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Doctors, nurses, and other healthcare professionals are the providers of our communities. They use their knowledge, skills, and technology to heal our wounded and treat our ill. Even with so much education and experience gained from their hard work, there is still the problem of some of these professionals succumbing to alcohol and/or drug dependency. Most with these substance dependencies are in dire need of fighting this addiction in order to reduce the chances of a work-related incident happening to either their patients, co-workers, or themselves.
Substance Abuse with Healthcare Professionals as a Social Problem
Doctors and nurses have been labeled as holding the highest addiction rate when relating to substance abuse (Juergens, 2019). It has been statistically averaged that around 100,000 healthcare professionals across the country are suffering from substance abuse or addiction to narcotics (Juergens, 2019). Their addictions stem from the necessity to stay alert for long shift periods or to escape from the emotional hardships experienced and upsetting outcomes (Juergens, 2019). On a positive note, the doctors and nurses who have developed addictions to narcotics have a high turnover rate to recover from such addictions (Juergens, 2019).
U.S. government surveys calculated and combined from 2003-2007 and 2008-2012 prove that around 164,600 healthcare professionals, who have used narcotics each year, had increased to 168,000 (Santiago, 2017). This statistic does not necessarily state that all individuals surveyed were addicted to narcotics, but it does bring light to the start of said addictions. Due to easily accessible addictive narcotics in the workplace, healthcare professionals are able to obtain these drugs by means of self-prescription or theft (Santiago, 2017). Within the U.S., our society is so accepting of substance abuse that it is no surprise for healthcare professionals to succumb to this controversy (Santiago, 2017).
There is a link between alcohol abuse and drug abuse, and either addiction is likely to encourage the practices of the other. With alcohol-related addictions, around one-quarter of American workers admit to ingesting alcohol during the workday at least once annually as reported by the National Council on Alcoholism and Drug Dependence (NCADD) ( Treating a Healthcare, 2019). With the portrayal of appearing highly educated and successful, medical professionals are not commonly viewed as the stereotypical alcoholic by tradition ( Treating a Healthcare, 2019). Prior to surveys conducted between 2008 and 2012, around 4.5% of full-time workers in the healthcare industry, aged from 18 to 64, admitted to heavy drinking ( Treating a Healthcare, 2019). 5.5% of this same group admitted to wrestling with a substance use disorder during the year national surveys were conducted ( Treating a Healthcare, 2019).
Aside from the healthcare professionals admitting their faults with handling their addictions, it may be difficult to identify the signs of addiction when many professionals give off the capability of being a highly functional addict (Juergens, 2019). The functional alcoholic subtype resides within 20% of alcoholics that fit the combined categories of middle-aged with stable jobs, high-level education, and families, which is another commonality in the healthcare profession ( Treating a Healthcare, 2019). The common signs listed share similar behavior qualities such as the addict continuously altering their movements and habits (Juergens, 2019). The normal behaviors non-addicts enact are inappropriately overused by addicts and draw more attention to themselves even if for a brief period of time it goes unnoticed by others (Juergens, 2019). Since the healthcare industry is fast-paced and stressful, attempts to emotionally distance oneself from events that are either distressing or painful highly encourage medical professionals to engage in substance abuse ( Treating a Healthcare, 2019).
Powerful prescription medication is usually unproperly accounted for when administered, along with the combination of a healthcare professionals extensive knowledge of the effects, substance abuse is commonly tempting to commence (Juergens, 2019). Those in emergency medicine, psychiatry, and anesthesia are the highest rated to involve themselves with substance abuse, but alcohol is also used to assist in coping with stress ( Treating a Healthcare, 2019). Not all addicts in the healthcare profession are capable of becoming a functional addict , but the inevitability of becoming an addict nonetheless is possibly caused by a lack of knowledge to effectively cope with the stresses they obtain from daily exposure to on-the-spot decision-making and stressing events (Yagoda, 2016). Since the reliance on a substance becomes more tempting, a person will lose their ability to handle stress and will turn to their alcohol or illicit drug of choice in order to continue their daily tasks at work (Yagoda, 2016).
A number of colleges with higher education do tend to show a rise in alcoholic social events (Barkan, 2016). Normally the reasons college students indulge in numerous alcohol-related social gatherings are to lower levels of anxiety, develop social relations with other students, and encourage fun (Barkan, 2016). Healthcare professionals who have gone through many years of collegiate schooling may have indulged in such drinking early on in order to begin their coping phase when handling the stress, and it may have bled over to affect their coping skills as they attempt to mature in their professional field of study. About 10%, around 3.4 million, of young adults between ages 18 and 25 had, or developed, an alcohol disorder in 2017, while those over the age of 26 were surveyed around 10.6 million (Thomas, 2019). In relation to illegal drug use, those aged between 18 and 25 averaged around 2.5 million, and adults over the age of 26 were statistically around 4.3 million or 2% (Thomas, 2019). These age groups are the premises of students who are either practicing nursing or earning their doctorates. Battling these disorders may relapse following college graduation.
When alcohol is being measured, studies show that more than half of American adults were exposed to drinking problems or alcohol addiction within their family history in 2017 (Thomas, 2019). Also, in 2017, statistics revealed that illicit drugs make women more likely to develop a prescription painkiller dependency than men, mostly inspired by chronic pain and high-dosage prescriptions (Thomas, 2019). Another study conducted by an addiction center from 1990 to 2010 reported a rise in an anesthetic named Propofol (Decker & Hughes, 2013). 22 healthcare professionals were identified, but they were all practitioners who had easy access to other anesthetics (Decker & Hughes, 2013). Propofol users have been a majority female, and have expressed experiencing depression, including a history of childhood physical or sexual (Decker & Hughes, 2013). The dependence of Propofol has been increasing within 1.6% of healthcare addiction cases that are requesting treatment (Decker & Hughes, 2013).
With the number of male nurses increasing drastically from 1970 to 2011, female nurses still dominate the nursing field by over 90% (United States Census Bureau [USCB], 2013). With the American Nurses Association estimating a probability where one in ten nurses defer to abuse drugs or alcohol, the chances of them being female is a high expectation (Gonzales, 2018). Aside from depression and post-traumatic stress disorder (PTSD), nurses practicing substance dependency normally experience fatigue from prolonged shift work, stress from providing emotional and physical support to patients and their families and being tempted by easy access to prescribed drugs (Gonzales, 2018). There has also been a long history of nurses partaking in substance abuse for decades, especially with fentanyl back in the 1970s (Gonzales, 2018). Without proper supervision of the hospital staff, nurses would remove the opioids from their vials and replace them with saline, causing an influx of addictions and overdoses among professionals (Gonzales, 2018).
A more unfortunate impact on the nursing profession that is not addressed is the sheer fact that they have developed loyalty within their ranks, usually from friendships established with one another (Gonzales, 2018). This incites an enabling behavior and allows their coworkers to ignore the side effects of the onset of addiction, which also leaves some nurses to not report the substance abuse for fear of colleagues being reprimanded (Gonzales, 2018). In generalization, nurses are not to be singled out for their substance abuse, but instead all healthcare professionals since 1842 (Butler Center for Research [BCR], 2015). Because a number of healthcare professionals were experienced with knowledge of the effects of most opioids, they began to exercise their use on patients, but it only further complicated the tempting need for professionals to engage more in other prescription drugs readily available to them (BCR, 2015).
Even with the highly regarded positions doctors and nurses are in, they are not exempt from the aftereffects of an alcoholic or opioid addiction. Only in the 1970s was the American Medical Association forced to develop a formal policy in response to impairment from either drugs or alcohol (BCR, 2015). With a policy in effect, many states have refined programs to help healthcare professionals combat their addictions and ensure they do not lose their licenses or practice (Juergens, 2019). There have been concerns about evaluations and treatments being undermined for fear of negative financial, legal, professional, or social consequences (BCR, 2015). There are also problematic attitudes and behaviors of healthcare professionals that will conflict with the treatment that they need, such as their independence, perseverance, and self-reliance (BCR, 2015). It affects their personal judgment to ask for help when it is truly warranted.
Since the treatment plans for these professions need to be of a much higher standard due to the safety of the patients affected, state medical boards have taken precautions to ensure critical treatment intervention is up to standard (BCR, 2015). Thorough evaluations and assessments are in order and are only to remain non-punitive and confidential if criminal or legal actions have not been filed against the healthcare provider for substance abuse ( Treating a Healthcare, 2019). Of course, detoxification is the first order of business once the professional has voluntarily opted to engage in the program ( Treating a Healthcare, 2019). This process, if successful, will determine the type of treatment program that is necessary ( Treating a Healthcare, 2019). The options are either inpatient or outpatient, with the latter being the most flexible to allow the volunteer to continue with daily tasks, but still restrictive when involving patient care ( Treating a Healthcare, 2019). The former is more restrictive, but structured and tailored to focus on the volunteers recovery ( Treating a Healthcare, 2019). Even with the treatment programs available to them, no bad deed goes unpunished. There is a high chance of license suspension or even revocation (Santiago, 2017). This disciplinary action does stay on the healthcare workers record and raises some red flags to other employers if they wish to relocate to another facility, thus causing major retraction from professionals from even admitting they have a problem (Santiago, 2017). The positive note to take away is the fact that those who have received treatment are highest rated to remain sober (Juergens, 2019).
Due to a large number of addictions within the healthcare field involving social interaction, it would be best to determine that symbolic interactionism is the most prominent theory to help us understand this social problem. It usually stems from a healthcare worker needing help dealing with either the long hours, the stressors of work, or both, and they confide in their peers/supervisors for advice. Their peers/supervisors show them which drug to use to assist with their performance or post-work stability, explain the procedures to take once the effects have taken over, and then entertain the idea of sticking to the continuation of relying on that substance as the only means to get through their day (Barkan, 2016). With an imposed team player mentality amongst healthcare professionals, this concept is widely accepted, even amongst others who do not engage in this type of behavior. The sheer fact that it happens without being reported is a prime example of professionals unwilling to cause distrust amongst their co-workers.
The treatment plans for these healthcare professionals are highly essential to be effective not only to provide the professional with a plan that will help them combat their illness but to ensure the safety of their patients. Patient care is still the primary staple of these treatment programs, and with voluntary submission, these professionals will learn to not endanger the safety of their patients, coworkers, or themselves ( Treating a Healthcare, 2019).
Judging from the sources I have reviewed when treatment plans are laid out, I find it very difficult to properly judge an effective solution aside from what the states have already laid out. It is difficult enough to get people to admit they have a problem, let alone go about trying to solve the problem in general. This was a difficult social issue to tackle, and I am glad to have been able to do so, but my augmentation would most likely steer towards quarterly training seminars from an outside professional so as not to bring about bias. I would also enforce random drug testing either monthly or bi-monthly in order to help prevent further substance abuse. There is also the need to have a system for two-way authentication of all inventory. One authentication is from the personnel assigned to the pharmaceutical department and another is from a senior officiate from administration. This may help with keeping accountability at its peak without worry of loss of inventory.
References
- Barkan, S. E. (2016). Social problems: Continuity and change. Minneapolis: University of Minnesota Press.
- Butler Center for Research. (2015). healthcare Professionals: Addiction and Treatment. Retrieved from https://www.hazeldenbettyford.org/education/bcr/addiction-research/health-care-professionals-substance-abuse-ru-615
- Decker, R. & Hughes, C. (2013). Study Shows Rising Rate of Propofol Abuse by healthcare Professionals. Retrieved from https://wolterskluwer.com/company/newsroom/news/health/2013/03/study-shows-rising-rate-of-propofol-abuse-by-health-care-professionals.html
- Gonzales, M. (2018). Nurses and Addiction. Retrieved from https://www.drugrehab.com/addiction/nurses/
- Juergens, J. (2019). Substance Abuse in healthcare. Retrieved from https://www.addictioncenter.com/addiction/medical-professionals/
- Santiago, A. C. (2017). Why Substance Abuse Is Growing Among Medical Staff. Retrieved from https://www.verywellhealth.com/substance-abuse-in-the-healthcare-workforce-4125792
- Thomas, S., M.D. (2019). Alcohol and Drug Abuse Statistics. Retrieved from https://americanaddictioncenters.org/rehab-guide/addiction-statistics
- Treating a Healthcare Industry Worker for Alcohol Abuse Issues. (2019, July 18). American Addiction Centers, Inc. Retrieved from https://www.alcohol.org/professions/medical-professionals/
- United States Census Bureau. (2013). Male Nurses Becoming More Commonplace, Census Bureau Reports (Publication No. CB13-32). Retrieved February 25, 2013, from USCB Web site via GPO Access: https://www.census.gov/newsroom/press-releases/2013/cb13-32.html
- Yagoda, R. (2016). Understanding the Link Between Stressful Occupations and Addiction. Retrieved from https://health.usnews.com/health-news/patient-advice/articles/2016-09-26/understanding-the-link-between-stressful-occupations-and-addiction
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