Why Nurses Are at Risk for Substance Abuse
Substance Abuse Among Nurses
Substance abuse can affect any individual and can occur within any occupation, including nursing. It is estimated that 10% of nurses will misuse drugs or alcohol at some time during their career.1 Nurses appear to drink less than the overall population, although one study reported more binge drinking among nurses compared to the general population aged 35 and older.2 Nurses report higher rates of prescription drug abuse, in part due to their access to these medications at the workplace.3
Why Are Nurses at Risk for Substance Abuse?
Nursing is a tough industry to work in, and there are many factors that put nurses at risk for developing problems with substance abuse and addiction.
Nurses differ from the general population in that they work in an environment where they can easily access controlled substances. Studies have shown that nurses are more likely to use drugs when their workplace access to these substances increases.4
The intense pressure of being responsible for the well-being of patients can be overwhelming for nurses, and this stress can be only exacerbated by inadequate support and increased work overloads. Studies have shown that chronic stress enhances substance use and is a major risk factor for the development of addiction.5
Lack of Education Regarding Substance Abuse
A lack of knowledge concerning substance use disorders results in a lack of awareness concerning signs and symptoms of addiction. This hinders the ability of nurses to identify and address signs and symptoms of abuse in colleagues. This lack of education also promotes the negative stereotypes and stigmas associated with substance abuse among nurses.6 These attitudes may deter nurses from divulging the truth about their addictions, thereby preventing them from seeking the help they need.
According to the United States Department of Labor, approximately 92% of registered nurses are women.7 Evidence shows that women tend to have a more intense course of addiction once they begin using drugs. Although females initially take drugs at lower doses than males, their use escalates more rapidly to addiction and they are at greater risk for relapse following abstinence.8 Based on this general pattern of addiction and the predominantly female population within the nursing field, it is not surprising that nurses are at risk for drug abuse.
Nurses spend a lot of time walking, bending, stretching, and standing. They are also vulnerable to back injuries because they are frequently lifting and moving patients. Although some nurses may be misusing a medication that was originally prescribed for their pain, these medications are not intended for long-term use and pose many risks to nurses.
Nurses often work long rotating shifts that can be very exhausting. A study of registered nurses found that typical 12-hour shifts are likely to lead to burnout and poor overall health.9 Nurses also work nights, weekends, and holidays and are often on call, meaning that they are on duty and must be available to work on short notice. This lifestyle often leaves nurses sleep-deprived and with very little personal time to simply unwind. Some nurses may resort to substances to provide relaxation after a long and grueling day of work.
The majority of state nursing boards offer alternatives to disciplinary action, including peer assistance and recovery monitoring programs, for nurses with substance abuse issues. Studies have shown that nurses who participate in these assistance programs have a higher rate of long-term recovery than people with addiction from the general population.10 These programs coupled with treatment from an addiction center can help facilitate success.
- Kunyk, D. (2015). Substance use disorders among registered nurses: prevalence, risks and perceptions in a disciplinary jurisdiction. Journal of Nursing Management, 22(1), 54–64.
- Kenna, G. A., & Wood, M. D. (2004). Alcohol use by healthcare professionals. Drug and Alcohol Dependence, 75(1), 107-116.
- National Council of State Boards of Nursing. (2011). Substance Use Disorder in Nursing.
- Trinkoff, A.M., Zhou, Q., Storr, C.L., & Soeken, K.L. (2000). Workplace Access, Negative Proscriptions, Job Strain, and Substance Use in Registered Nurses. Nursing Research, 49(2), 83-90.
- Sinha, R. (2008). Chronic stress, drug use, and vulnerability to addiction. Annals of the New York Academy of Sciences, 1141(1), 105-130.
- Howard, M.O., & Chung, S. S. (2000). Nurses’ attitudes toward substance misusers. III. Emergency room nurses’ attitudes toward impaired nurses, and the studies of attitudinal changes. Substance Use & Misuse, 35(9), 1227-1261.
- United States Department of Labor. (2007). Quick Facts on Registered Nurses.
- Becker, J.B., & Hu, M. (2008). Sex differences in drug abuse. Frontiers in Neuroendocrinology, 29(1), 36-47.
- Dall’Ora, C., Griffiths, P., Ball, J., Simon, M., & Aiken, L.H. (2015). Association of 12 h shifts and nurses’ job satisfaction, burnout and intention to leave: findings from a cross-sectional study of 12 European countries. BMJ Open, 5(9), 1-7.
- Smith, L.L., & Greene, M. (2015). Florida Intervention Project for Nurses: A National Model for ADP and Nurse Assistance. Journal of Addictions Nursing, 26(3), 159-162.