Substance Use Disorder in Nursing


Nursing often gives professionals access to the drugs and medications used to treat hospital patients. As patient treatment includes a wide variety of drugs, psychoactive substances are among them. The proximity and accessibility of such chemicals to the nurse can lead to the specialist using such medications themselves. This is dangerous both for the nurses and the patients who are treated at the clinic.

Main body

Substance use disorder (SUD) in the medical field is relevant, particularly because of the emerging professional and ethical responsibilities of colleagues who work with SUD-possessing nurses. In some states or jurisdictions, colleagues have a professional and moral obligation to report a nurse’s suspected drug use to their supervisor or nurse supervisor and the nursing board (NCSBN, 2020). Nevertheless, many people are afraid or reluctant to talk about their colleagues’ addiction, even if they have the information, because conscience or morals prevent them from creating problems for the person they work with (Meiner & Yeager, 2018). It should be emphasized that staff plays an essential role in helping to identify nurses with SUD, so they need to be aware of the indicators which may signal that a nurse has a problem. In turn, patients can also suffer from the nurse’s addiction (NCSBN, 2020). Medical care and health services are complex areas that require careful professional action. Psychoactive substances make a specialist less focused as well as prone to error, it can cost the life of any patient the nurse treats while intoxicated. It is difficult to distinguish between symptoms that indicate impaired well-being and stress-related behaviors and signs of substance abuse. There are three criteria to look out for: behavioral changes, physical movements, and drug diversion.

Behavioral changes are accompanied primarily by uncharacteristic behaviors and points that stand out but were not previously noticed. In addition, the knowledge and professionalism of nurses who have graduated from medical schools make them competent in analyzing symptoms. Thus, competence allows them to compare what they see with what they have already experienced and analyzed specific signals in a colleague’s behavior as addiction indicators (NCSBN, 2020). Changes in behavior may include the following:

  • Changes or shifts in job performance, which is well illustrated when nurse delays performing any duties or take too long to do the work;
  • Absence from the unit for extended periods, which is usually evident when a nurse disappears from her place of work without warning or good reason, and this happens repeatedly (Meiner & Yeager, 2018);
  • Frequent trips to the bathroom;
  • Late arrivals or early departures;
  • Nurses are committing excessive errors, including medication errors (NCSBN, 2020).

The following signs may be changes in the routine behavior of the professional, which may be both pronounced and social or almost invisible. Behavioral changes may be physical, including:

  • Invisible changes in appearance that may intensify over time;
  • Growing isolation from peers;
  • Inadequate verbal or emotional responses;
  • Memory problems, such as lapses, sluggish reactions and attention span.

In cases where the specialists do not have free access to medication, they may use a position of service. For example, asking the supervisor for psychoactive substances, and this leads to the following negative consequences, which can nevertheless indicate drug addiction:

  • Incorrect drug counts;
  • High consumption of narcotic drugs;
  • Numerous corrections in medication administration records;
  • Frequent patient reports of ineffective pain management;
  • Suggestions to anesthetize patients by co-workers;
  • Altered verbal or telephone medication orders;
  • Fluctuations in discrepancies in controlled substances between shifts or days of the week (NCSBN, 2020).

If nurse is suspected or found to be using psychoactive substances, the information should be immediately given to the supervisor or hospital manager. It is essential to understand that it is complicated to ascertain whether drug addiction is a personal fault of the trendsetter or a professional cost. The important factor is that such an incident does not end a professionals’ career. Nurses, who find themselves in addiction will be taken off the job to undergo an entire course of treatment (Meiner & Yeager, 2018). In addition, upon recovery, the nurse will be able to return to work and fully rehabilitate her credibility and professionalism (NCSBN, 2020). However, new preventive actions will be introduced to prevent remission and further use, such as taking a random blood drug test, medication recounts, and more detailed professional supervision. If a nurses’ addiction is detected in time, it is possible to prevent non-great consequences in the form of dismissal, severe drug addiction. In addition, it will avoid potential victims, which can lead to such symptoms as inattention, irritability and lapses in memory, leading to deterioration in the quality of work.

There is a stereotype that doctors and nurses cannot be addicted and abuse psychoactive substances. Arguments reinforce that professionals’ level and quality of knowledge allow them to control medications using and warn themselves against addiction’ appearance (Meiner & Yeager, 2018). Moreover, there is an idea that doctors work for the health and well-being of the community, so they can not harm themselves or their health (NCSBN, 2020). But this stereotype is fundamentally flawed because several human factors cause nurses to turn to drugs (NCSBN, 2020). Firstly, nursing is a stressful job that involves high stress, constant interaction with people of all kinds, and responsibility. Secondly, the reason is the unbearable burden of specific tasks that require effort and internal resources. All this factors lead to emotional burnout, which, in their turn, is the cause of such addictions. Therefore, nurses are in no way protected from the abuse of drugs and other psychoactive substances.

Our hospitals have a program of prevention of such cases and methods of preventing addiction. Firstly, all the specialists, without exception, take additional courses on substance abuse, which deepen their knowledge of the field and prevent the possible occurrence of these cases. Secondly, there is a psychologist whose activity is aimed at emotional work with doctors and nurses to relieve them from negative emotions, stress, and emotional burnout. Thirdly, supervisors need to keep an inventory of all medicines in the hospital every day to control the leakage and use of psychoactive substances. In addition, physicians’ disposal of ampoules and pills is prohibited, so specially authorized persons handle this. All of this together minimizes the chance of such situations occurring and keeps nurses and their patients safe.


In conclusion to all of the above, it is worth noting that substance abuse can affect anyone, including nurses. Nevertheless, having analyzed all of the above, it is necessary to understand that often it may not be a personal problem of a specialist but a consequence caused by work specifics. If such a situation has already occurred in the hospital, colleagues need to observe the team closely to identify the addicted nurse in time. It should be understood that equating betrayal with passing on information about an addicted professional is inappropriate since the nurses will be treated in time and will be able to continue working, thus not losing either their job or credibility. And timely detection of such a situation will protect patients and the entire team. To avoid such situations, clinics need to regularly check the psychological state of their workers, as well as to conduct courses and meetings on such addictions and means to combat them.


Meiner, S. E., Yeager, J. J. (2018). Gerontologic nursing – E-Book. Elsevier Health Sciences.

NCSBN. (2020). Substance use disorder in nursing. [Video]. YouTube.

Find out your order's cost