Substance Abuse: Peer Support The Best Answer?

Substance Abuse: Peer Support The Best Answer?

By Dr.Fourkan Ali

With the easy access to drugs coupled with the high stress of the job, nurses battling substance use disorder has become a quiet epidemic.

Given the stress of the profession combined with easy access to prescription medication, it is not surprising that a 2015 survey found that 48% of nurses reported drug or alcohol use at work. Due to the nature of their work and their access to vulnerable patients, such abuse is particularly disturbing. Exacerbating this issue, 40% of respondents believed that their competency level was affected by their substance use, and 25% admitted that they had obtained prescription drugs in the workplace. Given such an endemic problem, an answer needs to be found, and that answer very well could be the support of and guidance from fellow nurses.

In popular culture, the problem of substance abuse in the nursing profession was the focus of the successful Showtime drama Nurse Jackie, in which star Edie Falco played a healthcare professional addicted to Vicodin and Adderall. A major problem for nurses is easy access to the drugs combined with the high stress of the job where life and death decisions are made every day. Nurses can easily rationalize the choice to use prescription medications to take the edge off. Once that choice is made, all bets are off.

As former nurse Kristin Waite-Labott, author of the memoir An Unlikely Addict, explains, “It occurred to me one day while I was working in an emergency room that we throw away a lot of awfully good drugs.” Now over 10 years sober, she goes on to say that, “Nobody knew that I was using until, you know, they caught me stealing … I think this is a huge problem and I don't think there is a lot being done about it … Everything is very hush-hush. Nobody wants to talk about it."

A secondary problem is that once nurses fall into the pit of substance abuse, they tend to be unwilling to ask for help. This is where other nurses can play a major role. Problem recognition and seeking assistance is tricky for nurses due to various barriers. Over 50% of the survey’s respondents answered "somewhat" or "a lot" to the following reasons that keep them from accessing help once they started abusing drugs on the job: 

1. Too scared to admit the truth

2. Too embarrassed to seek assistance

3. Concerns about confidentiality and stigma

4. Fear of losing their license and livelihood

To overcome such barriers, education is needed, and the best source of such education is other nurses. According to Marie Manthey, the current chair of the board of Nurses Peer Support Network, a peer-run support organization for nurses struggling with recovery, “Although we as nurses understand intellectually that addiction is a disease, when it comes to ourselves, we believe it is a moral failure of the worst kind … This perception makes it extremely difficult for a nurse to move out of shame and into recovery.” 

In order to overcome the stigma and embrace recovery, peer support is essential. Manthey describes the two-part mission of the Nurses Peer Support Network: “One is to provide peer support where nurses can talk to nurses about their shame and stigma. The second part is to educate the profession and the public about the risks and consequences of addiction in nursing.”