The opioid crisis is familiar to most of us because it is negatively affecting individuals, families, and communities throughout our society and is a recurring topic in today’s media. Opioid misuse is one element of the broader problem of substance use disorder (SUD), which includes misuse of alcohol, prescription drugs, and illicit drugs, as well as nicotine.
The Center on Addiction (COA) estimates that 40 million Americans ages 12 and older (more than 1 in 7) abuse or are addicted to nicotine, alcohol, or other drugs (COA, 2018). Percentages can vary depending on the particular use disorder (alcohol, tobacco, cannabis, stimulant, hallucinogen, and opioid), age, gender, race, and ethnicity (US SAMHSA, 2017, 2015).
No group is immune to the possibility of substance use disorder, even those we might think would be especially knowledgeable or aware of the problem and its consequences. The American Nurses Association (ANA) has found that 6% to 8% of nurses use substances to the level that it affects their on-the-job performance; among nurse anesthetists the rate is 9.8% and it varies widely with other specialties. While rates among nurses are similar to those in the general population, nurses do have a greater risk of using prescription drugs (Smith, 2017; Cares et al., 2015).
In the most recent Gallup Poll, "More than 8 in 10 (82%) Americans describe nurses' ethics as ‘very high’ or ‘high,’” and they have received the designation “most trusted profession” for many years (Gallup News, 2017). The idea that nurses could be impaired while working is thus a difficult concept for many people to accept, but “Substance abuse occurs across all generations, cultures, and occupations, including nurses” (Thomas & Siela, 2011). And, when the signs of impairment in nurses are missed or attributed to other causes, patients’ lives can be endangered and nurses don’t receive the help they need to deal with their disorder.
Nursing work often requires practitioners to juggle many roles and actions in the course of a single work day. Their workload requires both a foundation of knowledge and an ability to focus closely on the particular task at hand. Nurses who are under the influence of drugs or alcohol cannot be counted on for focus and may be unable to carry out the day-to-day functions of their profession.
Historically, registered nurses found to be abusing drugs or alcohol were given little support; they lost their jobs, their means of financial support, and their network of professional peers, and were ostracized from the nursing profession. However, as noted recently by the National Council of State Boards of Nursing (NCSBN), “Non-disciplinary programs, offering an alternative to traditional discipline, are now used by a growing number of state boards of nursing” (NCSBN, 2018). Identifying substance abuse as a problem within professional nursing and providing alternative methods to promote and support recovery can enable many to return to work as licensed professional nurses.
Across all groups, including nurses, one of the biggest barriers to resolving this crisis is the lack of knowledge about substance use disorder—how it works, how to recognize it early, and what can be done to help those who are suffering from it. This course will address those topics along with information on relevant Florida statutes, employer initiatives, and prevention ideas.