The Nurse Addict Part 1: The slippery slope
Perpetuated by silence and steeped in shame—this taboo subject deserves to be brought into the light.
*The following accounts have been provided on agreement of anonymity—therefore names and certain identifying details have been changed to protect the privacy of those nurses who bravely share their stories with us.
According to recent data, at least 20% of all nurses struggle with alcohol or drug abuse. That’s 1 in 5. Think about the nurses who work with you on your unit—statistically, you are working with someone doing a pretty decent job of covering up…well, their suffering, really.
Nobody begins a career planning on becoming an addict. But, undoubtedly, there is an air of condemnation in the medical community toward nurses struggling with addiction. Part of this stems from falsely equating those who work in medicine as “knowing better.”
However, the startling statistic above shows us that being medically knowledgeable does not provide immunity from addiction. In fact, the risk for those working in healthcare such as nurses with substance abuse is disproportionately high—and the profession has only gotten more stressful.
Yet, as nurses, we don’t talk about this important issue enough.
In an effort to break the stigma, we are bringing you four very personal stories of nurse addicts. By their own descriptions, they are the ones you’d least expect. It turns out that nurse addicts are highly functioning in their addictions. At least, until they’re not.
It is our hope that these stories help to bridge the knowledge gap by shining a light on an important subject. There’s a lot to cover, so we’re breaking this series into three parts: the slippery slope to addiction, the recovery/discipline process, and the aftermath of broken careers.
Shame cannot live in the same sphere as empathy, and that’s where we begin.
For Sarah*, she first experienced diverting drugs as a simple med error. Working as a wound care nurse, she was assigned a new patient with an ischemic heel ulcer—Mrs. X. During the report, Sarah reviewed the patient’s medications—Mrs. X was alternating Dilaudid IV with PO oxycodone, maxing out each time on the allowable doses for both.
Anticipating a busy shift ahead, Sarah removed her patient’s next available dose from the Pixys, assuming she’d ask for it. Following her assessment, Sarah offered her two 5 mg oxycodone tabs, but this time, Mrs. X declined the second tab.
Having already scanned and popped them free from their coded wrapping—now buried in the trash—Sarah dropped the extra tablet into her pocket, making a mental note to do a narcotics waste with a co-worker later on. Changing out of her scrubs some 14 hours later at home, she cleaned out her pockets; there among the alcohol swabs and pens she found the forgotten oxycodone tab.
“I honestly didn’t give it too much thought. On impulse, I popped it in my mouth, chased it with some wine, and had a more relaxing evening than normal. Unfortunately, that seemingly “harmless” decision turned me onto a path of self-destruction that I wouldn’t even realize I was on for several more months.
Apparently, Mrs. X had taken a liking to me. And since she refused to proceed with the amputation recommended for her worsening ulcer, she was in our unit for almost 6 months. I was her nurse every shift I worked. That ended up being a lot of oxycodone.”
For James*, the decision to use was more intentional. Being the lone male nurse on his unit, he was often called on to help move patients. One particular shift, a confused elderly patient suddenly grabbed his neck and James felt a “pop.”
“I filled out an Incident Report at work, but still needed to see my doctor to make sure nothing serious was going on. Luckily, it was just a sprain. I was prescribed a round of Vicodin to help with the pain. My neck healed and I went back to work. However, as the weeks went by, I missed the euphoric feeling of the pills. My roommate had an old bottle of Percocet, which he gave to me. I didn’t feel I was abusing them, not really…I would just take one (or two, or four) at the end of my shifts.
I never went to work impaired; I thought that somehow made it okay. A couple weeks later, a patient fell and I happened to be in the room assisting. My hospital’s policy mandated that every employee involved with a patient incident has to be drug tested. Unfortunately, mine lit up for Percocet. When I couldn’t produce a prescription for it, I was fired and reported to the Board of Nursing.”
For Kiandra*, drug addiction developed like a slow burn. A burning in her uterus, to be specific. Diagnosed with endometriosis and adenomyosis, she endured excruciating and debilitating levels of pain every month. Yet, despite having two kids and “being done” with child-bearing, since she was still in her 20s, she could not find a GYN willing to perform a hysterectomy. As a last resort, she was prescribed narcotics.
“Without the medication, I couldn’t get out of bed. I’d either be maxed out on ibuprofen and acetaminophen under a heating pad or in a cold sweat on my bathroom floor trying not to vomit. It was that bad. I missed so many days of work. Eventually, I could only hold down a job at a nursing home where they overlooked my absences because they were so short-staffed.
At that point, I took the narcotics as prescribed, but then I developed uterine fibroids. At this point in time opioid pill mills were being busted left and right; there was also increased scrutiny on over-prescribing practices in general. Even though I was responsible with my medication, my doctor refused to increase my dose and mentioned the need to stop it completely.
The thought of being cut off made me panic. The next time I was issued a prescription—eight tablets for the month—I impulsively added a “0” to the quantity. It was easy enough to do. I filled it at a pharmacy that I never go to. An hour later, I had enough pills to last me 10 months. Unfortunately, they were gone in half that time.”
For Carla*, her addiction started long before her work as a nurse. But because her drug of choice is culturally acceptable, it didn’t register as problematic. That’s the trouble with alcoholism—for young, working women, it’s almost celebrated.
Every weekend Carla attended happy hours with her nursing school buddies. They studied, worked, and attended clinicals at a frantic pace during the week, so having a few glasses of wine together each week seemed like a fair trade-off. The problem for Carla was that it neither began (nor ended) with weekend drinking.
“Being young, I saw no problem with my drinking. My roommates certainly drank as much as I did. Or, I drank as much as they did…plus a little more. By the time I graduated, passed my NCLEX, and landed my dream job as a circulating nurse in the OR, I was drinking close to a bottle of wine a day. Have you ever noticed that it sounds so much worse when you say it that way?
Nobody bats an eye when you say you have a couple glasses of wine a night. But, if your glass is big enough, an entire bottle is empty before you know it. About a year into my OR job, I was assigned a call shift. I’d done a few before and had never been called in. I worked at a tiny community hospital; we almost never did emergency cases. Until, one night, we did; and I happened to be on call.
Unfortunately, I had made the decision to drink that night. When I got to work, despite the body spray and mints, my charge nurse immediately smelled it on me. I was pulled from the OR, drug-tested and placed on administrative leave, effective immediately. Two days later, I was terminated and what’s worse—reported to the BON.”
These stories are continued in “The Nurse Addict Part 2: Recovery in the Face of Discipline.”
Breanna Kinney-Orr
NurseDeck Ambassador
Breanna has been a Registered Nurse since 2008. Her clinical background in is neuro, trauma, and ED nursing, as well as nursing leadership. After having two sets of identical twins (yes, really!), she started her career as a nurse-focused writer and content creator. Breanna has a passion for story-telling and amplifying the collective nurse voice. She doesn’t shy away from controversial, political, or taboo topics and believes wholeheartedly that nurses play a pivotal role in healthcare reform. Most of all, through her writing, Breanna loves bringing nurses together and creating communities where nurses feel seen and supported. Outside of NurseDeck, Breanna enjoys anything outdoorsy, riding horses, books books and more books, and keeping her children out of the ER.
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