Sample Nursing Essay Paper on Substance Abuse among Nurses

Substance Abuse among Nurses


Substance abuse among healthcare professionals is one of the contemporary problems in healthcare, which affect professionalism and the delivery of quality healthcare services. A significant number of nurses are affected by drug abuse problems which affect their capacity to deliver. While some of the affected have sought treatment, most of them do not even realize they have a problem with drug use. Trinkoff & Storr (1998) posited that 6–8 % of the nurses in the U.S have a drug or alcohol use problem. Similarly, Talbert (n.d) reported that more than 10 % of nurses have drug use problems. In approximately 6 % of the nurses, the problems are serious enough to impair their performance as nurses. With these rates, the prevalence of drug use and abuse among professional nurses is parallel to that of the general population.

Various causes that have been cited to contribute to drug use issues among nurses, and understanding the reason behind drug use in a particular group of people helps to identify potential solutions to it. In the argument given by Trinkoff & Storr (1998) nurses of different specialties and genders were reported to have different prevalence rates for drug abuse. For instance, female psychiatric nurses were more likely to have alcohol use problems compared to other nurses in other specialties. However, there are limited ways for identifying at-risk groups among nurses due to the absence of extensive studies on substance abuse among nurses. The present essay explores the context of substance abuse among nurses and provides the potential causes and implications of the same.

Causes of Substance Abuse among Nurses

Various factors have been mentioned to contribute to substance use issues among nurses. For instance, Talbert (n.d) mentioned the family history of nurses as a potential driver of substance use and abuse. According to Talbert, nurses who had a family history of substance abuse were more likely to abuse drugs than those who did not have such a history. Moreover, a family history characterized by factors such as alcohol use, emotional impairment, and emotional abuse were more likely to expose the children to drug abuse vulnerability. Nurses from such families tend to have low self esteem, be overworked and also focus on overachievement as their source of comfort. In so doing, some of them pursue drugs as a way of keeping up with their family issues. A family in which there are multiple drug use cases also fosters an enabling environment for drug abuse; hence the prevalence of drug abuse among nurses from such families.

Secondly, workplace stress can also contribute to drug abuse vulnerability among nurses. The professional nursing environment can at times be highly demanding. For instance, in cases where there is under staffing, nurses are more likely to be overworked, especially when there are many patients with acute conditions. Nurses working in such an environment experience departmental rotations, shift rotations and a lot of overtime work. Each of these contributes to increasing stress, fatigue in the workplace as well as feelings of alienation from the normal world. To cope with these stresses, some nurses opt for drug use. The variation in drug use trends across nursing specialties can also be attributed to work stress. For instance, Trinkoff & Storr (1998) reported that nurses who worked in critical care and emergency departments were more likely to be engaged in marijuana and cocaine abuse. This was attributed to the concept of sensation seeking, in which the nurses desire to develop a particular feeling particularly when dealing with difficult situations including loss of life and the unpredictability of the pace of work.

Heavy work­loads, reliance on pharmacologics, ready access to controlled substances and the immediacy of interventions all push emergency and critical care nurses towards drug abuse. To deal with the challenge of sensation seeking among these nurses, the use of medical marijuana is recommended. For nurses working in oncology, it was established that binge drinking was the most common form of drug abuse. Trinkoff & Storr (1998) reported that this was probably meant to help them distance themselves from the emotional strain of taking care of cancer patients. Similarly, psychiatric nurses were found to be more vulnerable to smoking and use of pharmacological drugs which are readily available in psychiatry. Nurses working in pediatrics and women’s health were the least likely to be engaged in alcohol and drug abuse, probably due to the low availability of readily abused substances in these specialties, and the fact that most of those who work in these specialties are emotionally expressive.

Another factor that contributes to drug abuse among nurses is the availability and accessibility of medications. Talbert (n.d) reported that nurses are in constant contact with various medications including those for pain alleviation, reduction of anxiety, illness treatment and combating infections. They also constantly use drugs to curb the impacts of other medications. As a result of this frequent contact with medications, nurses develop the perception that they would be able to control themselves in case they begin using certain drugs. The process begins with the use of prescription drugs, which they feel they are able to control since they are in contact with the drugs on a daily basis. In this way, they find the motivation to begin using drugs and later become dependent on the drugs such that they cannot stop using them.

Impacts of Drug Abuse among Nurses

Drug abuse among nurses has been linked to various outcomes as in the general population. For instance, one of the complaints that have been raised pertaining drug users in the nursing profession is their susceptibility to irrational behaviors. This is described as any behavior that would go contrary to the ethics of the nursing profession including taking long and frequent breaks at the expense of the patients, and making decisions that are most likely to jeopardize patient recovery. In some cases, nurses who suffer from drug abuse disorders could use drugs meant for patients for their own benefit due to their dependence on prescription drugs. In such a case, the nurses violate the ethical code of conduct on professional responsibility. Furthermore, such a nurse places the patient at risk of death.

Nurses who use drugs also suffer from impaired ability to practice nursing professionally. The basic duties of a nurse are to provide care to patients, conduct patient assessments, diagnose patient problems, plan various aspects of patient care, implement the plans made by different healthcare professionals towards the well-being of the patient, and to conduct research for promoting evidence-based practice. These roles require sobriety, and any nurse that is incapable of fully performing these roles as per the professional code of ethics can be considered impaired in professional practice. Drug abuse results in such an experience in that dependence on drugs limits nurses from performing certain roles in relation to patient care and well being. In this way, their productivity in the workplace reduces.

The most common indicator of drug use and/ or abuse among nurses is the change of emotional or physical characteristics of the nurse. Such changes are indications of underlying issues, which for those nurses who abuse drugs, could result in additional symptoms. For instance, Cares et al. (2015) reported that nurses who are undergoing drug abuse could exhibit symptoms such as increased tardiness, decreased reliability in professional practice, increased use of patients’ pain medications instead of administering them to patients, increased wastage of drugs through breakages, increased extra shift works to gain access to more drugs, and verbalized stress that is directed at co-workers. Increased complaints by patients about lack of pain relief, is also a symptom of drug abuse by a nurse. For instance, in a case described by Talbert (n.d) the nurse in consideration, Tammy, was suspected of drug use due to frequent complaints by patients about lack of pain relief following her shift. For a professional nurse leader, addressing such complaints call for a deeper examination of the problem and potential development of a solution.

While there are many nurses who suffer from drug abuse related issues, identifying these nurses and offering them help has been found challenging. According to Cares et al. (2015), most nurses who suffer from drug abuse do not seek assistance for various reasons. Some of the nurses are still in denial as to whether they have a drug use problem. Without the acceptance of their conditions, it is impossible for them to seek help. On the other hand, there are those who are aware of their drug use problems yet are incapable of seeking for help. Some of these nurses cite factors such as the fear that they may lose their practice licenses, confidentiality concerns, and embarrassment as barriers to seeking drug abuse alleviation assistance (Cares et al., 2015). Others have also been reported to be too ill to seek assistance. Lack of health insurance cover and inability to pay for the services are also mentioned among other factors.

To address the problem of drug abuse among nurses therefore, there needs to be specific measures towards encouraging them to seek for help. One of the strategies is by providing an assurance that they would not lose their practice licenses even if they seek assistance since they are perceived to be on track towards positive change. They also need the support of family, friends and professional colleagues to ensure that they sustain their efforts towards change. Greater awareness of the available treatment opportunities and lower treatment costs can also help to encourage nurses to access medical assistance in dealing with drug abuse.


Like in the general population, nurses in various healthcare settings are faced with the challenge of vulnerability to drug abuse. More than 6 % of nurses are affected by drug abuse, which is attributed to various factors. For instance, the family history of a nurse, accessibility to drugs and work place stress contribute significantly to vulnerability to drug abuse. Drug abuse affects nurses significantly in the performance of their roles, and can be diagnosed through physical and emotional changes in the affected individuals as well as through behavioral changes such as increased tardiness and decreased performance standards. While there are many opportunities to reduce the prevalence of drug abuse among nurses, getting the affected nurses to seek for assistance is the greatest challenge to healthcare since they often face barriers such as concerns about confidentiality and the risk of losing their jobs.


Cares, A., Pace, E., Denious, J. & Crane, L.A. (2015). Substance use and mental illness among nurses: Work place warning signs and barriers to seeking assistance. Substance Abuse, 36(1), 59-66. Retrieved from….pdf

Talbert, J.J. (n.d). Substance abuse among nurses. Clinical Journal of Oncology Nursing, 13(1), 17. Retrieved from

Trinkoff, A.M. & Storr, C.L. (1998). Substance use among nurses: Differences between specialties. American Journal of Public health, 88(4), 581- 585. Retrieved from