Substance Abuse Among Registered Nurses

Substance abuse among nurses threatens not only the quality of patient care, but also the professional standards of nursing. The term "substance abuse" refers to both abuse and dependence and is defined as "the maladaptive pattern of substance use that is manifested by recurrent and significant adverse consequences related to the repeated use of substances" (^{U.S. Department of Health and Human Services, 2006} ). The American Psychiatric Association (²⁰⁰⁰ ) defines addiction as a condition in which the body must have a drug to avoid physical and psychological withdrawal and dependence occurs when the drug dominates one's life and the addict develops tolerance, which forces the person to consume larger doses of the drug to get the same effect.

Approximately 17.8 million Americans 18 and older used illegal drugs in 2008; of that number, 12.9 million, or 72.7%, were employed (^{U.S. Department of Health and Human Services, 2008} ). Registered nurses have a 50% higher rate of substance abuse than the general public, and 1 in 7 nurses remains at risk for addiction. Dittman (²⁰⁰⁸ ) states that approximately 5% of registered nurses are alcoholics and 3% are dependent on drugs. Talbert (²⁰⁰⁹ ) estimates that among registered nurses, 10% may have a drug or alcohol problem. Tariman (²⁰⁰⁷ ) found that the prevalence of substance abuse is as high as 32%. Drug use varies among nursing specialties: emergency department nurses are 3.5 times more likely than nurses in pediatrics, general practice, and women's health to abuse substances, and oncology and administrative nurses are twice as likely to binge drink (^{Young, 2008} ).

Drug abuse decreases workplace productivity, increases absenteeism by as much as 66%, increases episodes of disciplinary action by 90%, increases benefit use in dollars by 84%, and substantially increases employee turnover (^{National Center for Health Statistics, 2008} ). Nurses who abuse substances become financial liabilities to their employers because of increased absenteeism, disability, and workers' compensation claims, decreased productivity, and increased turnover. Hidden costs include lower morale, poor communication within departments, and inefficient use of supervisory and management time (^{Dunn, 2005b} ).

Substance Abuse Among Other Health Professionals

Substance abuse and dependence among health professionals vary by discipline. Physicians, for example, may self-prescribe...