Info for non-addicted nurses with chronic pain taking opioids

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For almost 5 years now, my sister has been undergoing an ordeal with her state Board of Nursing because of a complaint lodged by her employer. Long story made short, she had chronic pain, underwent many, many conservative medical therapies, had a 3-level cervical spine fusion, and eventually required use of opioid medications. She was under close supervision of a pain specialist and there were no issues of impairment, drug diversion, or patient safety. She has now spent thousands of dollars on attorney fees (3 attorneys, so far), experienced an unsuccessful mediation, went through a trial that was prosecuted by an Assistant Attorney General (representing the Board), had her license suspended for 9 months (the suspension didn't actually occur until after her pain resolved to a point that she no longer required the pain medication), and is now in a 3-year Peer Assistance Services program for people who have substance abuse and mental issues. In this program she must submit to weekly random urine screens, attend two group therapy sessions per month, and two private counseling sessions per month. Her employer must monitor her and send lengthy reports to Peer Assistance Services. She has received a letter from the federal government stating that because her license was suspended for drug reasons, she is not permitted to work in a facility that receives federal funding (i.e., Medicare or Medicaid) for five years. She is fortunate to have employment, but makes about half the salary she would in other positions for which she is qualified.

That said, it has been very difficult to find information that pertains to the issue of healthcare professionals, management of the healthcare professional's chronic pain, and fitness for work. I just came across the following statement issued by the AANA (American Association of Nurse Anesthetists). I post it below in the event that it can help another "non addicted" nurse who appropriately utilizes prescribed pain medications in her employer/Board dealings. The statement does make a recommendation for a neuropsychological evaluation and written clearance for return to work by the physician. This would mean disclosure to to nurse's employer.

It is my opinion that employers (yes, healthcare providers) and staff/members of the various Board's of Nursing are largely uneducated about this subject. In the interest of protecting the public (an important consideration) they (employers and regulatory agencies) would rather err on the side of conservative, rather than potentially face public outcry in the event that a patient safety situation arise - and then have to explain for their apparent lack of due diligence. Position statements, such as the one cited below, may help to inform and inspire productive conversations and lead to actions that will benefit patients and be fair and supportive to nurses.

AANA Advisory Opinion 5.4

Patient Safety and CRNAs on Drug Therapy Regimens for Pain Management

http://www.aana.com/resources.aspx?ucNavMenu_TSMenuTargetID=51&ucNavMenu_TSMenuTargetType=4&ucNavMenu_TSMenuID=6&id=2185

Specializes in Foot care.
People that know I am on the medications ask me if I am afraid of addiction. I usually respond that I don't have any fear of addiction because I only take the medication for pain. True I may develop some tolerance or physical dependence, but that is still a different issue than addiction.
I'm new to this pain experience myself, and a new grad looking for a job, to boot. I have radicular pain from a herniated disc at C6-7, not d/t any specific injury. In retrospect I now know it has been cooking for a few years, and I'm thankful it waited until I graduated before worsening. I am awaiting an appointment for an epidural steroid injection. I'll be transitioning from percocet to ultram (tramadol) this weekend.

I'm unhappy about the prognostic uncertainty. I wanted to get that 1-2 years hospital nursing under my belt, but I'm not sure this would be good for my body. And I'm not sure anyone will want to hire me. I'm now very interested in pain management; luckily, it fits nicely with my other interests.

This is just to say that I, too, have no fears of addiction. I think anyone who talks to someone in pain about addiction doesn't know what it's like to have pain. I take the medication b/c I have pain. When I don't have pain, I don't take it. I get a little bit of a euphoric buzz about 30 minutes after taking it; this goes away in the next 30 minutes. I have absolutely no urge to take more to get more of a buzz. I think this is why I don't worry about addiction. I think the oxycodone makes me a little emotional; prone to cry if talking in detail about this latest discouraging development.

Good luck to us!

I would really like to review this opinion but it is no longer available on the site. Does anyone have it copied so that it can be published on this site for review?

Now I'm really freaking out! I've been on percocets for years due to various neck and back problems. I go in two days for my drug test with the company that offered me my graduate nurse position. They told me to bring my prescrition bottles, as I also take heart meds, etc. I wasn't worried about this, as I do not abuse my meds, but now after seeing this, I am worried!!! Will they refuse to hire me now in NY?

Chocolate in my opinion I would not do the drug test if you are going to test positive. Not only will they withdraw the offer of employment but they can also report to the ipn program and the board of nursing. That is not an entanglement you want to get into. They can place you under supervision for years.

chocolate, if you have an RX for them it wont show that you tested positive

chocolate, if you have an RX for them it wont show that you tested positive

Thanks B52-H, I'd brought my bottle with me when I went. She made a copy of the label, but I haven't heard back from them. I went a week ago, she said they'd call if they needed anything. I'm still nervous, but so far no calls to withdraw my job :yeah::yeah:

Specializes in NICU, ER, OR.

my question to the op, how did your employer/bon even find out about you taking these meds?

I'm SO sorry your sister has been going through all of this. This might sound radical, but I'll throw it out there...use the media. See if she will give an interview with a local newspaper, TV, or radio show. Get attention for what is discrimination. You're right. Lack of education about pain and proper pain medication is nearly universal. And there are places that DO get it- I worked at a chemical dependency facility in TX, and they understood the difference. I don't understand how they can prosecute her for not breaking the law. Another idea is contacting the Americans With Disabilities site, and seeking info on free legal help. Can she do anything about appealing the decision? (I don't know how different courts do those things). Another idea is to ask the pain management doc if he/she knows any attorneys that may work with your sister based on principle, and what seems like a huge miscarriage of 'justice'.

I've had to do pre-employment drug screens just about everywhere I've worked since 1985- until being officially disabled in 2004, and when on Darvocet I listed it on the form for the test (refusing the test was an automatic withdrawl of the job offer), and brought in my prescription bottles. End of story. The test did come back with propoxyphene present, but since it was all prescribed, it was a non-issue. They can't really do much about a legal prescription. If they get in a snit, offer a one time letter from your MD about the need for that medication. IF they're still horrible about it, do you want to work there? JMHO

It's going to look worse if you hide pain medication prescribed for legitimate issues. It's more likely to be an issue of what requires the medication, but if you have medical clearance to perform the work required, the facility needs some really good reasons to blow you off or make your life difficult.

Best of luck with all of this.

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