RN taking prescription benzo's for sleep

Nurses Recovery

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Is it legal for a RN to take prescription xanax for help with anxiety and sleep? Will I get in trouble for this?

Specializes in Community, OB, Nursery.

I have an addiction to food - specifically sugar. But I can take or leave alcohol, and opiates. I work nights, not really a choice at the moment, and it screws my body up. So I take Lunesta on occasion. And....I will never ever voluntarily go off my Zoloft.

Specializes in Nephrology, Cardiology, ER, ICU.

While we want to be supportive of the op, we need to be mindful that we are only offering support and not suggesting different med regimens. Thanks everyone.

I guess I basically see not much different between self-medicating with alcohol for anxiety and taking benzos on a daily basis. In both cases your body starts to crave it, you develop an increasing tolerance, you become physically dependent, you hurt your liver, and you need it to get through the day.

There's metabolizing a small amount of a prescribed substance and drinking your way into cirrhosis and wet brain.

I never took a Xanax and decided not to go back to work from lunch.

Specializes in Med/Surge, Private Duty Peds.

i have a script for ambien cr- because the side- effects of 4 bp meds and other heart meds cause me to have major insomnia. so yes if one is under the care of a medical care giver, md/np.

Nicely said Sue:yeah:

Specializes in Med/Surge, Private Duty Peds.

[ and....i will never ever voluntarily go off my zoloft.

:yeah::yeah::yeah::yeah::bugeyes::bugeyes::bugeyes:

tried that and it didn't work so now i make sure my zoloft scrip never runs out! same thing again, magor side effects from heart meds.

Specializes in ICU.
As long as you have prescriptions for them and are taking them as prescribed there is NOT a problem.

Nurses have the right to take any medication that is medically necessary for them as prescribed as long as it does not interfere with their ability to do their job!

This statement right here throws up a huge red flag. Do you realize that this is one of the first coping mechanisms that an addict uses?? "I have a prescription! It MUST BE ALRIGHT!"

Jack, chime in on this one?

This statement right here throws up a huge red flag. Do you realize that this is one of the first coping mechanisms that an addict uses?? "I have a prescription! It MUST BE ALRIGHT!"

Jack, chime in on this one?

Um, and "the taking them as prescribed" counters that.

Are you now psychic and able to diagnose addicts via couple-of-sentence internet posts?

Specializes in ICU.
Um, and "the taking them as prescribed" counters that.

Are you now psychic and able to diagnose addicts via couple-of-sentence internet posts?

nooooooo.. dear.

I am not diagnosing anyone. However, it is a red flag when someone says "It's a prescription, so it must be alright!" It is a HUGE red flag. That coupled with other things like taking too much of a dose, using it incorrectly, and adding alcohol or other drugs for a more grande effect and you've got your perfect addict.

That quote is one of the first things an addict tells themselves to make it 'okay'.

I'm not an addict, I have a prescription for those vicodin, xanax, soma and ALL of my pills! lol duhh,, okay. sure. Keep telling yourself that...

Specializes in Family Practice, Mental Health.

This post reminded me of the time that I asked a co-worker (RN) for some Ibuprofen because I had a terrible ache at work. She fished out some of her Ibuprofen out of her Xanax bottle for me and handed them over. I still chuckle when I remember the laugh we had about me getting the "contact" relaxation from the Xanax dust.

Specializes in Impaired Nurse Advocate, CRNA, ER,.

Lots of interesting discussion in this thread.

There is a legal webinar coming up in March that discusses this very topic. Follow this link to read more about the program. "A Balancing Act in the Workplace: Managing the Risks When a Nurse Takes Prescribed Medication"

How does addiction start? It can happen slowly or quickly depending on several variables. These variables include, but are not limited to the following:

  • Genetics
  • Age when first exposed to mood altering chemicals
  • The potency of the chemical (alcohol has a low potency while sufentanil has a high potency (1,000 X's more potent than morphine)
  • The intensity of the effects when first used
  • Frequency of use

My drug of "choice" was opioids. I had a chronic pain issue due to spondylolisthesis. Once or twice a year I would have back pain which required opioids for a couple of days. I rarely used the entire prescription. I eventually had back and leg pain which required more than one prescription. After several refills the neurologist refused to order any more because "The xrays and CT scans don't show significant advancement of spondylolisthesis, so you couldn't be having this much pain. I started using the left over fentanyl from my cases to help me get some sleep. This was the first sign the gene responsible for addiction had been "activated". The thought of taking drugs from work had never occurred to me in my 20 years of practice, yet it seemed the logical thing to do now that my addiction was blossoming.

The point is, someone with the genetic possibility of addiction can develop the disease despite following the prescription. Since we have no idea when the gene is activated, minimizing exposure to mood altering chemicals is the best prevention available today. A family history of addiction is the best indicator of genetic susceptibility. So, if there are addicts in the family, avoiding the use of mood altering substances (including alcohol) unless they are absolutely necessary. A common misconception is that addiction to opioids, cocaine, barbiturate, benzodiazepines, sedatives, stimulants, etc. is somehow different than alcoholism. In reality it's the same disease with alcohol as the drug of choice.

Dr. Carl Erickson, director of the Addiction Science Research and Education Center says it pretty well:

Dependency is a brain chemistry disease.

"The problem with alcohol dependence is not in the bottle and it's not in the glass. The disease is in the brain," says Erickson. "The uncontrolled drinking is just the symptom."

Erickson points out two major types of drug and alcohol problems. One is willful drug abuse. The other is the chemical dependence disease of the brain. How do they differ? "One has the ability to stop on his own and one doesn't. The latter will drink until he dies if he's not intervened upon," he says.

Why is that? "It now appears that a person must have what it takes to become dependent on drugs," says Erickson. "In many cases, genetics is the main risk factor for determining who develops the disease." To make matters more complicated, each of us has triggering factors or environmental factors that scientists have not yet identified that make some people more vulnerable when they are genetically predisposed to dependency and others less vulnerable.

This applies to all substances with addicting properties. Alcohol is simply one of the many drugs that can cause addiction in a susceptible person.

The second concern; does taking a sleeping medication or other prescribed mood altering medication interfere with a clinicians ability to practice safely. Is there a fitness for duty policy where the nurse works? If so, follow the procedures spelled out in the policy. Ask the prescribing physician under what conditions may the nurse return to work. What does the nurse practice act say about the nurse taking medication that has the possibility of impairing their practice? While a nurse has the right to take any medications ordered by a physician, the nurse also has the responsibility to be sure it won't impair their ability to practice safely.

Finally, if a nurse is involved in an alternative to discipline program, what does the program have to say about the nurse receiving prescribed medications with a risk of dependence?

The Texas Peer Assistance Program for Nurses says this about "abusable drugs"

7. Abusable Drugs

Participants must abstain completely from the use of all abusable drugs. Abusable drugs include alcohol,

illicit substances, controlled substances (with or without prescription), uncontrolled substances

(prescription or over-the-counter medications that contain alcohol or other abusable substances).

Antidepressants are not considered in this category.

If pain management is needed:

* TPAPN recommends that participants try non-addictive approaches before taking or continuing abusable

medication.

* If any potentially abusable medication is prescribed or taken:

  • Participant must immediately notify TPAPN and employer about the prescription.
  • Participant must refrain from nursing practice until approved to return to work.
  • The prescribing healthcare provider must complete the TPAPN PRESCRIPTION INFORMATION form forparticipant to fax to TPAPN.

* Unreported use of abusable medications or failure to disclose prescriptions at the time they are obtained is

considered behavior inconsistent with good recovery and may result in dismissal from the program, an

extension of the participation, or a renewal of the participation agreement.

PARTICIPANTS WITH CONDITIONS REQUIRING LONG-TERM USE OF ABUSABLE MEDICATIONS MAY NOT BE

APPROPRIATE FOR TPAPN.

The Talbott Recovery Campus has a publication called "Medication Guide for a Safe Recovery (download it at this link). They have 3 classifications...Class A Drugs, B Drugs, C Drugs. To see which drugs are in which category follow the link and scroll through the first couple of pages.

Class A drugs must be avoided completely, as they are well known to produce addiction and are the most dangerous of all. Only under very unusual conditions can Class A drugs be taken by a recovering addict or alcoholic, and only when given by a physician or dentist and with the consent of the addiction medicine physician that follows your care. These exceptional circumstances can include severe illness and injuries, including major surgery, car accidents and other trauma, and tests or procedures that can only be done under sedation or anesthesia. Medication treatments for certain psychiatric conditions are in this category as are medications used for drug detoxification. The street names for relevant drugs are also included in Class A.

Benzodiazepines:

Ativan (lorazepam), Restoril (temazepam), Centrax (prazepam), Serax (oxazepam), Dalmane (flurazepam), Tranxene (chlorazepate), Doral (quazepam), Valium (diazepam), Halcion (triazolam), Versed (midazolam), Klonopin (clonazepam), Xanax (alprazolam), Librium (chlordiazepoxide)

These medications can produce an immediate change in mood or affect and can cause central nervous system depression (dose related) resulting in sedation, dizziness, confusion or ataxia, which may impair physical and mental capabilities. Abrupt discontinuation or a large decrease in dose can lead to seizures, coma or death.

This is a complex issue with far reaching consequences. Each nurse needs to be aware of their state nurse practice act and practice accordingly. When in doubt, seek clarification from the board of nursing, state nurses associations, peer assistance/alternative programs (if they exist), hospital policy, risk management, and the treatment facility where the nurse was treated.

One day at a time!

Jack

nooooooo.. dear.

I am not diagnosing anyone. However, it is a red flag when someone says "It's a prescription, so it must be alright!" It is a HUGE red flag. That coupled with other things like taking too much of a dose, using it incorrectly, and adding alcohol or other drugs for a more grande effect and you've got your perfect addict.

That quote is one of the first things an addict tells themselves to make it 'okay'.

I'm not an addict, I have a prescription for those vicodin, xanax, soma and ALL of my pills! lol duhh,, okay. sure. Keep telling yourself that...

Don't dear me, dear.

I have no idea what an addict tells himself. I know that blanket condemnation of prescription medications can hurt people. I've seen it done in AA, back when the earth was till cooling, and schizophrenics were urged to get off of their psychotropics because they were mind-altering. Well, I certainly hope so!

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