Nurses Who Are Drug Addicts

jill48, ASN, RN · Apr 15, 2007

I'm pretty much torn on this one. On the one hand I think hmmmm, nurses who are recovering addicts working in a position of easy access to narcs...probably not a good idea. On the other hand everyone deserves a second chance and people can change. People like cattitude who have the power to admit a problem and will find a job that is in their field but restricts them access are great...good work to you cattitude.
Incidently...I don't believe addiction is a disease. Although it may seem like one in the end, it starts as a choice and progresses from there. It also ends with a choice. Do I have a disease because I smoke tobacco? Personally, I don't think so, I think I just made an incredibly bad choice. I know the DSM lists it as a disease now and it is widely accepted that it is, I just disagree...but I have strong opinions on many things.

How can you not think addiction is a disease? If one person can take a drug and never care to touch it again, but another person takes the same drug and has to have it again and again, then one of them has an addiction and one doesn't. No, your smoking is not a disease, but it will surely lead to disease. How is it possible, this day in age, can a nurse not think this is a disease? Have you never had anyone close to you suffer from an addiction?

AirforceRN, RN · Apr 15, 2007

Yes Jill48, I have and still do. ETOH runs strong in my family and I have relatives also into percs and T3s...started after another family member died and went down hill from there. It has taken a serious toll on their lives, in fact I lost both my grandparents to the drink.

What makes addiction to drugs different from nicotine? I go through withdrawl if I stop smoking. I crave it when I don't have it. I've rolled nickels to buy a pack. Is it different because its legal? Is it not included because then millions of Americans and Canadians (and indeed people worldwide) would have to be labelled as diseased?

RJ---RN · Apr 15, 2007

Over the years I have worked with nurses who are addicts. I have reported them to the nurse manager, and maybe she was fired, but went to the next facility and began all over again.

When I became nurse manager, I had a nurse who was suspect of stealing drugs. I did a thorough investigation...that is I pulled charts, looked at the MAR, compared narc signout sheets, and found discrepancies. It took quite a while. I wanted to be sure before I reported her to state board. Finally, I had the documentation I needed and reported her. Someone from the atty generals office came and did a review. Thanked me for my thorough documentation. Long story short............her license was eventually revoked.

Now here is the kicker............Several months later this now "former" nurse came back to talk with me. I figured she was gonna lay into me, but lo and behold she thanked me. She told me I was the only one out of many many jobs that had the courage to stop her. All the rest, she said, just swept it under the carpet.

Go with your heart............remember your nursing pledge and good luck!

Bluehair · Apr 15, 2007

Our state BON has a program to help get nurse's back to work while they are recovering from addiction. It's pretty strict, not cheap for the nurse going through it. Nurse has to pay her own way for weekly therapy, plus be actively involved in a 12-step program, plus pay for all their own pee tests, etc. BUT - these 2 nurses are great! They are so thankful for a chance to rebuild their lives. They take full responsibility for what they did, and are working to get through the program. Eventually they will 'graduate' and not have to do so much (one only has to do monthly and prn pee tests instead of weekly, submits reports from her NM to BON every other month instead of monthly etc.).

It feels like it does when I am helping patients, helping a nurse get her feet back on the ground and get her life back. Maybe better.

Cattitude · Apr 15, 2007

Yes Jill48, I have and still do. ETOH runs strong in my family and I have relatives also into percs and T3s...started after another family member died and went down hill from there. It has taken a serious toll on their lives, in fact I lost both my grandparents to the drink.
What makes addiction to drugs different from nicotine? I go through withdrawl if I stop smoking. I crave it when I don't have it. I've rolled nickels to buy a pack. Is it different because its legal? Is it not included because then millions of Americans and Canadians (and indeed people worldwide) would have to be labelled as diseased?

I'm sorry you have family members w/addiction, it's hard I know. In addition to being an addict, I also have family with it as well. But BEING the actual addict brings an understanding that is beyond just being the son or wife or father etc.

As far as the nicotine issue? Well nicotine doesn't ususally cost you your job, marriage, license, sanity, etc. Most smokers don't steal and commit crimes to get ciggies. While smoking is an addiction, there is a difference in levels.

Our state BON has a program to help get nurse's back to work while they are recovering from addiction. It's pretty strict, not cheap for the nurse going through it. Nurse has to pay her own way for weekly therapy, plus be actively involved in a 12-step program, plus pay for all their own pee tests, etc. BUT - these 2 nurses are great! They are so thankful for a chance to rebuild their lives. They take full responsibility for what they did, and are working to get through the program. Eventually they will 'graduate' and not have to do so much (one only has to do monthly and prn pee tests instead of weekly, submits reports from her NM to BON every other month instead of monthly etc.).
It feels like it does when I am helping patients, helping a nurse get her feet back on the ground and get her life back. Maybe better.

Thank you Bluehair.. Most states have alternative programs to assist recovering nurses. they are very intense, time consuming, and expensive for the nurse. Many do last years and these programs closely monitor recovering nurses. It is not easy or quick so most that go through these programs are serious about their recovery.

rn/writer, RN · Apr 16, 2007

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As far as the nicotine issue? Well nicotine doesn't ususally cost you your job, marriage, license, sanity, etc. Most smokers don't steal and commit crimes to get ciggies. While smoking is an addiction, there is a difference in levels.

If nicotine were an illegal substance that was under extreme scrutiny and regulation, perhaps we would see the ravaging losses now associated with alcohol and drug addiction. The fact that it is legal, readily available, and not something we routinely have to dispense in a hospital setting takes away the "forbidden fruit" aspect.

Nicotine addiction seems to level off or progess at a shallow rate compared to ETOH and drug use. Smokers need their fix, but many can cut back to a lower level as long as they get a certain minimum amount. Others don't try to cut back, but neither do they escalate. It's common to hear of two- or three-pack-a-day smokers (occasionally more). But, for whatever reason, there seems to be a leveling-off point beyond which smokers don't generally go. Many drinkers and druggers do keep progressing, needing greater amounts to reach the same high.

The disease vs. choice conflict, like so many other debates, is futile. Each idea contains part of the truth. Neither contains the whole truth.

The reality is that addiction is a condition. You don't have a choice about having the condition. You do or you don't have it, and that's a fact. But as with other conditions, you do have a choice about how you live with it. You don't get to opt out of having an overly responsive system that craves certain substances. You do get to decide--when you are clean and sober--whether you will throw yourself headlong into the abyss or whether you will structure you world in such a way that you will avoid as much tempation as possible.

Addicts are NOT responsible for being addicts. They ARE at least somewhat responsible for remaining addicts.

Anyone who has the courage, the wisdom, the humility and the strength to fight for their sanity and sobriety has my admiration and respect.

jill48, ASN, RN · Apr 16, 2007

Yes Jill48, I have and still do. ETOH runs strong in my family and I have relatives also into percs and T3s...started after another family member died and went down hill from there. It has taken a serious toll on their lives, in fact I lost both my grandparents to the drink.
What makes addiction to drugs different from nicotine? I go through withdrawl if I stop smoking. I crave it when I don't have it. I've rolled nickels to buy a pack. Is it different because its legal? Is it not included because then millions of Americans and Canadians (and indeed people worldwide) would have to be labelled as diseased?

I understand the points that you are making and I am not trying to be rude so please don't take it that way. I am just really interested in what you are saying because I have never known any nurses that feel this way (that I know of, anyway). So, what do you think the difference is between a disease and an addiction? If I'm hearing you correctly, and correct me if I'm wrong, you are saying that an addict asked for whatever happens to them because they chose to take the drug. Is that what you are saying? If so, how do you account for someone who is on prescribed pain medicine and they become addicted? Again, please don't take this sarcastically or the wrong way, I really do want to know what your thinking is behind this. Thanks. :lol2:

AirforceRN, RN · Apr 16, 2007

So, what do you think the difference is between a disease and an addiction? If I'm hearing you correctly, and correct me if I'm wrong, you are saying that an addict asked for whatever happens to them because they chose to take the drug. Is that what you are saying? If so, how do you account for someone who is on prescribed pain medicine and they become addicted? Again, please don't take this sarcastically or the wrong way, I really do want to know what your thinking is behind this. Thanks.

Easy question first...Do addicts ask for whatever happens to them? No, absolutley not. Losing your home, family, job, acquiring HIV, HepC etc. I don't think anybody asks for that. In saying that however, I think that the vast majority of people do understand that bad things can happen. A nurse stealing meds from work must know that his/her job is at stake. Somebody robbing a bank for drug money knows that they may be caught and sent to prison. They may not be thinking about it at the time, but surely they know that it is a possibility. I think it is the "it will never happen to me" scenerio or the "I'll worry about that if it happens...first things first" scenerio.

Now the tough question...What is the difference between disease and addiction? I think the whole question here is what is my definition of disease? For me, disease is a state of the body. It is an abnormality in one or many of the body's processes. Cancer, asthma, schizophrenia etc are all diseases. I know that CT and MRIs show abnormalities in the brains of addicts but this is after the fact. Drug use causes changes in the pathways to the brain.

So, to sum it all up...is it fair to say that drug use can lead to addiction which leads to disease? Sure, smoking and cancer proved that years ago. Is it fair to say that disease lead to an addiction? I don't think so.

Anyway...I'm sorry that this may be very convaluted. I've tried to type and retype so many times to explain my position but anyway I do it just doesn't sound right. I think in the end calling addiction a disease, at least for me, removes responsibility which I don't think is right. I don't think people should be able to say "I don't have a problem, I have a disease" I know I'm going to take flack for that and I apologize if I offend people by saying it, but it is my opinion.

Cattitude · Apr 16, 2007

A nurse stealing meds from work must know that his/her job is at stake. Somebody robbing a bank for drug money knows that they may be caught and sent to prison. They may not be thinking about it at the time, but surely they know that it is a possibility. I think it is the "it will never happen to me" scenerio or the "I'll worry about that if it happens...first things first" scenerio.
Now the tough question...What is the difference between disease and addiction? I think the whole question here is what is my definition of disease? For me, disease is a state of the body. It is an abnormality in one or many of the body's processes. Cancer, asthma, schizophrenia etc are all diseases. I know that CT and MRIs show abnormalities in the brains of addicts but this is after the fact. Drug use causes changes in the pathways to the brain.
So, to sum it all up...is it fair to say that drug use can lead to addiction which leads to disease? Sure, smoking and cancer proved that years ago. Is it fair to say that disease lead to an addiction? I don't think so.
Anyway...I'm sorry that this may be very convaluted. I've tried to type and retype so many times to explain my position but anyway I do it just doesn't sound right. I think in the end calling addiction a disease, at least for me, removes responsibility which I don't think is right. I don't think people should be able to say "I don't have a problem, I have a disease" I know I'm going to take flack for that and I apologize if I offend people by saying it, but it is my opinion.

Ok, first, when an addict is using, they are not thinking of repercussions at all. So a nurse that is diverting will not be thinking of "what happens if I get caught", they are ruled by the disease at that moment. The disease is telling them "get me the drug, NOW".

Even when you're not using, you WANT to be well and healthy but the darn sickness won't let you! It takes something stronger than the disease to help.

Addicts DO react differently to drugs BEFORE they become addicts. How come some people HATE how drugs make them feel and others love it? Differences in brain chemistry. Maybe abnormal differences. I know for me, I LOVED the feeling of opiates from Day one. I know poeple that hate that dizzy, fuzzy feeling. I belive they are now finding genetic links to addiction as well. There is so much yet to be known about this field, I think it's too bad that some are so judgemental. (not you)

As far as calling addiction a disease and having that removing the responsibility. I don't think so. I know that every single addict I know in recovery that calls it a disease, takes full resposibility for their actions, none of them blame their use on the fact of it being a disease. What I have heard is it said "We're not to be blamed for having a disease but to be held accountable and responsible for our recovery"

One thing I have rarely seen addressed, do we shun those that need heart surgery or a lot of care due to poor dietary choices? I can think of a multitude of diseases caused by those, yet we still look at Htn, diabetes, PVD,CAD, and many more dx's as DISEASE. Yet sometimes those are caused by people's actions as well. Matter of fact, MANY diseases are caused by people's "choices" yet they still get treated with empathy and respect. Addicts have such a long way to go. I know that many a fellow nurse looks at me like dog doo on their shoe.

Honestly, you don't offend me at all because I have heard much worse and you managed to get your opinion across in a respectful manner. I think that as time goes by, and more and more health professionals are educated and exposed to this, we can change minds and feelings.

I am already surprised and grateful for some of the wonderful, caring repsonses I have read here in the last several months on this topic and I thank all of you for your input. I one day want to help other nurses like myself and also spread the word about addiction and nurses and recovery!

Ok, long enough, ack!

AirforceRN, RN · Apr 17, 2007

I think one of the best things about nursing is the we develop (or already posses) the ability to discuss with arguing. I appreciate the fact that people let me say my opinion and they feel free to state theirs without others poopooing all over the place.

Interestingly, I just read part of a study that showed that rats that are addicted to cocaine will choose coke over food and water to the point of starvation. I would like to think that we have more willpower and foresight than a rat but man!!!that has to say something about the power of addiction eh?

Lacie, BSN, RN · May 7, 2007

Ok, first, when an addict is using, they are not thinking of repercussions at all. So a nurse that is diverting will not be thinking of "what happens if I get caught", they are ruled by the disease at that moment. The disease is telling them "get me the drug, NOW".
Even when you're not using, you WANT to be well and healthy but the darn sickness won't let you! It takes something stronger than the disease to help.
Addicts DO react differently to drugs BEFORE they become addicts. How come some people HATE how drugs make them feel and others love it? Differences in brain chemistry. Maybe abnormal differences. I know for me, I LOVED the feeling of opiates from Day one. I know poeple that hate that dizzy, fuzzy feeling. I belive they are now finding genetic links to addiction as well. There is so much yet to be known about this field, I think it's too bad that some are so judgemental. (not you)
As far as calling addiction a disease and having that removing the responsibility. I don't think so. I know that every single addict I know in recovery that calls it a disease, takes full resposibility for their actions, none of them blame their use on the fact of it being a disease. What I have heard is it said "We're not to be blamed for having a disease but to be held accountable and responsible for our recovery"
One thing I have rarely seen addressed, do we shun those that need heart surgery or a lot of care due to poor dietary choices? I can think of a multitude of diseases caused by those, yet we still look at Htn, diabetes, PVD,CAD, and many more dx's as DISEASE. Yet sometimes those are caused by people's actions as well. Matter of fact, MANY diseases are caused by people's "choices" yet they still get treated with empathy and respect. Addicts have such a long way to go. I know that many a fellow nurse looks at me like dog doo on their shoe.
Honestly, you don't offend me at all because I have heard much worse and you managed to get your opinion across in a respectful manner. I think that as time goes by, and more and more health professionals are educated and exposed to this, we can change minds and feelings.
I am already surprised and grateful for some of the wonderful, caring repsonses I have read here in the last several months on this topic and I thank all of you for your input. I one day want to help other nurses like myself and also spread the word about addiction and nurses and recovery!
Ok, long enough, ack!

Couldnt have said it any better!!!Very well put Cat and congrats on your recovery. Many a nurse has said "No way, never me." You never know until you end up walking in those shoes. And when the BON's have also ensured you have lost everything before you can even get to the process of bringing yourself back up then hearing co-workers and others sometimes nasty comments. Believe me it cant hurt any worse. These nurses have to go through hoops to get back in the game and redeem thierselveswith every penny of the cost out of thier pocket (with no job in the usual case). They may have put themselves in the situation but its even harder getting support to come back up and out.

superchicken4000 · May 15, 2007

It is sad to steal the drugs of a patient and to make the patient have to suffer only so the nurse can get her high. It is quite obvious that the only reason the patient is taking the medicine is because they are in alot of pain. Not to mention the psycological problems the patient will have to face after leaving the hospital for the wrong doing of the nurse and the neglect they received, ecspecially after you consider the hospital stay alone for 10 days cost almost $70,000. Most patients know when the nurse hasn't been giving them their meds. , but what can they do. File a greivence , but that doesn't help them while they are in the hospital. That only brings more stress after they leave for home and are trying to recover. For $70,000 you would think they would receive good care. But they don't . Only during the day never at night. Why ? because the night shift nurse is stilling their meds. and is to high to do her job properly.