As a profession, nurses are more likely to have a substance abuse issue with drugs or alcohol, than most. According to the Journal of Clinical Nursing 1 in 5 nurses can struggle with an addiction to drugs, alcohol or both.
Nurses see drugs daily: Is that why addiction impacts them more?
Compared to other professions nurses do appear to be in a higher risk group for addiction. Nursing is a job with a great deal of responsibility. Depending on the role and the location, you can be facing death on a daily basis. You may be speaking with people about their pain, or administering medication that could – if done wrong – literally end someone’s life. Though it is an incredibly rewarding job at times, it can definitely have downsides including long hours, high stress and less pay than other medical professions.
In contrast on Koh Chang island, people with high-pressure jobs like nursing have an opportunity to reboot.
Nurses on the frontline of abuse
Dave* says “I have been yelled at on a fairly regular basis by families. When their kid or mum is in hospital and their emotions are running high it’s pretty common to lash out.”
Dave is an emergency nurse who is undergoing treatment at DARA Rehab for addiction to alcohol and ketamine. He says “it’s easy to steal drugs. Easier than you would expect.”
Working at a well respected private hospital in Sydney, Australia, Dave has on multiple occasions checked Ketamine out for use for in the Intensive Care Unit (ICU), and then pocketed – rather than disposed of – the drugs.
“Protocol is that if an emergency – for example, a car accident – is coming in you may not know exactly what you’ll need but you do need to prep. Drugs are carefully accounted for but the obvious loophole is that the disposal bins do not get checked. So, if you want free drugs, rather than put them in the bin you can put them in your pocket and no one is the wiser.”
Don’t ask, don’t tell culture enables nurses addiction
Program director Martin Peters, a registered nurse himself for 20 years, says “part of the problem is the culture within hospitals. People are discouraged from “dobbing” on each other. If one person speaks up, they can be shunned. It’s a very tight, close-knit culture – and that is usually wonderful – but the dark side is it can mean enabling alcoholism and substance abuse.”
The problem with drug use in hospitals is so rife amongst medical professions, according to studies, the amount of medical professionals using drugs is considerably higher than you may expect.
“It’s that culture of secrecy that really encourages addiction. The way we help people at DARA Rehab is by encouraging them to open up and talk. Here they are in a non-judgemental environment. If you have been lying about money, where you spend your time, why you are late to work, and just about every aspect of your life to everyone, being able to tell the truth is a massive release.”
At DARA Rehab clients undergo one on one therapy as well as group therapy. Doctors, nurses and a range of medical professionals are often amongst the clientele.
“Addiction does not discriminate. We have financial planners, actors, stay-at-home mums and just about everyone you can picture here together, united by their addiction. We have two nurses with us now in treatment for addiction. The positive thing is they are also united by their recovery and desire to change.”
Access to drugs
Opioids and other prescription drugs are more accessible for medical professionals – like nurses – than most people. Access to these drugs can make it easier to start a habit, and harder to stop.
“Some people start drinking, it can be social and relatively harmless,” says Martin. “Then, with the stress of their job, the drinking escalates and they start using it as a coping mechanism.”
Getting help in your own city can be a deterrent for some medical professionals. Addiction has a stigma. Not only do you risk losing your job, but there’s also reputational fallout. Shame drives many people to keep their addictions a secret.
“I let things escalate before I got help and came to DARA,” says Dave, client at DARA Rehab and registered nurse. “I didn’t want to ask for help at home because people can find out. The psychologist I was planning on seeing knows people I work with. It just felt like it would cause me more stress than it was worth. So, instead of getting help I had a drink.”
Dave experienced firsthand the negative impact drinking and drugs had on his life. He highlights the worst being relationships deteriorating with his partner, his parents, and his housemate.
Drinking a bigger problem than drugs
Nurses typically work long shifts. Shift work can mean finishing at 2am. Martin says “in many hospitals, you finish a shift and you pop to the local pub or bar. Groups go together and it can be a way to discuss what happened that day and work through the traumatic events. Keeping in mind nurses see the results of violent acts – sometimes involving children, they cop abuse from families and they see people die. They don’t have an easy job. When you are experiencing trauma, drinking can be a form of escapism.”
Most hospitals are in close proximity to bars and pubs and some offer discounts for nursing and other hospital staff members, where they can show their i.d. and receive special drink prices.
Aftercare: Can a nurse with an addiction return to work?
Recovery is possible and clients do leave rehab and return to their work. Part of the value of rehab is learning how to recognise triggers after, and having the skills to overcome those temptations.
As part of personalised treatment care, a DARA Rehab therapist will help clients plan ahead. In addition to talking through scenarios, this often involves helping a client to make local connections with Alcoholics Anonymous groups, or Narcotics Anonymous groups near their home. A support system, and a safe place to go amongst people you will not be tempted to use drugs – or drink – around, is an important framework to help maintain sobriety.
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*Dave’s name has been changed for privacy reasons. The quotes provided remain anonymous unless he in future stipulates that we can change these to his real name.