My CRNA friends do illegal drugs

[DrugReptoNurse]

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.

[paindoc]

Having to deal with patients that feel it is just fine to use recreational drugs whenever they damned will please and in whatever intervals they wish (appropriate use of recreational drugs is completely self defined and based on just how high a person wants to be), it is surprising to see professionals defending their "rights" to use illegal drugs and commit illegal acts whenever they see fit. It is the law that defines the boundaries of society and permits us to live in a manner that reduces injury potential to others. Those that constantly reinterpret the laws of the land to fit their own needs are dangerous to the rest of society, because they believe there should be no restrictions on their activities. The slippery slope of those that place themselves above the law at the expense of those who do not should not be condoned by society, but especially by professionals. Image is not the issue, it is responsibility, and professionals are expected to behave in a more responsible manner than drug addicts. For a professional to condone the use of illegal drugs on the basis of their uncompromised morals and ethics is disingenouous and is an anathema to our way of life.

Terrorists do not see the value in obeying laws. Neither do professionals that condone illegal drug use.

[ZASHAGALKA, RN]

Knowing the implications on continued licensure and yet STILL using illegal recreational drugs - at any time - is addictive behavior.

You can bring up alcohol and cigs all you want. IF I choose to use any legal substance on my day off, I am not risking my license. To risk your license is a sure sign that the NEED to use is more important than the NEED to protect that high investment.

And, as has been pointed out, working anesthesia is one of the most abuse prone jobs simply because of access.

It's simply playing with fire. I could not in good conscience know that someone was playing with fire in such a way and not intervene - if not for their PATIENTS, then for them personally.

Friends don't let friends put themselves in such positions. Professionals don't condone such behavior in fellow professionals.

If I know a friend intends to commit suicide, I'd intervene, regardless the cost. I just don't see much difference in standing by and watching a friend commit professional suicide.

It's unprofessional behavior. Simply put, it's not only against the law, it's rightly grounds for a mandated peer review program or loss of licensure.

~faith,

Timothy.

[jwk]

Professionals don't condone such behavior in fellow professionals.

This really says it all in a nutshell. Well said Timothy!

[catcolalex]

If the board of nursing can take away a license if you are caught doing any illegal drugs whether you are working or not, does that not answer what should be done? things are "illegal "for a reason.

[CaseManager1947]

I will refer interested individuals to www.Drugabuse.gov/meetings/MDMA/MDMAExSummary.html

This is the government's take on MDMA or ectasy. This compound has "dissociative qualities" similar to pot and if anyone remembers Ketamine, also similar to that. It does not actually produce hallucinatory experiences, but causes a rather out of body type experience from what I've read. Attend closely, however, to the portions of this web page that address long term affects, as this drug affects the serotonin system in the brain. Also, can damage fetus, if a young, potentially pregnant CRNA were to use. it. Bottom line, this is an illegal drug, and there have also been reported deaths with it, as some users will "bump" the dose, to get an additional high. I guess people will do what they're going to do,as some have said. I think it is ill advised, however.

[Alpha13]

So many posts that keep rehashing the same arguments. I'll just break down the one below because I feel it covers the most bases.

Knowing the implications on continued licensure and yet STILL using illegal recreational drugs - at any time - is addictive behavior.

The fallacy that "knowing the risk and still using = addiction" is pretty obvious so I won't elaborate.

You can bring up alcohol and cigs all you want. IF I choose to use any legal substance on my day off, I am not risking my license. To risk your license is a sure sign that the NEED to use is more important than the NEED to protect that high investment.

You are right, it certainly is a sign (key word) that these people may have developed a dependance. But you can't exclude the possibility that they are just using the drugs for recreation! Think about it, what if these ladies are the club type that occasionally take ecstasy under the assumption that it's very unlikely they'll get caught? We do risky things all the time and our actions don't always imply need

And, as has been pointed out, working anesthesia is one of the most abuse prone jobs simply because of access.

It's simply playing with fire. I could not in good conscience know that someone was playing with fire in such a way and not intervene - if not for their PATIENTS, then for them personally.

*inserts standard alcohol defense*

Friends don't let friends put themselves in such positions. Professionals don't condone such behavior in fellow professionals.

If these professionals felt that the drug was hampering the collegue's job performance then yes, they have a responsibility to turn that person in. But is that the case with recreational ecstacy use? I dare you to say yes (so I can use the alcohol defense again!)

If I know a friend intends to commit suicide, I'd intervene, regardless the cost. I just don't see much difference in standing by and watching a friend commit professional suicide.

Professional suicide? What a horrible analogy!

It's unprofessional behavior. Simply put, it's not only against the law, it's rightly grounds for a mandated peer review program or loss of licensure.

It's a bold claim to state that recreational ecstasy use is unprofessional when you don't really have any reason to believe these CRNAs are impaired in any way for their professional duties. I'd be comfortable making an assertion like that for a hard drug but not ecstasy. As for your latter sentence, no argument here but the question is should a friend turn these people in? You could take the hard line and say that yes, in ANY case where a friend is breaking the law they should be turned in, but I doubt that you take such a hard line with the law (if not, do you speed? I love to ask that to hard liners) It is up to the the friend to turn these people in and if she doesn't have a nazi view of illegal drugs like some of you people, I don't see any reason for her to do so.

~faith,

Timothy.

~Anarchy!

Alpha

[ZASHAGALKA, RN]

I'm all for being an anarchist, if that is your desire. But, rebelling against the system means that the system can and should turn it's back on you.

So, in your anarchist state of mind, my response would be complete disassociation and that includes no licensure. You can't have it both ways, the world doesn't work that way.

It IS unprofessional behavior. Any action that you have to hide from the BON is, by definition, unprofessional as considered by the BON.

Look up the word 'professional'. A key definition is adherence to a standard of professional practice. And not exhibiting addictive behavior IS a standard when your job entails handling addictive substances.

~faith,

Timothy.

[Josh L.Ac.]

Ecstasy is an "unclean" designer drug that also contains various amounts of ephedrine, DXM and ketamine (which produce PCP-like effects), cocaine and methamphetamines.

The threat of adulterated ecstacy might be a possibility, but anyone can order an ecstacy testing kit to make sure what they are getting is clean. If someone is intelligent enough to make it through CRNA school, they could probably figure out how to use the reagent kits to make sure they are not getting all of the "nasty stuff".

Also a reality check. Usually people making fake pill are going to adulterate the pills with cheap ingredients in order to make more money. They probably are not going to use cocaine or heroin. But even if they do...it will show up on the kit.

On the other hand, I would hate to have a CRNA working on me that is having "the next day blues"...although there are ways to prevent that as well.

Oh, and the only people that I've ever seen that reported "ketamine-like effects" while doing ecstacy were those that were actually doing ketamine.

[/off-topic]

If it is your professional opinion that the drug use of your collegues [whether it be illegal, legal, prescription, herbal, synthetic, or whatever] is endangering their patients, then it has to be reported. And while legal =/= moral, as a medical professional, you have certain ethical responsibilties that others might not be subject to.

[susswood]

Terrorists do not see the value in obeying laws. Neither do professionals that condone illegal drug use.

Comparing terrorists with drug use? Lets get real here. That's insulting.

And just to clarify, just because you believe people heve the right to do what they want in their own time does not mean you condone or endorse the behavior. Many of us just believe in the right to privacy.

The fact that ecstacy is illegal does not make it any more dangerous than a legal drug like alcohol. In the right circumstance, alcohol can be just as illegal and much more dangerous than ecstacy (i.e. driving). Alcohol related deaths are in fact frequently reported... when was the last time you heard about an ecstacy related death? Want your health-care provider to work with an alcohol hang-over? No, but it's legal, and it probably happens way more often than you think. In fact, alcohol addiction is a common and unfortunate problem... ecstacy addiction? I don't think so.

Honestly, I would think very hard before I went off and tried to ruin someone's life 'cause they party on the weekend. Honestly, I'm way more afraid of alcoholics... they're everywhere, and they're well within the law to carry out their addiction. Like I said... get a grip, people.

[RNCRNA2BE]

Comparing terrorists with drug use? Lets get real here. That's insulting.

And just to clarify, just because you believe people heve the right to do what they want in their own time does not mean you condone or endorse the behavior. Many of us just believe in the right to privacy.

The fact that ecstacy is illegal does not make it any more dangerous than a legal drug like alcohol. In the right circumstance, alcohol can be just as illegal and much more dangerous than ecstacy (i.e. driving). Alcohol related deaths are in fact frequently reported... when was the last time you heard about an ecstacy related death? Want your health-care provider to work with an alcohol hang-over? No, but it's legal, and it probably happens way more often than you think. In fact, alcohol addiction is a common and unfortunate problem... ecstacy addiction? I don't think so.

Honestly, I would think very hard before I went off and tried to ruin someone's life 'cause they party on the weekend. Honestly, I'm way more afraid of alcoholics... they're everywhere, and they're well within the law to carry out their addiction. Like I said... get a grip, people.

:yeahthat:

[Focker, CRNA]

This website should enable posters to do polls, most web bulletin board services have that feature. That way we could see a running tally of what everyone thinks/would do. So far the categories, from one extreme to the other, look like:

1. Mind your own business/blowing it out of proportion

2. I'm on the fence

3. Confront the friends before doing anything else

4. Turn them in immediately

5. They are terrorists :uhoh21:

[deepz]

.... "dissociative qualities" similar to pot and if anyone remembers Ketamine, also similar to that. .........

'Remembers ketamine'?

Remember it? Do you wish to imply that ketamine is not used in everyday current practice? Not so. Hardly a week goes by that I don't employ ketamine in some manner as an adjunct to general anesthesia or MAC sedation.

deepz