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Medically Reviewed

Substance Abuse Treatment Options for Nurses

Substance Abuse among Nurses

Nurses are prone to extreme work-related stress, and like anyone else they may turn to substances for coping and self-medication. Substance abuse among nurses has been recognized by professionals in the field for over 100 years.1 It is currently estimated that 1 in 10 nurses suffers from alcoholism or drug addiction.2-3 Nurses abuse drugs at about the same rate as the rest of the population, although they are more likely to abuse prescription medications which are readily accessible through their workplace.4-5

Nurses may exhibit some tell-tale signs of their addiction. Signs, symptoms, and behavioral changes that may indicate substance abuse in nurses include:

  • Mood swings
  • Agitation
  • Fatigue
  • Hand tremors
  • Bloodshot eyes and/or runny nose
  • Decline in hygiene and appearance
  • Lapses in memory
  • Difficulty with completing work assignments
  • Decreased productivity
  • Negligence in patient care
  • Frequent bathroom trips
  • Incorrect narcotic counts
  • Lack of witnesses during disposal of unused medications
  • Unexcused tardiness or absence from work
  • Seeking prescriptions from peers

Untreated substance abuse can jeopardize patient care and safety. Nurses under the influence of substances or going through symptoms of withdrawal are more prone to impaired judgment, slower reaction time, which could lead to increased errors and mistakes. Another significant problem is the diversion of prescription medications for their own personal use, meaning that patients are not receiving prescribed treatments.

Treatment Options for Nurses

Nurses often do not report their addiction due to the fear of potential consequences, such as the loss of nursing licensure and termination of employment. It is therefore usually up to colleagues and family to recognize signs of drug abuse and refer nurses to the appropriate agencies. When a substance abuse disorder is suspected, the nurse will typically be placed on leave until an investigation can be conducted. In most states, the nursing leadership team must report cases of substance abuse to the Board of Nursing and local police.

Nurses are then referred to a state-based alternative-to-discipline program, also commonly known as nurse assistance programs. Although they vary by state and are called a variety of different names, for the most part these programs provide monitoring, support, and advocacy to nurses. Alternative-to-discipline programs allow nurses to avoid disciplinary action and safely return to work while under strict guidance and supervision. The basic requirements for participation in these programs include counseling, drug testing, and worksite monitoring.5 These voluntary programs often provide access to services that typically include:

  • Helpline for confidential inquiries
  • Legal assistance
  • Peer assistance
  • Mentorship
  • Advocacy
  • Rehab treatment
  • Support groups

Alternative-to-discipline programs have proven to be very effective, with Florida’s program, the oldest in the nation, estimating that 80% of treated nurses safely return to practice while fewer than 25% relapse.6 Together with professional treatment, aftercare, and peer assistance, these programs provide nurses with the best chance of long-term recovery with successful reentry into the profession.

Seeking help from an addiction specialist is the first step toward a successful recovery. At American Addiction Centers facilities, we have the proper tools and treatment plans to help nurses suffering from substance abuse overcome their addiction.


  1. Heise, B. (2003). The historical context of addiction in the nursing profession. Journal of Addictions Nursing, 14(3), 117–124.
  2. Baldisseri, M.R. (2013). Impaired healthcare professional. Critical Care Medicine, 35(2 Suppl), S106-S116.
  3. Dunn, D. (2005). Substance abuse among nurses: Defining the issue. AORN Journal, 82(4), 573-596.
  4. 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.
  5. National Council of State Boards of Nursing. (2011). Substance Use Disorder in Nursing: A Resource Manual and Guidelines for Alternative and Disciplinary Monitoring Programs.
  6. Hastings, J., & Burn, J. (2007). Addiction: A nurse’s story. American Journal of Nursing, 107(8), 75–77, 79.
Last Updated on October 30, 2019
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