CRNA Drug Addiction

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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)??

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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The reason CRNA's have a higher incidence of drug abuse more than any other group of health care providers boils down to one thing and that is access to the drugs. It is extremely easy to write in the anesthesia record that 7cc of fentanyl were given when really only five were given. Or to draw up saline and waste that at the end of the case instead of the fentanyl. CRNA's that are stealing drugs almost always get caught by a behavior change from being on the drug, not because there are errors in the tracking of the drugs. I know of one CRNA that made others suspicious when he fell asleep during a case. Those are the sorts of things that get people wondering about you.

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Does anyone know if most CRNA's that are addicted were addicted prior to CRNA school? In my program we have several students who continually try and work throughout the program and was wondering if that is indicative in any way.

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What on earth is wrong with working? How is that indicative of an addiction disorder? Not everyone can afford to stop working and just go to school.

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Specializes in CRNA, Finally retired.
Does anyone know if most CRNA's that are addicted were addicted prior to CRNA school? In my program we have several students who continually try and work throughout the program and was wondering if that is indicative in any way.

If you have some time and really want to educate yourself about CRNA's and addition, start at AANA.com and then click on peer assistance. There's practically a library there.

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I'm not sure that the addiction rate is higher for CRNA's. I've worked for many years in many OR's and have heard of a many anesthesiologists, OR RN's & Techs, PACU RN's, EMT's and med/surg/re-hab/LTC RN's but NEVER a CRNA. Perhaps the numbers are so small that it doesn't take many to skew the percentage rate.

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In a recent lecture by a peer assistance counseler from AANA, we were told the rate of crna drug abuse was proportional to the country. Does anyone know if this is true? I assumed yes, but have never read anything.....

And to open up another topic, what do you all think about recovered addicts returning to practice? I have a strong opinion on that, always just thinking "what if my mother was the patient" type of approach, what do you guys think?

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You could contact Dr. Bernadette Roche the Director at the ENH school of anestheisa. She has published extensively and made films of MDA and CRNA addiction. I sure she could answer your questions with the latest facts and figures

Qanik

[email protected]

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In a prior career as an anesthesiologist, I saw 2 CRNAs become addicted to fentanyl. One quit practice immediately, one went through a drug addiction program requiring monitoring for one year with naltrexone being given orally (witnessed) daily. Within a month after the year probation, the CRNA relapsed sadly again, and quit practice. He was a friend of mine and I was very distraught at his demise. I have seen anesthesia residents addicted to fentanyl, halothane, sufentanil, ketamine, and demerol. One resident that had been on probation once already for substance abuse (fentanyl) had a positive urine drug screen for ketamine 2 days before the end of residency. He never practiced anesthesiology thereafter.

Many who became addicted were the thrill seekers...the base jumpers, mountain climbers, mountain bikers, downhill skiiers....those that like a little living on the edge. But some were quiet and had rather bland lives....

Addiction is a very sad reality of our profession that can bite any of us at any time. Many feel stressed as the inciting cause, turning to fentanyl, an easily accessable drug, thinking they can control their use. But rapid escalation is the rule, and within a few weeks to a few months, most have escalated their doses to massive amounts, sometimes up to 20-50cc per day IV.

You can help...take note of those that are dissheveled, frequently late or unreliable, frequently early (when the obtain the drugs), staying late, seem preoccupied, pinpoint pupils, withdraw from social groups or engagements, and are less conversant than previously. Their charting may become sloppy or abbreviated. Their patients arrive in the PACU screaming in pain and require much higher doses of narcotics in the PACU than do those of other providers. If you notice these signs, don't just chalk it up to too much hard work or study...by notifying your program director, you may save their life. We lost two lives over the past 10 years by not noticing soon enough....don't make the same mistake or think someone else will file a report...everyone else is thinking the same thing and nothing gets reported.

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I'm in CRNA school and I'm actually doing my thesis on this topic which I became interested in after we watched a video on CRNAs and addiction in one of my classes....I'm just getting into to it but the drug of choice seems to be fentanyl..and addiction to fentanyl is quick and deadly...As posted before personalities traits play a part...CRNAs are for the most part Type As,thrill seekers, and risk takers...They also think that if they can administer powerful narcotics safely to their patients they can administer it safely to themselves...the thing is...you have to keep giving yourself more and more to get the "high" you had before...so you walk a fine line between getting high and a deadly overdose....

As far as being able to get the drugs without getting caught I think would be the easiest part. Who knows how much you really give? This isn't something I noticed after going to CRNA school but I really started thinking about it when I worked in the ICU prior to grad school. In the ICU all of our pts were sedated with propofol drips that we keep in the pixis....most had fentanyl drips we keep in the pixis...and most if not all had demerol, morphine, ativan etc prn....Now if you're a nurse who becomes an addict how hard would it be to get your morphine prn and then NOT give it to your gorked patient on a diprivan and fentanyl drip...he's not going to know....Also....you have a 250cc bag of fentanyl hanging...you can take a few ccs out for yourself who's going to know that either? I guess a start would be frequent drug testing, you'd be less likely to do it knowing that once a month a few people are getting tested.....

Most don't get caught because of the paper trail, that comes later....they usually get caught because of their actions and changes in personality etc...

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Specializes in CCU,ICU,ER retired.
In a recent lecture by a peer assistance counseler from AANA, we were told the rate of crna drug abuse was proportional to the country. Does anyone know if this is true? I assumed yes, but have never read anything.....

And to open up another topic, what do you all think about recovered addicts returning to practice? I have a strong opinion on that, always just thinking "what if my mother was the patient" type of approach, what do you guys think?

It is really a crap shoot on recovering nurses going back to work.They all have the same opportunities. Some get it and some don't.

I have been recovering since 1986. I don't drink and I go to NA/AA meetings frequently. Plus I work for the Perr review in our state. I have done that for 6 years. I know there are more recovering nurses than ones that still use drugs.

But I do know an addict when I see one. I would be the first to report it too just so that nurse can get help. and have a better life.

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McD-2 = McDonough, J.P. 1990. Personality, addiction and anesthesia. AANA Journal. 58: 193‑200.

Bell, D.M., McDonough, J.P., Ellison, J.S., 1999. Controlled drug misuse by Certified Registered Nurse Anesthetists. AANA Journal. 64: 133‑140.

Excellent resource for more information.

CRNA and Anesthesiologist are MORE likely than any other type of nursing or medical speciality to have chemical dependency issues, and are more likely than the general population to abuse various substances. Access is a big issue, as well as personality.

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