As a health care provider you see first hand the abuse of drugs by nurses. Although that happens to be the title, nurses (which can include Registered Nurses or R.N.s, L.P.N.s and C.N.A.s) are not the only ones that are guilty. Because of a couple of factors, the professionals in the medical field are in a higher risk group for substance abuse than members of the other fields.
Many times the nurse in question will have a valid prescription for a painkiller (usually hydrocodone which would have brand names that include Vicodin, Lortab, Norco among others) as well as muscle relaxers (such as Soma or Flexeril). This will in effect create a person that is “legally” dependent on a controlled substance. In the case of the hydrocodone, which is a powerful, pharmaceutically pure narcotic, it will cause a powerful physical and mental addiction. As anyone that has any experience with drug abuse can confirm, the amount you use will go up over time. You will develop a tolerance to the drug. This means that the same amount that worked before doesn’t work now. The nurse in question will begin to take more and more. Often the amount that is prescribed is not equal to the amount taken by the nurse anymore. Just like any kind of drug addict (even if the nurses have a completely legal prescription to take the drug in question) the nurse will find a way to get the drug.
Since they are nurses, they will have access to a medical cart. Almost every medical facility in the US has such a cart. It will contain all the medications that will need to be dispensed to the patients. On this cart there will be a second locked area that contains the controlled substances (such as the narcotics). The locked area is one of those “looks good on paper” concepts. Guess who has the keys to the lock box? That is right, the very topic of the article, the nurses that have a problem with substance abuse.
Of course there are procedures in place that, in theory at least, will prevent these drugs from being taken by the medical staff. As a supervisor in a medical facility, part of my job is to do a drug count at the beginning and end of each of my shifts. This is done at the same time by both the incoming and outgoing personnel. Even if meticulous records are kept, and the drugs are constantly under lock and key, an addict will always find ways around the precautions that are in place.
I have had to sit on an investigation board where a nurse was accused (and shown on camera) replacing a very strong narcotic (MS contin) with tic-tacs. The medication was suppose to go to a patient dying from pancreatic cancer, which happens to be very painful. This nurse was not only stealing and illegally using drugs at work, she was causing a patient that was in extreme pain to suffer so she could feed her addiction. Obviously she was fired as well as losing her license to practice medicine (and with good reason).
Even if the nurses in question are not stealing the drugs from a facility, it is not hard to find them on the street. In today’s world there is a market for painkillers that rivals that of cocaine or heroin. The old fail safe of drug testing is not going to work because the nurse has a valid prescription from a doctor to take the medication. When the narcotic shows up in the urine sample, they have the legal right to be taking the drug, even if they happened to get it by illegal means.
Back injuries are a fact of life in the medical field. Painkillers are the way they are treated. It causes a vicious cycle that causes many problems. There is not an easy answer, but do not doubt for a second that a national epidemic of drug use exists in the medical field. Nurses are not the only ones that are part of it. It ranges from a person that is newly hired to Doctors that have been practicing medicine for decades.
Hopefully some kind of answer can be found. Even with a drug problem, most nurses are professional and are the backbone of the medical field. If they are not guilty of gross dereliction of duty there needs to be a way for them to get help with their problem without putting a permanent black mark on their record (that is if they are even able to keep their license). If rehabilitation is successful and the nurse is capable of dealing with the issues, we need to keep as many good medical professionals working. After all, everyone gets hurt or sick. These are the people that fix us. Even with a mistake (no one is perfect) we will always need nurses with experience.