This series follows the stories of four nurses dealing with addiction. The following accounts have been provided on an agreement of anonymity—therefore names and certain identifying details have been changed to protect their privacy. In case you missed it, here’s part one and two.

Nursing is among the most vulnerable professions when it comes to substance abuse. One of the biggest factors driving this phenomenon is a higher rate of anxiety and depression. Frontline healthcare workers have been dealt an especially big blow these past few years, working under incredible levels of stress during the COVID-19 pandemic. Increased patient mortality, hazardous work conditions due to personal protective equipment shortages, and the uncertainty about how long the pandemic would rage on ignited a pilot light of mental duress - one that was always on the back burner anyway. 

It’s hard to think of more stressful circumstances that might lead nurses to want to numb out and escape. While the long-term data still remains to be seen about the mental health consequences left in the pandemic’s wake, anecdotally, nurses are speaking up about the toll that burnout has taken on them. PTSD-types of symptomatology are being reported more and more, fueled by the Great Resignation and what do increased of staff to patient ratio mean for nurses 

“If I hadn’t already developed—and recovered—from an addiction 5 years ago, going through this past year might have kicked it off for me,” said Kiandra. “I work in dialysis now. It’s one of the few specialties that readily takes nurses in monitoring programs. And while I’m so grateful to have gotten my license back and to be working, taking care of medically fragile patients, who often come from nursing homes and then must get treatment together in close proximity has been devastating. The majority of my patients either had COVID-19, or had family members with it. We lost so many of them. So many nights driving home, I cried for them, for their families…for myself. Things are better now since the vaccine has rolled out, but it’s been the hardest few years of my life. I’m so fortunate that my recovery is in a good place, and my support system is strong.”

Overall, Kiandra* reports her experience in IPN to be positive. She had a lot of guilt and remorse from forging a prescription, but eventually was able to get her criminal record—a felony conviction—expunged. Her license remained clear and active, and she was finally able to get the hysterectomy she needed, essentially stopping the chronic and debilitating pain that led her to abuse narcotics in the first place. Overall, she spent five years being monitored with IPN, the minimum required, yet achieved by few. 

For Carla*, her time in IPN was just shy of a decade. “I had to start over—twice. The first time was an honest mistake, failing a drug test because of cough syrup. That landed me back in acute rehab for another 28 days. Coincidentally, the doctor who evaluated me owned the rehab facility that was recommended. I thought that was a giant conflict of interest, but the message IPN gave me was clear—go, or lose my license. The second time I failed a drug test was my own fault. I know now that relapse is a part of recovery, but at the time it felt like I was never going to get better, or stay gainfully employed. Even now, one year since I graduated out of IPN, I still feel like I’m being watched. The stigma never leaves you.”

Being shunned by the medical community - the same one that ought to understand addiction for the disease that it is - is often the hardest part of recovery. 

For many nurses, their work life provides more than a paycheck. The social support from those that share your profession—especially the high-stress role that lay people may not understand due to the life and death struggles nurses encounter every day—leaves a gaping hole if removed. 

James* recalls this being the worst part for him. “It sounds silly, but all my work friends unfollowed me on social media, effective immediately. No one called to check on me, to see how I was doing, or to make sure I was okay. Even though at work I was known as the one to call to help them, it didn’t seem to matter once I was branded an addict. I attempted the IPN program but found it to be really punitive.

It’s almost as if they were wanting you to fail so that you could wrack up more services and shell out more money. I went through recovery on my own terms; ultimately, I decided that being in a profession where I would be around temptation was too great to risk my sobriety. I let my license lapse, and now work in the corporate world. I miss nursing at times but I’m still bitter about how I was treated—generally speaking, nurses have a pretty poor attitude towards addicts, which is sad.”

Sarah* couldn’t agree more with this assessment. She was able to complete her monitoring program with IPN, as well as pass through her probationary work periods without too much difficulty. But her overall impression during her recovery time was that of suspicion and skepticism. 

“It’s true the monitoring programs accomplish their goal: nurses actually have a pretty good track record when it comes to returning to the bedside and safely practicing. But I believe the programs could do a lot better when it comes to supporting the nurses in their recovery. What’s in place now is hardly better than professional house arrest. Nurturing shame is so counterintuitive to a healthy recovery. Now that I work as an addiction medicine nurse, I’ve seen the systems in place break so many good nurses when they needed help the most. That’s not to say treating addiction in healthcare practitioners is easy—but like most mental health modalities, it requires nuanced care, grounded in compassion.”

Lifting up this topic is the right first step in battling the stigma that comes from addiction. Nursing has only gotten more challenging—physically, mentally, emotionally, and spiritually. The field has never been more ripe for addiction to take hold. And once it does, fighting one’s way back to sobriety and reclaiming a professional capacity to work safely is an uphill battle the whole way. We owe it to nurse addicts not to let them fight alone.