Why Substance Abuse Is Growing Among Medical Staff

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Healthcare professionals, in the United States and abroad, may be particularly prone to substance abuse, recent studies indicate. One study out of Australia, for example, revealed that, on average, 37 healthcare professionals die each year from drug overdoses.

Meanwhile, U.S. government surveys found that more than 168,000 healthcare and social assistance workers engage in illicit drug use each year.

Between 2003 and 2013, Australian coroners documented 404 drug-related fatalities among healthcare professionals, with nurses accounting for 63 percent of those deaths and medical practitioners for 18 percent.

Researchers noted that most of the drugs were obtained illegally from employees’ workplaces, either by theft or self-prescription. They theorize that several factors may predispose healthcare workers to substance abuse and premature death, including high-stress careers, long work hours, and ready access to controlled substances.

Many experts feel that the problem is caused by a combination of high job-related stress and easy access to pharmaceuticals.

To shed some light on this trend, Kent Runyon, the Compliance Officer and Vice President of Community Relations for Novus Medical Detox Center in Florida, shared some of his thoughts on the increasing rate of substance abuse among healthcare workers.

(Novus Medical Detox Center is a drug treatment facility which aims to help inform the healthcare community about the growing epidemic of substance abuse within the healthcare workforce and prompt employers to proactively address it via professional programs devoted to preventing substance abuse and providing appropriate treatment.)

Why do you think substance abuse is so prevalent among healthcare workers?

Substance abuse is prevalent across our entire society, so the fact that it is hitting our healthcare workers as well is not a large surprise. A contributing factor for many healthcare workers is their access to prescription drugs in the workplace, making it easier, albeit risky, to use these substances. We recently [treated] a physician who was stealing Fentanyl from his workplace to feed his own addiction to the drug.

What can a healthcare worker do if he or she suspects a coworker of substance abuse?

Each workplace will have different structures for reporting issues such as this in the workplace. In most cases the right answer will be to either report the concern to an immediate supervisor or report the concern directly to someone in the Human Resources Department.

What are some of the signs or potential habits a health professional may exhibit if he or she is addicted to, or is abusing drugs or alcohol?

  • Frequent tardiness or unexplained absences. This would also include a change or unusual amount of breaks taken
  • Inconsistent on-the-job performance.
  • Financial problems.
  • Frequent small accidents resulting in minor injuries or broken objects.
  • Unusual physical symptoms or behaviors (unsteady gait, hyperactive/manic activity, sudden weight loss, dental problems, wearing long sleeves on hot days, etc.)
  • A sudden lack of concern over personal appearance and hygiene.
  • Moody and overall change in their response to constructive feedback and other routine work communication.
  • An unwillingness to talk about hobbies, family life, or personal interests in someone who was forthcoming before.
  • Lower levels of productivity in the morning; a general sluggishness when first reporting to work
  • Bloodshot eyes, or bags under the eyes indicating a lack of sleep.
  • A change in social engagement with co-workers.  Most notably no longer spending time on breaks of after hours with co-workers.

What can healthcare employers do to mitigate this problem in the workplace?

Employers should maintain a strong Drug Free Workplace policy, along with good practices such as drug testing, employee education, and Employee Assistance Programs (EAP). Additionally, employers and senior management needs to implement and maintain a high level of security and accountability for controlled substances. Mitigate any risk that a nurse or physician can re-direct [pharmaceuticals] for personal use.

A Closer Look

Within the United States, the latest report on substance abuse by industry compared combined data from 2003–2007 and 2008–2012, and found the number of healthcare and social assistance professionals engaging in past-month illicit drug use rose from an average of 164,600 to 168,400 per year. A USA TODAY investigative story further revealed that 1 in 10 practitioners will succumb to drug or alcohol abuse at some point in their lives.

What makes this trend so concerning, is that healthcare workers are entrusted with caring for others, while many medical professionals are in need of intensive treatment themselves.

“Healthcare workers are expected to play a key role in identifying and treating patients with substance use disorders. Yet studies show that a number of them are waging their own battles against addiction and dependency,” observed Will Wesch, Director of Admissions for Novus Medical Detox Center. “These are people who undoubtedly understand the risks of substance abuse and misuse, so the fact that they’ve fallen victim to it proves that nobody is immune to addiction or dependency.”

Though substance abuse in the healthcare industry may have previously been overlooked or under-reported, Wesch says that popular dramas like the Netflix series Nurse Jackie have raised awareness of the issue, while news stories have demonstrated the potential repercussions. For example, one hospital technician who was found to be injecting himself with patients’ medications and refilling the syringes with saline is believed to have infected more than 45 patients with hepatitis.

“Drug diversion among healthcare workers can have dire consequences for practitioners and patients alike,” warned Wesch. “That’s why it’s in employers’ best interests to have programs and policies for dealing with these kinds of issues before they lead to fatal outcomes. Administrators should be monitoring staff for signs of stress and overwork, and providing appropriate mental health services to deter workers from ‘self-medicating’ to cope with the demands of their jobs.”

Adding to the complexity of the situation, is the fact that many healthcare workers are well aware that their career can be derailed for substance abuse. Disciplinary action may include license suspension or even revocation unless and until treated. Even if a physician, for example, is able to successfully complete treatment for addiction or substance abuse, a license suspension remains on his or her record, serving as a red flag for future employers. This may cause healthcare workers to avoid seeking help in an effort to hide the problem. Even so, the problem of substance abuse often eventually catches up with the abuser, but not until after even more damage is done to all parties involved: patients, coworkers, and the abuser himself, or herself.

Therefore, Wesch also advises employers to provide and promote access to drug treatment programs rather than relying solely on punitive policies. “If healthcare professionals fear for their jobs, they’re more likely to hide their substance use than seek help. Likewise, workers may be more apt to cover for colleagues they suspect of using drugs because they don’t want to get anyone fired,” he explained. “When employers support drug rehab and detox programs, it can motivate users to get clean. It also gives the healthcare facility an opportunity to regain a committed and experienced worker rather than having to recruit and train a replacement.”

Sources:

Pilgrim, Jennifer L.; Rhyse Dorward; and Olaf H. Drummer. “Drug-Caused Deaths in Australian Medical Practitioners and Health-Care Professionals”; Addiction; November 20, 2016. onlinelibrary.wiley.com/doi/10.1111/add.13619/full

Bush, Donna M. and Rachel N. Lipari. The CBHSQ Report: Substance Use and Substance Use Disorder by Industry; Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality; April 16, 2015.

Scott, Sophie and Dr. Norman Swan. “Study Indicates High Rate of 'Intentional' Drug-Related Deaths Among Nurses”; ABC (Australian Broadcasting Corporation); November 20, 2016.

Eisler, Peter. “Doctors, Medical Staff on Drugs Put Patients at Risk”; USA TODAY; April 17, 2014.

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