Drug addicted nurses - page 19

I am a nursing student and in one of my classes we have recently talked about nurses and substance abuse. I think that it is hard for me to wrap my brain around the issue. My questions are: 1.... Read More

  1. by   subee
    I also believe that you need to "mourn" the fact that you cannot use ANY mood altering substances except under the most tightly prescribed circumstances (surgery, etc). But if you can successfully accept this change into your heart and mind, you can come to peace with it. It MAY be difficult in some social circumstances not to be able to drink but its not necessary to see it as a BAD thing. Its just who you are and its not only alcoholics that can't drink at weddings (you're NOT the only one in the room) but there are entire cultures and religions that frown on drinking. If you can see your brain changes as something that just IS and strip the emotions that come when you finally accept anything that just IS, the blame and shame will be over with. Its a much more peaceful place to be. Good luck. You've still got raw edges. It gets better. Peace.
  2. by   NeedchangeofPace
    Jackstem said
    "Even in person's with over 20 years of documented sobriety, had these areas of the brain light up when exposed to cues specific to them. And the really interesting discovery was most of the people weren't aware of the stimulation of these areas. This means that the process of relapse can be started and develop momentum before the recovering person is aware it's happening."

    Don't I know...I was 23 years into sobriety and was having some major issues at work. I was on a mini-vacation and found myself sitting at a bar and had ordered a double VO on the rocks and I just stared at it for the longest time, I started to shake, sweat and was just very very uncomfortable to say the least. I was going through a mental list of pros and cons of why I was sitting there. After about 5 intensive minutes of should I? Just One? I will be okay later,one wouldn't hurt........and a few serenity prayers, I paid the bartender tipped him $10 got up and left and found a meeting.......got back on track, but it was close.

    Carlos Santana performed a song, "Put Your Lights On, it goes (in part):

    Written by E. Schrody

    There's a monster living under my bed
    Whispering in my ear
    There's an angel, with a hand on my head
    She says I've got nothing to fear
    There's a darkness deep in my soul
    I still got a purpose to serve
    So let your light shine, into my hole
    God, don't let me lose my nerve
    Lose my nerve

    .....it ain't easy some days........

    Mark
  3. by   jackstem
    Amen, Brother!!!
  4. by   jackstem
    I like your screen name nxtgr8RN

    FirstLab is one of the leading laboratorys for recovery monitoring. They say this about "routine" drug screens for "wellness" programs:
    "Standard urine drug testing panels range from five to 10 drugs. Specimen validity testing is available to detect adulterants or specimen substitution resulting from a donor’s attempts to mask drug use. Expanded profiles for medical professional monitoring are also available."
    They have information regarding all of your questions about testing. You can browse their site or contact them for more information. I'm sure there are other labs as well but LabCorp is the one I see monitoring 95+% of the clients I have contact with. They have a FAQ regarding toxicology, another for Web Tools that allow clients to track the process of their specimens, view chain of custody forms, etc. (No...I receive no "kickbacks" from LabCorp).

    Now for the "tough part". First the disclaimer: I am not an attorney so none of this should be considered legal advice.

    I've teamed with a nurse attorney in my area to produce a series of workshops for nurses. We did our first one this past Monday evening. Her topic was "2009 RN Renewal Application and the Ohio Board of Nursing". There were several questions on how to answer some of the questions on the renewal application regarding past legal actions and their potential impact on 2 specific things...ability to obtain/renew a nursing license and the ability to take the NCLEX exam (bottom line, you have to be elligible to obtain your nursing licnes to take the exam). After listening to her presentation and the Q&A that followed, I strongly recommend you consult with an attorney who specializes in administrative law and is experienced in dealing with the board of nursing where you will obtain your nursing license. (The American Association of Nurse Attorneys)

    She said she has had a sharp increase in phone calls and clients who have graduated from a nursing program only to discover they were ineligible for the NCLEX exam. These clients were extremely angry (with good reason) that they didn't find out about this ineligibility BEFORE they took out student loans and completed the program. Not every case fits a cookie-cutter form, so what happened to one individual with a similar situation may have an entirely different outcome than the other individual. I know many, many nurses balk at hiring an attorney for licensure and board of nursing issues because of the expense of legal fees. "I can't afford an attorney" is the most common refrain.

    Consider this: Can you afford to rack up significant debt for a degree you can't use because you can't obtain a license?

    As health care professionals, we have to know and understand the laws that allow us to practice our profession. Since a non-lawyer won't know the intimate details of the laws, a conscientious professional seeks consultation for input to make appropriate decisions about practicing our chosen profession legally, responsibly, and ethically. We consult nurse specialists, physicians, pharmacists, and other health care professionals in order to practice clinical nursing. We should do the same when our practice involves legalities. Most MDs, RPhs, DDs, etc. would never consider representing themselves before their licensing board. Most nurses do just that. They only contact an attorney when things don't turn out as expected. Many times that's too late!

    My final thought, and I don't want you take this the wrong way...I think the fact that you are in the process of recovering from this ugly disease has the potential to make you a better nurse. But, I'm not aware of any board of nursing that will allow an RN to practice while in a methadone maintenance program. Every monitoring contract I have ever seen specifically states a recovering nurse may not return to clinical practice while on opioids, benzodiazepines, barbiturates, etc.There is even a growing trend in which nurses who are receiving mood altering substances for a medical condition are placed on medical leave until the condition is resolved and the medication is no longer necessary (AND the nurse is no longer taking the medication).

    Again, I urge you to consult with an attorney familiar with nursing law and dealing with these issues before the licensing board in your planned state of licensure!

    I wish you luck and congratulate you for dealing with your chemical dependence! :wink2:

    Jack
    Last edit by jackstem on Apr 1, '09 : Reason: spelling
  5. by   iloveclay
    I know I will be in the minority here but I need to tell my story. I was fired from my job in Sept 11, 1986 for drug diverting. I was taking Tylenol w/codeine. I went to tx the next day for 2 weeks and then to long term treatment 500 miles from my home. Talk about an adjustment. I felt like I was going to the end of the earth. I went on to find a job as a DON in a small nursing home. My nursing licence was suspended in 1988. I then decided to return to college and received a bachelor's degree in mechanical engineering. I attended AA meetings and had a sponser. I graduated in 1993 and moved back home.

    While I was in college I had, what I was to later find out were mood swings. In 1996, I went to see a psychiatrist who diagnosed me with depression and put me on an antidepressant. Unfortunately I was misdiagnosed. I continued to have mood swings, crying spells with no reason for them. I had a good job, a new car, a great family and yet I was still unhappy.

    I continued on this route til I saw a psychiatrist who diagnosed me bipolar and got on Lithium and Depakote and am now well controlled. I must interject that I was not using nor drinking alcohol but I was up and down til 2003. Haven't used anything since 1986.

    I am doing really well and occasionally have a glass of wine or a beer. I have been prescribed pain med for 2 hip replacement surgeries. Oh, and no meetings.

    I really don't consider myself an alcoholic or drug dependent. Maybe others would argue but I know myself and how I feel today and I have no urges to use drugs to deal with anything.

    I'm not sure what others think but I know myself and I know that 23 yrs ago I was having some personal issues and it was just the start of my mental health issues that went on undiagnosed for a number of years. My psych doc says I was using to make up for the messed up nuerotransmitters in my brain.
  6. by   Rascal1
    With regard to iloveclay's post, it becomes so apparent how vastly different our circumstances may be that drive some of us "to drink". But then can there be those who become addicted because it feels, they have repeated use... and then bam...the genetic switch is flipped ?
    And those same individuals are not seeking a coping mechanism either consciously or subconsciously. For me, the theory I hold for myself is that , #1. My usage began as a coping mechanism for underlying difficulties,both conscious and subconscious ones. #2. There was sufficient exposure for my genetic makeup to become triggered. Thus, I know for a fact,that I can never drink again,ever.
  7. by   Magsulfate
    I look around today, at all the things I have, material and not so material... like my family, my happiness, my health... and then of course my new living room furniture haha.. (had to add that) I am sooo proud of myself to be able to go out and buy things. Sometimes I just sit and look around, feeling happy for no reason. It's nice.

    Four years ago I barely had a place to live. An apartment in the bad side of town,, dirty old furniture, and no car. I had lost everything little by little in my quest to get and stay high. I turned into some sort of alternate version of myself. Something that I will never go back to.

    Now that I see how good life can be,, I will never go back to that place. I want to live and be happy. Everything is not perfect in my life, I still have to work on things, like my nutrition,, exercise, and stuff like that... but I am so proud of where I am right now. I can set short term and long term goals,, and I can meet them and set more.

    Heck, I've learned how to use spreadsheet on my computer and I'm doing my household budget.. I can't believe this, but it is actually fun!

    I don't know why I am rambling on,, maybe I hope that someone will read all of this and a light will go off in their head,,, and I will be able to help them. Who knows.
  8. by   jackstem
    Research seems to be pointing to genetics as the major component for the development of addiction. Substance abuse can no doubt cause significant problems in a person's life, even kill them (and others around them...DUI, domestic violence, accidents, etc.). But the difference between the addict (loses control over substance use or behaviors...gambling, sex, etc.) and the abuser (eventually has something happens that makes them decide to "get clean"). And right now the estimate for the general public is somewhere between 10 - 15% (depending on the study). The problem with those statistics is the under-reporting associated with the disease of addiction due to the stigma. People get so hung up on the statistics. Who cares if it's 10, 12, or 15%? This is the number one public health problem in this country and the "war" mentality isn't working. We need early recognition, intervention and appropriate treatment...appropriate in length and philosophy. This is a chronic, progressive disease that we are treating as an acute problem that people expect to be "fixed" after one treatment attempt. The person leaves treatment and goes back to the places and people they used with...live in the same toxic family situations, and then everyone is surprised when the addict begins using again. We don't expect that from other chronic, progressive diseases like cancer, CAD, HTN, diabetes, asthma, COPD, etc.

    It's clear what we're doing isn't working. If things don't change people will just keep dying...after they ruin themselves and those around them. And the attitude of health care professionals is hindering, not helping the situation. All you have to do is read some of the judgmental, inaccurate, unscientific comments on this web site and other nursing sites to see how much work needs to be done. If nurses and other health care "professionals" can't or won't accept the science that's been discovered over the past 2 and a half decades, how can we expect politicians, police, and the general public change the way they look at this disease.
  9. by   cursedandblessed
    big hugs to all of you who have stayed clean and sober. my hubby battled etoh( sober now 5 +) and what most of you guys have said is true it's a chronic battle. daily for him. i also believe the genetics part, his mother, father, brother, and sister (now dead from suicide r/t her use of etoh.) all had or have some type of substance abuse problem.

    i guess my question to you all is this, is it possible to recognize the alcoholic/addictive personality type in some people?? in working with my hubby's aa group-he goes pretty much daily, i've had a lot of social interaction with recovering and relapsing alcoholics.

    1. i've watched the people in their first year (i'm pretty good at telling who will be there in a year and who won't-something in the attitude and why they're there-are they there for themselves or to be able to drive?). many are ticked off at the world, i'm thinking probably because of the physical withdrawal. many of them have an attitude that the world should be grateful they quit drinking-most don't seem to understand the facts that they are lucky to still be alive, haven't killed anyone or in my hubby's case at that time that he had a place to live. i saw this in my husband. he thought he should be entitled to get his driver's license back early and that the state dmv should make and exception for him because he was sober for three months.

    2. he has a friend who is going through the terrible 2's as i call it or read somewhere. he's currently at the stage where he thinks everything is okay again. i see him isolating and pushing his wife away, which is a very dangerous time in my opinion.

    3. year three was easier for us, he began to make amends and i quit worrying about his slipping. and years four & five have been better.

    there is someone in my school and when we interact, it reminds me so much of how my husband and i interacted back when he was drinking. they also disappear at times, are having extreme highs and lows, lots of anger and seem a little bit in a fog sometimes. it occurred to me earlier that this was like interacting with my husband when he was drinking, that perhaps they're using something.
  10. by   krisssy
    Quote from jackstem
    Research seems to be pointing to genetics as the major component for the development of addiction. Substance abuse can no doubt cause significant problems in a person's life, even kill them (and others around them...DUI, domestic violence, accidents, etc.). But the difference between the addict (loses control over substance use or behaviors...gambling, sex, etc.) and the abuser (eventually has something happens that makes them decide to "get clean"). And right now the estimate for the general public is somewhere between 10 - 15% (depending on the study). The problem with those statistics is the under-reporting associated with the disease of addiction due to the stigma. People get so hung up on the statistics. Who cares if it's 10, 12, or 15%? This is the number one public health problem in this country and the "war" mentality isn't working. We need early recognition, intervention and appropriate treatment...appropriate in length and philosophy. This is a chronic, progressive disease that we are treating as an acute problem that people expect to be "fixed" after one treatment attempt. The person leaves treatment and goes back to the places and people they used with...live in the same toxic family situations, and then everyone is surprised when the addict begins using again. We don't expect that from other chronic, progressive diseases like cancer, CAD, HTN, diabetes, asthma, COPD, etc.

    It's clear what we're doing isn't working. If things don't change people will just keep dying...after they ruin themselves and those around them. And the attitude of health care professionals is hindering, not helping the situation. All you have to do is read some of the judgmental, inaccurate, unscientific comments on this web site and other nursing sites to see how much work needs to be done. If nurses and other health care "professionals" can't or won't accept the science that's been discovered over the past 2 and a half decades, how can we expect politicians, police, and the general public change the way they look at this disease.
    I greatly appreciate what you have written, and I agree completely. It's about time the moral stigmas get lifted, and addicts get the help they need to treat their disease like anyone else with any disease. It is just another form of prejudice in my opinion. Thank you again for saying what I believe and know to be true. I have not been working for some time, but I want to go back to work as an RN in this field. I want to do anything I can to help. Krisssy
  11. by   jackstem
    Krisssy,

    By working on your recovery everyday, by writing and speaking about your struggles and triumphs, your fears and anxieties, and all the things we all deal with as recovering individuals, you are helping immensely. Coming back as an RN and working in the field of recovery will be a daily example of someone who has met this disease head-on and survived...thrived! Sharing our experience, strength, and hope IS the best form of help we can offer to the addict who still suffers. And you are doing that here and in your daily life.

    Glad your part of the family!!

    Jack
  12. by   southernbeegirl
    Quote from Magsulfate
    I look around today, at all the things I have, material and not so material... like my family, my happiness, my health... and then of course my new living room furniture haha.. (had to add that) I am sooo proud of myself to be able to go out and buy things. Sometimes I just sit and look around, feeling happy for no reason. It's nice.

    Four years ago I barely had a place to live. An apartment in the bad side of town,, dirty old furniture, and no car. I had lost everything little by little in my quest to get and stay high. I turned into some sort of alternate version of myself. Something that I will never go back to.

    Now that I see how good life can be,, I will never go back to that place. I want to live and be happy. Everything is not perfect in my life, I still have to work on things, like my nutrition,, exercise, and stuff like that... but I am so proud of where I am right now. I can set short term and long term goals,, and I can meet them and set more.

    Heck, I've learned how to use spreadsheet on my computer and I'm doing my household budget.. I can't believe this, but it is actually fun!

    I don't know why I am rambling on,, maybe I hope that someone will read all of this and a light will go off in their head,,, and I will be able to help them. Who knows.
    Hey mags!!

    i know exactly how you feel!

    i bought a car on my own for the first time in my life 2 yrs ago. because of my bad credit my payments are thru the roof but thats just another result of the consequences of my actions while using. but every month when i pay that payment...i am happy to pay it. it tickles the chit out of me! just knowing that finally I bought something on my own....feels so good.

    and i know what you mean about just sitting around happy for no reason. i do the same! nice to meet a kindred
  13. by   southernbeegirl
    Quote from jackstem
    Krisssy,

    By working on your recovery everyday, by writing and speaking about your struggles and triumphs, your fears and anxieties, and all the things we all deal with as recovering individuals, you are helping immensely. Coming back as an RN and working in the field of recovery will be a daily example of someone who has met this disease head-on and survived...thrived! Sharing our experience, strength, and hope IS the best form of help we can offer to the addict who still suffers. And you are doing that here and in your daily life.

    Glad your part of the family!!

    Jack
    When i went to rehab, i personally told every nurse i worked with. i felt i owed it to them as their supervisor. i am extremely honest about my recovery at work...probably too much so sometimes. but what it has done is gave us all an open discussion of addiction. many times people i work with (every dept) come to me about a family memeber in crisis. they all also know my husband works in a treatment center so many bypass me and go straight to him for help. they all know that he and i respect their privacy.

    but what ive noticed about us as a group of nurses is that our open communication about addiction has made us have many, many discussions and debates about addiction. sometimes it's about a patient we might think has drug seeking behavior, sometimes it might me be talking to the nurses about a certain patient that i think needs more pain control, sometimes it's the docs asking me specifics about how i stole drugs to help them write better orders to make it not so easy for nurses to steal (we have totally changed the way we write narc orders). most are supportive of me. no wait...all are supportive of me and i love them so for that. but some also have differing opinions of whether or not nurses that are addicts should be allowed to practice, but mostly it is the fact that 75% of our license cost goes to TNPAP. many are resentful of that. but what we have is the ability to talk openly about it...all opinions. i dont get defensive and they know they can speak honestly with me. i might defend my position and sometimes i dont....depends on the conversation.

    but what im proud of is that we are talking. we are a closeknit group that have worked together for years and years in a small facility (less than 100 beds) so we are a family. and my addiciton and my openness of my sobriety has opened up a line of communication that is a rarity in healthcare. and i'm so proud of us!!

    they've seen it all thru me. it's a common joke at work about how i "used" to act. when i first started working there and was just starting to try and get sober, i was horrible. i was the "it's my way or the high way type supervisor". over the past 5 years they have watched me morph into a very laid back type supervisor that they can come to for anything. i'm the first one to admit how bad i was. so when we get a new employee that comes in with that type of attitude, it's common for someone to use me as an example of how it doesnt work, lol. the employees tried to run me out of there on a rail the first 6 months i was there because of how bad i was. i was a horror to work for and work with. i'm able to see that now. and im able to talk about it. and laff at how ridiculously i behaved.

    but we are able to laff about it because they have been there and watched me as i faced my disease head on. what theyve seen is that while my recovery got stronger and stronger, i began living the steps and thats what changed me inside and out..at work and at home. it wasnt something that just happened...it's been a slow process. it's not like i announced to them "i am going to change". i just started living in recovery...not just sobriety. and recovery affects every aspect of your life. it's a whole disease..it affects your whole life. so when you live in recovery....all of you changes.

    i'm proud of the fact that, in our little facility, i've been able to be part of the solution and the change in our healthcare community and that we have that open dialog amongst ourselves. and believe me, they've all probably learned more about recovery than they ever wanted to know, lol.

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