now, if you take that to a room, how in the world would you have the time, energy, or guts to shoot the rest of it in your own arm w/o anyone seeing or wondering whats going on? Thats what i dont understand....
  8. by   WntrMute2
    Remember that big pack of narcotics I mentioned? It goes INTO THE ROOM WITH YOU. 5 cc of fentanyl looks just like 4 ccs with a cc of saline. Besides, no one is watching you, one could give 9 ccs for a case instead of the 10 they charted. I don't want to put any more ideas into the heads of the "just say no generation"A little naive there my friends.
  9. by   OBNURSEHEATHER
    Originally posted by jfpruitt
    how in the world would you have the time, energy, or guts to shoot the rest of it in your own arm w/o anyone seeing or wondering whats going on? Thats what i dont understand....
    Hope y'all don't mind me popping in on this thread...

    It's accessibility, pure and simple. You guys will have such easy access to these drugs, and it's sad, but as someone stated, statistically, someone will succumb to the pressure.

    As for having enough guts to steal and abuse drugs, I worked at an inpatient drug & alcohol rehab for about a year. Addiction is so powerful and overwhelming, that consequences become irrelevant. I could not even repeat some of the stories of risky, horribly degrading things people have done to get their fix.

    Thanks again for letting me add my 2 cents

    Heather
  10. by   kmchugh
    Heather hit the nail right on the head. We see the relief these drugs bring every day. Some feel they can "self treat" to bring themselves relief from similar pain. When you start talking about some of these drugs, addiction can be amazingly quick. There was a study once upon a time that looked at the survival period of addicts (how long an addict will survive once becoming addicted to a certain drug if they don't get treatment). I don't remember the exact figures, but survival for a fentanyl addict was about six months. Sufenta was about six weeks, and remifentanil was an astounding ONE WEEK.

    It would be incredibly easy to chart a patient was given 5cc of fentanyl, while holding back three for yourself. After all, you can achieve a similar effect by increasing the delivered percentage of volatile agent. The bottom line is its a slippery slope, and you must never take the first step.

    Kevin McHugh
  11. by   ma kettle
    I guess it is not as hard as it would seem. But, I knew of a person that was so into their addiction that they actually had a INT (prn line in their ankle) for the straight to the vein rush. I was amazed at that, at that time.
    Did they say in that study of addictions, with CRNAs , was it just medications they had access too, or was this all drugs?
    For those who sought treatment was this on their own or was this a result of getting caught?
    I am sure this is one career you would not want to be drug inpaired.
    Sandy
  12. by   jskibis
    Its interesting that some people think that signing out narcotics is in anyway going to prevent someone from diverting drugs! The "paper trail" is one of the last clues to alert anyone to the problem.
    Certain people are going to be more at risk: someone with a parent with a substance abuse (including alcohol) problem is at greater risk. Also think about it, we are control freaks, we use drugs to control every aspect of our patients, why not use it to make ourselves feel better?
    I've known 2 anesthesia providers and 2 perioperative nurses who started putting drugs in their veins, and at least 1 of them are dead.
  13. by   caroladybelle
    It is incredibly naive to think that any amount of paperwork, cosigning of wastages, return of PCA/epideral tubing etc. will prevent drug abuse. If healthcare workers want to get a hold of drugs, they will find a way. Just like the general public.
  14. by   nrw350
    I was chatting with an Anesthesia Tech. from accross the globe who got addicted to one of the gases used. I do not know which one it was (it was not NO2 because he said it was one of the ones used to put toe patient to sleep). I chatted with him before and after his addiction. What triggered the addiction were personal problems which prevented him from getting sleep at night. I to this day do not undertand how he snuck the bottle home and had all the necessary equipment to put himself to sleep with that stuff. Anyway, he got caught when a family member tried to get into contact with him while he was "out" at home. They went to his house to check on him and found him "asleep" in his room with the mask to his side. He was rushed to the ER at the very same hospital where he worked. He got treatment for the addiction and became a Born-Again Christian afterwards. I do not remember if he was ever able to get back in Anesthesiaology. We just stopped talking for some reason.

    Hope my $0.02 is worth something here lol.

    Nick

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