How Nurses Slip into Substance Abuse


I once worked with a nurse who nobody would have guessed suffered from substance abuse.

He was the most pleasant and kindest nurse on the unit.

Being an operating-room nurse, his role was to give the patients premedication prior to surgery.

The main premedication that was given was Pethidine.

Pethidine is a strong analgesic and narcotic, and even though it is primarily a pain reliever, it has the side effects and addictive nature of narcotics.

His addiction started when one day, he decided to give himself an IV dose of Pethidine when he was in severe pain.

Nobody noticed that there was a missing vial; slowly he started injecting himself more and more.

It came to a point where he was so addicted and had lost all integrity -that instead of giving a female patient her pain medication while she waited to go into the operating room for her fractured femur surgery, he injected himself as the patient watched.

Even though the patient was in so much pain and realized the nurse was taking her medication, she gently said, “Why are you destroying your life!”

That was when he realized he had gone too far.

It was sad to watch him get fired and lose his license, but we knew he could get help and recover.

The common reasons why nurses start abusing substances include the following:



It’s easy to self medicate when one is in pain.

Even though your doctor may give you a prescription, you decide that you need more than you got -and slowly start treating yourself from the medication cart.

Nurses tend to get addicted to prescription medication because it is easily accessible to them.


Stress and Depression

Never learning to cope with challenging and stressful situations can lead you to self medicate.

Challenges are part of life, and feeling depressed happens to most people.

It is better to seek professional help if you are depressed.

Avoid going down the slippery slope of self -medicating.



When your coworker is suffering from substance abuse, you will notice a change in their behavior.

They take on a personality that is unfamiliar to you.

One minute they are as sweet as pie, next minute they have outbursts for no reason.

They start to miss work, become sloppy and their work quality declines.

They take several breaks and go to hidden or out-of-site areas for their break.

Another telling sign is they are always medicating patients with narcotic pain medication -even those patients who never complain of pain.

The patients also complain that when a particular nurse gives them IV pain medication, it has no effect.















What you can do

If you realize that one of your colleagues is addicted, be sympathetic and supportive to them and offer a helping hand.

This is not a time to say stuff like, “Busted!”

If you are close to them offer your assistance otherwise, inform your manager so they can handle the situation.

There are several organizations willing to help addicts.

Many recovery groups use the 12 Step approach and the Serenity prayer.

Refer them to the local hospital for information on drug addiction centers or help them look up addiction centers on-line.

To overcome addiction, one needs to use a multidisciplinary approach which includes doctors, psychologists and counselors.

The spiritual approach must never be left out when treating substance abuse because addiction is a spiritual problem.


What are some of your experiences?


If you want more spiritual support, I talk about overcoming addiction in my book; Reflections and Prayers for Nurses. It is a great resource to have.


Read what other nurse bloggers say about addiction:

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  1. Very powerful story, Joyce. I come from a family that has dealt with having a member with a strong drug addiction and it is heart wrenching. To be a caregiver who can’t break the cycle is disheartening. We all need help sometimes and if we, as nurses, recognize the problem in a coworker or friend we must act for both their safety and the safety of the patients. Thank you for sharing this example.

    • Joyce says:

      Jennifer. It is really hard when the affected person is family.
      And sometimes nurses feel guilty about not being able to do very much.
      But, we can strive to encourage them to seek help because it is out there.
      -and you are right, we need to act for the safety of our patients as well.

  2. This is a very powerful story. And it’s extremely sad to think that approximately 1 in 10 nurses may be doing the same. 🙁

    • Joyce says:

      I agree Brittney.
      It is sad for nurses to suffer from addiction.
      Many end up with no license after working so hard for it.

  3. A very eye opening account indeed Joyce. This just reinforces the concept that having a support system both in and outside of the clinical setting is key. Nurses and many other clinicians are exposed often witness and become very intimate with a patient’s physical and emotional pain. This can certainly have a cumulative effect on a clinician, especially if there isn’t an adequate support system to off-load these emotions of what we see in our practice.

    • Joyce says:

      Absolutely right Kevin.
      There are not enough support systems for nurses out there.
      I know one nurse who worked with suicidal teenagers. She became an alcoholic so that she could numb the pain of seeing these youth take their lives.
      This is one nurse who needed a system to help her vent/debrief and just get some support.

  4. Great post. Addiction to pain medication is a real rampant problem. It was not until I became a nurse that I become to realize the statistical number of people (not just nurses) that are facing the problem. I hope awareness and acceptance can help people that are addicted get help.

    • Joyce says:

      True Erica.
      The number of people addicted to pain medication is almost unbelievable.
      Prevention is the best way out for nurses.
      Education while still taking the nursing course is crucial,
      so that student nurses are aware of how this problem affects many nurses.

  5. Hi Joyce,
    Insightful blog. Thanks so much for sharing!
    As an advocate for nurses and nursing students with disabilities, I hear from nurses struggling to gain employment during or following participation in state board of nursing impaired nurse programs.
    Are there positions you would recommend?
    In addition, I am saddened to read that so many nurses continue to “use” while in programs and others relapse following completion of programs. What can we do about this?

    • Joyce says:

      Hi Donna,
      I know it’s hard to get employment after a nurse has been through the recovery program.
      They have to be on probation and have Narcotic restrictions.
      Many employers don’t want to deal with the complex situation that the courts may order, eg filling out progress information, etc,
      I would recommend that nurses seek out jobs that do not require them to handle narcotics, like working in a low acuity doctors outpatient office,or being an admission nurse or school nurse.
      It is hard -but not impossible to get a job after being in a recovery program.

  6. A truly SINCERE post. Nurses are patients too. Thank goodness health care is recognizing addiction is a DISEASE, a sickness, and not something to judge and put down with an air of superiority. Thanks for shining a compassionate light on this challenge. xo

    • Joyce says:

      Thanks Annette.
      When someone is addicted, they are not at a good place.
      They need help, and we have to reach out to them.
      Putting them down will not help the situation.

  7. Thank you, Joyce. This is a tough, tough situation. I appreciate you placing the Serenity Prayer in this post My family has struggled, lost and won with the battles of substance abuse. Reading this man’s story is sad. I do hope he was able to recover. And then the rest of your post shares such truths. There are things that are beneath the substance use. The use is a coping mechanism that the person is trying to use to deal with challenge. When we help people get to the underlying issues, we can help them heal. Great article. Enjoy the day, Elizabeth

    • Joyce says:

      Thank you Elizabeth for sharing and being so open about your family.
      When one family member is affected, it brings chaos to everyone.
      I totally understand when you talk about the struggle.
      You are right by stating that we need to “help people get to the underlying issues.”
      It’s important to know that there is help available.

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