The Healthcare Worker Drug and Substance Abuse Problem
It’s no secret that the healthcare industry has a drug and substance abuse problem. Doctors and nurses with addiction issues have made news headlines recently. In a July 2014 report for KTUU, Lacie Gorsvold explains how a nurse that admitted to drinking while at work and a physician that prepared for surgery under the influence are both still practicing medicine in Alaska. The problem, however, is not just unique to Alaska. This is an issue that affects doctors, nurses, and other healthcare professionals across the nation.
In this article, I discuss some of the latest statistics related to drug and substance abuse for healthcare workers, the nature of the problem, a recent case that’s shocked the industry, and what healthcare organizations can do to address the issue.
The Prevalence of Prescription Drug and Substance Abuse Among Healthcare Workers
By now, you’re probably familiar with the USA Today report released in April 2014 that states: “More than 100,000 doctors, nurses, medical technicians and healthcare aides are abusing or dependent on prescription drugs in a given year, putting patients at risk.” That’s definitely more than just the healthcare professionals from Alaska mentioned above.
Patrick J. Skerret, Executive Director at Harvard Health, estimates that one in 10 physicians develop problems with alcohol or drugs at some point during their careers. The numbers don’t look any better for nurses. According to an article in American Nurse Today, the official journal of the American Nurse Association, about one in 10, or 10-15% of all nurses, may be impaired or in recovery from alcohol or drug addiction.
Factors Contributing to Substance Abuse Among Healthcare Workers
In a study published in the October 2013 issue of the Journal of Addiction Medicine, Merlo et al. found that self-medication was a leading reason for misusing prescription medications among the 55 physicians of the study. As Amy Norton from U.S. News explains, doctors are doing it to deal with overwhelming stress or physical or emotional pain. Recreational use, however, was also cited as an important factor by the study.
While physicians and nurses do not have a higher risk of developing drug addiction compared to the general population, MedicineNet states that many experts believe healthcare workers (including doctors, nurses, dentists, pharmacists, and veterinarians) may be at increased risk for prescription drug abuse. The reasoning behind this statement is that healthcare professionals have easier access to these controlled substances due to the nature of their job.
Patient Safety at Risk: The Case of David Kwiatkowski
You’ve probably heard the highly publicized case of David Kwiatkowski, a medical technician described as a “serial infector” by prosecutors for infecting over 40 patients across 18 hospitals in seven states with hepatitis C. Kwiatkowski injected himself with the painkiller fentanyl and then used the same syringes on patients, exposing thousands of patients to the virus throughout his career jumping from hospital to hospital. In December 2013, Kwiatkowski was sentenced to 39 years for causing a multistage outbreak of hepatitis C, according to a report from CNN.
This case shows that the prescription and drug abuse problem is not only unique to physicians and doctors, but other healthcare workers as well. It’s unfortunate that an individual like Kwiatkowski can move from one healthcare facility to the next, harming patients in the process, before being stopped. It’s a wakeup call that these things happen in the healthcare industry and perhaps certain measures could prevent cases like these.
Random Drug Testing—An Emerging Trend in Healthcare
Although some hospitals have started random drug testing to identify doctors, nurses, and other healthcare professionals with substance abuse problems, it is neither required by law nor the standard at this time. Nevertheless, there are a few reasons why random drug testing could become an emerging trend in healthcare.
First, the prescription drug abuse problem among healthcare workers is too large to ignore, with 100,000 healthcare professionals estimated to abuse drugs annually according to the latest statistics. With such large numbers and patient safety at risk, having a random drug testing program in place makes sense.
Second, the latest research suggests that random drug testing is necessary in healthcare. According to a commentary published April 29 in The Journal of the American Medical Association, physicians and patient safety experts noted that “mandatory alcohol-drug testing for clinicians involved with unexpected deaths or sentinel events is not conducted in medicine.” In the commentary, the authors recommend that hospitals take a number of preventive measures, including a program of random alcohol-drug testing.
Third, Inspector General Daniel R. Levinson and Erika T. Broadhurst from the U.S. Office of Inspector General (OIG) has addressed the issue of random drug testing physicians in the New York Times in March 2014. Citing David Kwiatkowski’s case, the OIG provided a few recommendations for healthcare organizations. “We believe hospitals should be required to perform random drug tests on all healthcare workers with access to drugs,” states the OIG’s column.
For these reasons above, I believe random drug testing will eventually become the norm in the healthcare industry. Both regulators and researchers have recognized the issue and endorsed random drug testing, so it’s only a matter of time before healthcare organizations adoptive more progressive measures.
Are you reviewing your healthcare organization’s drug testing initiatives? Contact us today to learn how PreCheck can help you administer your drug testing program.
Merlo, L., Singhakant, S., Cummings, S., & Cottler, L. (2013). Reasons for misuse of prescription medication among physicians undergoing monitoring by a physician health program. Journal of Addiction Medicine, (7)5, 349-353. Accessed July 2014.
Thomas, C., & Siela, D. (2011). The impaired nurse: Would you know what to do if you suspected substance abuse? American Nurse Today, (6)8. Accessed July 2014.