Today's topic often brings feelings of shame, stigma, secrecy, and sadness; substance use disorder (SUD) among nurses. We acknowledge that these feelings make it a delicate topic that should be handled with care and respect, alongside the firm belief that it must not be ignored.
What is Substance Abuse Disorder (SUD)?
According to the NCSBN (National Council of State Boards of Nursing), "SUD is a disease that can affect anyone regardless of age, occupation, economic circumstances, ethnic background or gender."
It is important to remember that as healthcare professionals with rigorous training and knowledge, they are not immune to developing the diseases we treat, including SUD.
In this article, we'll review some data and statistics, summarize some of the reasons that lead to SUD according to research and respected organizations, explain why there is a rise in substance abuse among nurses, and, importantly, look at who is helping nurses with SUD and how to find that help for yourself or a nurse that you know who is struggling.
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What Data and Research Say on SUD Among Nurses
It is difficult to say how many nurses suffer from drug or alcohol addiction. Indeed, the prevalence of substance abuse among nurses is not concretely known, and self-disclosure may be unreliable due to stigma and fear of punishment.
- Estimates of nurses' substance use rate are believed to be around that of the general population, between 6% and 8%.
- The Nurse Worklife and Wellness Study found that illicit drug use for 2021 was 5.7%, and misuse of prescription drugs was 9.9%.
- Furthermore, the study found nurses working in home health or hospice care and nursing homes had higher rates.
- Nurse educators and nurse researchers were less likely to have SUD.
- Staff, charge nurses/coordinators/nurse managers, and administrators were nine to twelve times more likely to have SUD.
- Male nurses are less likely to misuse prescription drugs than female nurses.
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Why Is There a Rise in Substance Abuse Among Nurses?
Research has shown that of people seeking treatment for SUD, up to 36%-50% also meet the criteria for PTSD, and while there are many studies and opinions on what causes the link between trauma and SUD, the two most popular models theorize either that the SUD leads people into situations where traumatic events can occur or that people experience trauma and turn to SUD for coping.
The COVID-19 pandemic, for many nurses, was a battle fought on two fronts. A struggle at work; beds, patients, patient deaths, patient families, staffing shortages, PPE shortages, and more. And a battle at home; fear of exposing family, isolating from family to prevent contagion and isolation from a social support network. Staffing shortages have been a concern among nurses even before the pandemic. Still, until the pandemic hit, these nurses could go home and recharge, find support from family or friends, and reconnect with other interests separate from their jobs. Knowing this was the reality for thousands of nurses nationwide, is it any wonder that SUD may rise among nurses? Lest we forget, nurses are human with the same vulnerabilities and complexities of emotions and decision-making. Not all humans are the same, nor do we have the same resiliency or coping strategies.
According to the authors of Increased Substance Use among Nurses during the COVID-19 Pandemic, "In the coming years, the emotional well-being of nurses should be a topic of focus for both researchers and administrators. In addition to focusing on substance use and cognitive failure, anxiety and trauma symptoms may be particularly important."
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Who is Helping Nurses with SUD?
The sooner a nurse with SUD starts treatment, the better their chances for a safe return to their job. While fear of disciplinary action is a legitimate concern for nurses experiencing or witnessing other nurses with SUD, it keeps nurses silent. Thankfully, most states have Alternative to Discipline (ATD) programs in place for nurses to help them "demonstrate to the BON (board of nursing) in a non-disciplinary and non-public manner that they can become safe and sober and remain so while retaining their license." To find an ATD program, contact your state board of nursing or review the program list on the NCSBN site here.
