My CRNA friends do illegal drugs

Specialties CRNA

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Two of my friends who are CRNA's take recreational ecstasy almost every weekend. They will take it on Saturday night...stay up all night....and then try to sleep it off on Sunday. When Monday morning comes around they go to their contract per diem positions and perform anesthesia mostly in private practice plastic surgery clinics.

I am worried that one day they may provide anestheisa while the ecstasy is still running through their systems.

A couple of questions for those of you who are currently CRNAs.

1. How do you approach a CRNA and tell them you are worried they might harm a patient while under the influence.

2. What else would you do to make sure they don't harm anybody? Should I contact the state board or should I mind my own business? For the record I am just a nursing student.

They have both been practicing for 8 years and have never had any problems in the past. I just know I wouldn't want to be patient under their care.

Specializes in critical care.

As a SRNA wannabe and a recovering drunk/drug addict with >12 years of sobriety I think I have something to add to this conversation. There are many people in this world that can use alcohol and drugs recreationally and not become addicted. Most estimates I've seen point to about 10 % of the population becomes addicted to alcohol or drugs. Some, like me, become instantly addicted shortly after first experimenting with these substances. Some experience several years of "normal" drinking and using before crossing the line into full blown addiction. And the rest of the population can use drugs or drink without developing an addiction to it.

Regarding the situation you described in your post, I would just watch them. Addiction is self limiting. If they become addicts or already are, don't worry, their very nature as addicts will lead to them to being revealed by their colleagues. There will most likely be frequent sick calls, being habitually late, missing narcs, etc. I would continue to watch and notify their supervisors only if you feel they are impaired while providing anesthesia care.

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Sorry to say, I disagree with you all. While I acknowledge these people have worked extremely hard for their license, and it is possible they have never been "impaired" during a case...it is not certain. The sheer fact that they can use, and rationalize the use, of illegal designer drugs shows poor judgement. It is impossible to know whether they are minimizing the effects of the drug abuse to make others feel as though it has no impact on their performance during anesthesia. I feel as if the right thing to do would be to confront your friend in a firm, yet non judgemental manner and insist that they have a drug problem and should seek immediate help. And the consequences for refusing to help will force you to speak to their employer. I would not take it to the BON. This is my opinion, how I would handle it, and I don't expect anyone to agree with me. Just my two cents.

I'm with you 100% on this one. Would I want this individual giving anesthesia to my wife, mother, brother? If your allegations are true, absolutely not. There are a lot of people that work very hard for their degrees, but that doesn't exempt them from professional conduct. If they want to do recreational drugs, fine...but perhaps a career where you aren't responsible for the lives of others might be more appropriate. The well-being of their patients is far more important than their years spent in schooing or the debt they have accrued. Not even comparable.

And I asked myself how I would feel if something DID happen as a result of their recreational drug use...I would feel absolutely horrible and a bit responsible. In my opinion, putting one's head in the sand and not reporting these types of things (either to the employer or the BON) is irresponsible.

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Specializes in Critical Care, Pediatrics, Geriatrics.

ever heard of an enabler? making excuses for the offender...denying the effects of the abuse? etc.

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Question for those who condemn these CRNAs: Would you feel the same way if their drug of choice was cigarretes or alcohol? I ask because you guys seem to assume they have some drug abuse/addiction problem even though the poster didn't make any claims to imply this.

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Specializes in Medical Telemetry, LTC,AlF, Skilled care.

That's an incredibly tough situation. To be honest I don't know what I would if I were in that situation, best of luck to you in dealing with this.

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Specializes in Critical Care, Pediatrics, Geriatrics.
Question for those who condemn these CRNAs: Would you feel the same way if their drug of choice was cigarretes or alcohol? I ask because you guys seem to assume they have some drug abuse/addiction problem even though the poster didn't make any claims to imply this.

Cigarettes do not impair one's ability to perform the task at hand, and recreational alcohol is legal. Ecstasy, if that is indeed what is being used, even as a recreational drug is illegal. I don't believe these nurses should be burned at the stake and never allowed to practice, but intervention is necessary with the goal of rehabilitation so they can continue their practice.

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Specializes in Critical Care, Pediatrics, Geriatrics.

The following is from http://www.nida.nih.gov/Infofacts/ecstasy.html

For some people, MDMA can be addictive. A survey of young adult and adolescent MDMA users found that 43 percent of those who reported ecstasy use met the accepted diagnostic criteria for dependence, as evidenced by continued use despite knowledge of physical or psychological harm, withdrawal effects, and tolerance (or diminished response), and 34 percent met the criteria for drug abuse. Almost 60 percent of people who use MDMA report withdrawal symptoms, including fatigue, loss of appetite, depressed feelings, and trouble concentrating.

Cognitive Effects

Chronic users of MDMA perform more poorly than nonusers on certain types of cognitive or memory tasks. Some of these effects may be due to the use of other drugs in combination with MDMA, among other factors.

Physical Effects

In high doses, MDMA can interfere with the body's ability to regulate temperature. On rare but unpredictable occasions, this can lead to a sharp increase in body temperature (hyperthermia), resulting in liver, kidney, and cardiovascular system failure, and death.

Because MDMA can interfere with its own metabolism (breakdown within the body), potentially harmful levels can be reached by repeated drug use within short intervals.

Users of MDMA face many of the same risks as users of other stimulants such as cocaine and amphetamines. These include increases in heart rate and blood pressure, a special risk for people with circulatory problems or heart disease, and other symptoms such as muscle tension, involuntary teeth clenching, nausea, blurred vision, faintness, and chills or sweating.

Psychological Effects

These can include confusion, depression, sleep problems, drug craving, and severe anxiety. These problems can occur during and sometimes days or weeks after taking MDMA.

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Effects even from recreational use extend after the drug's initial high has worn off. Don't know about you, but I do not want a CRNA with a fuzzy memory.

It's unprofessional and illegal. We should not enable the abuse to continue by rationalizing that they are not "impaired" while working, but intervene to promote this person's well being. They are using a mind-altering drug with disregard to the laws of the US, risking their license (just because they don't get caught/or may not use at work does not mean they can't get pulled over on the street and sent to jail.), and excercising poor judgement. They need help. They are not demons, they have just fallen victim to drug abuse (which occurs whether you are physically addicted or not).

We learned in class this past week that 8-10% of nurses fall victim to drug abuse, and roughly 30% of nurses come from homes where drugs/alcohol were readily abused. It's not shocking to me, but the reactions of "don't get in their business" and sweep it under the rug mentality are surprising. :(

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Occasional recreational drug use does not equal addiction, nor does it necessarily lead to addiction. Additionally, the occasional use of ecstacy (or any other recreational drug use, including alcohol) does not necessiate the need for any type of "rehabilitation."

Get a grip people.

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Why are we justifying the illegal use of drugs? Cigarettes and alcohol (when consumed in accordance with statutes) are legal. Ecstacy is not...It's illegal, shows very poor professional judgement and there needs to be some sort or an intervention. Sounds like the OP tried, but to no avail. I don't understand this "understanding" attitude for their situation and for their debts and time in school. Accountability, folks!

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I hope the people condoning this aren't CRNA's. Anesthesia providers have the highest incidence of substance abuse above all other groups. It is an illegal drug. What else do they take? Why would they be honest about ever being impared at work? Turn them in. This is not the cub scouts. If you take your responsibilities seriously about being an anesthetist, you would take some official action. Tell the chief CRNA, or supervisor.

And for god's sake, non nursing people read this board. It looks really bad when nurses tell other nurses to turn the other cheek to substance abuse. At least act like you're mildly bothered.

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Specializes in CRNA, Finally retired.
Why are we justifying the illegal use of drugs? Cigarettes and alcohol (when consumed in accordance with statutes) are legal. Ecstacy is not...It's illegal, shows very poor professional judgement and there needs to be some sort or an intervention. Sounds like the OP tried, but to no avail. I don't understand this "understanding" attitude for their situation and for their debts and time in school. Accountability, folks!

"Understanding"= enabling. Period. For all: Read Spacenurses's web site cited in her posting. You'll read that exctasy has a half-life of 8 hours (i.e. around for 40 hours post-ingestion) and has active metabolites. And as one poster reminded us, you're not getting the unadulterated drug - you don't know what you're getting. Grow up, druggies, you're in the real world now where one drug test can measure nanograms and send you to working for an insurance company for a long time.

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Specializes in Critical Care, Pediatrics, Geriatrics.
Occasional recreational drug use does not equal addiction, nor does it necessarily lead to addiction. Additionally, the occasional use of ecstacy (or any other recreational drug use, including alcohol) does not necessiate the need for any type of "rehabilitation."

Get a grip people.

There is a distinct difference between drug abuse and drug addiction. One can also be psychologically addicted to a drug without a physical addiction. It is just as much, if not more harmful, to that individual. If these CRNAs are in denial about the effects of their abuse, then intervention IS necessary because they are showing lack of insight into their problem and poor judgement. Do they belong in a drug rehab facility? Based on the information provided, assuming it is accurate, then no. But they should probably attend some form of AA (which is for more than just alcoholics) for some type of support and insight on their problem. And there is obviously a problem if they have turned to illegal drugs to illicit a mind-altering and mood-altering stimulus/pleasure.

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