RN husband addicted to opiates

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Although I am not the RN in the family, my husband is, I am very concerned about him and thought maybe one of you can give me some advice. He just graduated a year and a half ago and over this time period, has developed a problem with opiates. He started out with a valid prescription for vicodin and muscle relaxersand I am now finding hypodermic needles hidden in various parts of the house. His behavior is frustrating and we have two children. I believe this stuff is coming from the hospital and he has been suspended twice for mishandling patient medications. Actually, I know that is where it is coming from, because of the codes on the things I have found. He denies he has a problem and refuses to get help. His drug tests come back as positive for opiates, but he has that prescripton to fall back on. Do I report an anonymous problem to HR or let the chips fall where they may? And how can he possibly be getting away with it? I am very worried about him, as is our children and his parents. We don't want him to go to far someday. Please advise, as you are the ones who would know how to best handle this situation. Thank you.

Thanks to all of you for your responses. I guess the really difficult part of it all is that he went back to school at age 35 to pursue this degree. He stopped working so that he could dedicate himself to school, while I supported our family. It was a rough few years. But he graduated with a 4.0, sole valedvictorian of his class, works all the O.T on his floor he can get, I think he really is a great nurse. But no one knows the truth. I am assuming the nurse manger knows something is up, she gave him the corrective action notices along with the corporate lawyer. And I also believe he is already in the hospitals "Work/Life program" or something, because after his first write-up, he told me they made him sign some kind of contract stating he would work there for two more years or they would have to turn him in to the board. But now I happen to find out that, coincidently the program this hospital offers is two years. Also someone asked how he is still working there if his drug tests come up positive for opiates. Well, I am assuming since he has a legit prescrition, they can't do anything about it. His parents had to call 911 a couple weeks ago because they found him unresponsive with three needles and a bottle of some kind of drug in their basement. He gets taken by ambulance to the E.R, wakes up, refuses treatment and walks out. The doc had the bottle. knew it was stolen from his employer, but said they could not report him because of patient confidentiality. We couldn't believe it, we thought for sure this was it. But to no avail. The doc and nurses tried to talk to him about his problem, but he says everyone exagerates and he has it under control. Isn't there some kind of Code of Ethics for healthcare professionals? I thought they would for sure inform his employer. How is he getting this stuff w/out getting caught?

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Specializes in ER,ICU,L+D,OR.

Go to narcotics anonymous and leave him before he brings you and your children down with him.

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If he is taking vicodin and has a valid prescription, then it's not a problem. As far as the needles go, does he have needle marks on his arm? If he does, I think that's far more serious than the vicodin thing. I wouldn't report his name to anyone, unless you can afford to go without the income from his side of the table? I have no idea how to go about to get him to go to a NA meeting. Also, does he have pain/a reason to take the vicodin? Maybe he has chronic pain or something. Just explore all of your avenues and be absolutely certain before you do anything radical

ummmm, just disregard what i said above! i just saw your most recent post. that's quite serious!! i have absolutely no advice for that!

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Specializes in Geriatrics.

I'm so sorry for your problems. Life just isn't fair sometimes; but it is lifenonetheless. I see it two ways...everyone has a choice and you do too. You can either "Live now" (if you call this living) and pay later (because you all surely will) or......pay now....and live much better later. I'm sure you will be helped by all your family and friends as you go through it....and go through it you must. But in the end...it will work out, it always does. God just has a way of doing that for us. This will only get worse, as you know, the longer you wait. Go to his boss, administration, the hospital social worker...tell them what's going on and bring evidence (like the needles). They can run tests on the ingredient for proof...ask them for help. It's a start and one day (soon hopefully)you'll look back and give thanks with a smile as youhold your head up for doing the right thing and overcoming just one more of life's battles. You Go Girl...save your family...YOU CAN DO IT!!!

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Specializes in Impaired Nurse Advocate, CRNA, ER,.

Joker2,

I'm a peer assistance advisor for a state association for nurse anesthetists in the midwest. I'm also a recovering opioid addict with 13+ years clean and serene.

Based on the information you have provided here, your husband is most likely dependent on opioids.

Chemical dependence, or to use the common term addiction, is a chronic, progressive, potentially fatal disease of the brain. This disease occurs as a result of genetics and the right set of circumstances. This forum doesn't really allow a long, detailed explanation of the pathophysiology.

Chemical dependence is not a lack of willpower or moral weakness. It's a disease that alters the physical and chemical structure of the brain resulting in aberrant emotional and psychological behavior. Obsessive thinking about their drug of choice leads to behaviors that are focused on obtaining their drug or drugs. Once they have the drugs in their possession, they have an overwhelming compulsion to use their drug.

As the disease progresses, they must use increasing amounts of drug to attain the desired effect. This is described as tolerance. Another change that accompanies tolerance is called physical dependence. The body adapts to these large doses of drug. When the body eliminates the drug, the phenomena of withdrawal occurs. With some drugs (barbiturates, benzodiazepines, and alcohol) withdrawal can be a life threatening situation. Fortunately, that's not the case with opioids. The withdrawal is extremely unpleasant (speaking from experience) but is not life threatening.

The biggest obstacle to overcome is the pathological denial associated with this disease. The addict truly believes they can control their use despite the overwhelming evidence to the contrary. For this reason, the addict almost never asks for help. The fact that your husband is a professional health care provider means absolutely nothing when it comes to this disease. Comments such as "He should know better", "He should see that he needs help", or "He should be grateful and accept the help being offered", are all based on what I call the 3 "M's"...myth, misbelief, and misunderstanding. Because of the physical and chemical changes in the brain, the addict is incapable of making rational decisions. These brain changes are seen in the negative behaviors exhibited.

Depending on the state you live in, the board of nursing may have an alternative to discipline program which would get your husband into treatment and possibly protect his license. HOWEVER...the fact that a state has an alternative program doesn't mean the members of the board of nursing truly understand this disease and how to deal with it so the public is safe and your husband gets the treatment he needs and deserves. Very few nurses (or doctors for that matter) understand this disease and how to deal with it.

Send me an email or private message and I'll do my best to get you connected with people in your state that can help.

Jack

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Jackstem has given you some very good advice as have others on this post. Having been through this myself, I would advise you to try to handle this through you states diversion program but not through his employer yet because as someone else said - he would probably be fired and have legal charges brought which makes the situation worse. I would think that receiving notice from the board that he has to have an eval and possible treatment or lose his license might be enough of a shock to get him to accept treatment. He needs to become aware of the possible consequences due to his addiction. Please try something like this and the NA groups before you report him to someone who may involve the legal system in this. Maybe show him this forum and let him see that he's not alone and the different outcomes he may have if he doesn't seek treatment. At this point I would think that he has to be somewhat miserable, but the denial and shame he is probly feeling dissuades one from asking for help or even admitting the addiction. Good luck!

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I really have been doing alot of research on the subject. So much that I feel it has consumed my life. My goal is to get him help but I know from what I have read that this stuff does chemically alter the brain and I can tell that he just is not the same person he was a few years ago. I do not want to hurt his career, which is why I have not talked to his employer, I do not think you can FORCE someone to hit bottom. For Jackstem, I will be getting ahold of you for further information. As far as NA goes, I will be attending my first meeting Wednesday night. Thanks to all of you, you've been a big help. My very first concern is to keep our children safe. He has fallen asleep behind the wheel too many times and I can not risk the kids safety when they are with him. I know it is important for him to be with his kids, but not at their risk.

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Please intervene NOW!

I was fired a week ago and now am facing legal issues as well as BON issues.

If I would have stepped up and reported myself BEFORE my employer found out, I would have been so much better off.

Trust me on this, please get him help before he gets caught. I wish I could go back and get help when needed but I was to ignorant and now I am paying a HEAVY price.....

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Specializes in Impaired Nurse Advocate, CRNA, ER,.
I really have been doing alot of research on the subject. So much that I feel it has consumed my life. My goal is to get him help but I know from what I have read that this stuff does chemically alter the brain and I can tell that he just is not the same person he was a few years ago. I do not want to hurt his career, which is why I have not talked to his employer, I do not think you can FORCE someone to hit bottom. For Jackstem, I will be getting ahold of you for further information. As far as NA goes, I will be attending my first meeting Wednesday night. Thanks to all of you, you've been a big help. My very first concern is to keep our children safe. He has fallen asleep behind the wheel too many times and I can not risk the kids safety when they are with him. I know it is important for him to be with his kids, but not at their risk.

Actually, you CAN force him to experience a bottom...it's called an intervention.

Jack

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Specializes in Rehab, Infection, LTC.

he needs to be out of patient care right now. if he were to kill someone at work from being high...well...what would you do?

contact a local treatment center and ask them to help you stage an intervention. does he have EAP thru work? if so, call them right away. they can do the intervention. they will also do an evaluation of him and take him out of patient care.

at this point it is moot whether or not you can survive without his income. he is not safe to practice.

and noway is he passing a drug test with his prescription to vicodin. he is obviously injecting himself and vicodin doesnt come that way.

i had an intervention at work. it saved my life.

good luck to you and my prayers are with your whole family.

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Then how is he passing drug tests? He told me himself that they are testing him and they watch his every move since he has been written up twice before. They even went through his locker and found some things that should not have been there. He said they sent him down for a test right then, but could not do anything because he has a script. So instead of terminating him they suspended him. I found a bag full of the things that was in his locker(pictures of our kids, the pad lock, etc) It's just all very scary. At least he is now , for the first time today saying that he has been selfish and has gone to far. also, that he needs to try to get help for his problem so that he can be the dad and husband he should be and he will not come home until he does that. This is what he told the children tonight. Now, does that hold water? I don't know. But I guess it's something. I was honest with the kids and told them not to get their hopes up, but to pray he has the strength to folow thru. I've made sure he knows I will be there to help him and support him. But we can not have our children finding drugs and needles in the house. So the choice is his. But I still question how he is passing the tests? I just don't get it. What I do get is I do not think he can do this on his own, he needs professional help. I hope that is in his plan otherwise, all attempts to quit on his own won't work, right? I mean, usually. Statistically speaking, people normally can not just stop cold turkey? I wish I knew what it is he is shooting, but I don't. I know that night at the ER it was a small brown bottle of some kind of sedative type stuff. The Doc said something that started with a "M". I really think it's just whatever. I found little vials, this was the first time I had seen this bottle. But how is the nurse manger not noticing that this stuff is missing from the pyxis? Do they not inventory? I thought that was standard.

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Specializes in Impaired Nurse Advocate, CRNA, ER,.
how is he passing drug tests?

When a drug screen is performed, they test for general drug classifications, not specific drugs. If your husband has a valid prescription for an opioid (vicodin, percocet, morphine, etc), and his urine tests positive for opioids, he has a "legitimate" reason for the presence of opioids in his urine. A tox screen won't tell you which opioid is in his urine. Inorder for the hospital to find the presence of a specific opioid, they have to request the lab to check for that drug. So he could be using morphine, demerol, dilaudid, et. and all the screen says is there is an opioid present.

So instead of terminating him they suspended him

Good! This means he can "voluntarily" enter treatment before he gets reported to the board of nursing or the police, unless the hospital has already reported him. Also, his treatment might be covered by his health insurance, and also might be able to file a claim on his disability insurance (if he has one through his employer. Entering treatment before he is mandated will be a positive if he does get reported.

...for the first time today saying that he has been selfish and has gone to far. also, that he needs to try to get help for his problem so that he can be the dad and husband he should be and he will not come home until he does that. This is what he told the children tonight. Now, does that hold water?

Yes and no.

He may mean exactly what he said. The problem is, the signs and symptoms of this disease are expressed in negative behaviors and actions. Addicts with an active disease process will lie, cheat, steal, etc. in order to feed the monster growing inside. I know I wanted to stop using, but couldn't until an intervention took place..an accidental overdose.

Interventions come in a variety of way, including:

  • A DUI
  • Overdose
  • An accident (falling off a ladder or down stairs while under the influence
  • Infections at injection sites
  • Caught stealing drugs and being arrested
  • Death

pray he has the strength to follow thru

This disease isn't about being weak or lacking willpower or strength. It's about a progressive disease that eventually ends in death if nothing is done. An addict won't follow through on seeking help because the disease has altered their ability to make rational decisions.

I've made sure he knows I will be there to help him and support him. But we can not have our children finding drugs and needles in the house. So the choice is his.

GOOD!!!! Family support is a crucial part of helping him achieve recovery. That doesn't mean you are responsible if he relapses.

I agree with you regarding your children.

he needs professional help. I hope that is in his plan

He isn't capable of making plans. He's out of control because of this disease. He needs those around him to make the plan that gives the best shot of getting him into treatment. This plan is called an Intervention.

An intervention is where family, friends and colleagues confront him (as a group, not one on one) with specific acts and behaviors they have witnessed, pharmacy records that show discrepencies, charting that has become increasingly sloppy, incomplete, or absent. Before the intervention takes place, the intervention team consults with an interventionist on the plan of presenting this information you have gathered. Each member of the team writes a letter to him explaining how his drug use has affected them and how their relationship will change if he doesn't enter treatment NOW. He will also have a bed ready at a treatment center. That way, if he does agree to go to treatment, you can take him directly to the facility for admission. He'll come up with all kinds of reasons why he can't go now. If he rebuffs the offer to go to treatment, you bring out the big gun...you will report him to the board of nursing.

I wish I knew what it is he is shooting. The Doc said something that started with a "M"

Most likely midazolam (Versed). But it doesn't really matter what he's shooting, just that he enters treatment.

But how is the nurse manger not noticing that this stuff is missing from the pyxis?

Addicts can be very good at covering there use in a number of ways. As the disease progresses they become increasingly careless. That's when it becomes easier to "catch" them because of the discrepencies.

The time to start preparing for an intervention is now. Delaying in the hopes he might "get it" only allows the disease to progress and places patients, the hospital, fellow nurses, and your family in danger.

Again, contact me by private message or email.

Jack

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