Nursing Resources for Substance Abuse
Nursing Addiction and Recovery Resources
Substance Use Disorder
Substance use disorder refers to the full range of complaints from abuse to dependency or addiction to alcohol or drugs. Substance use by nurses can cause significant harm or neglect to patients, as well as the nurse, and should immediately be reported to the Board of Nursing.
If you or someone you know is experiencing a problem with drugs or alcohol, we encourage you to use the resources below to learn more about how and where to get help:
VIDEO – Substance Abuse Disorder In Nursing
Substance Use Disorder in Nursing from NCSBN on Vimeo.
Warning Signs: Identifying Substance Use Disorders in Nurses
Behavioral Signs:
- Tends to administer more medications, always uses the maximal dose
- Volunteers to give medications
- Demonstrates patterns of excessive wastage and breakage
- Increasing discrepancies in management of controlled substances
- Complaints from patients reporting ineffectiveness of pain medication
- Requests to work evenings, nights, week-ends when there is generally less activity and less supervision
- Exhibits increased anxiety, sudden mood swings, inappropriate anger or crying
- Demonstrates problems interacting with peers and supervisors
- Exhibits forgetfulness or memory lapses
- Makes frequent trips to the bathroom or has other unexplained absences
- Demonstrates patterns of absenteeism, tardiness, and sick calls especially following days off
- Sloppy or illogical documentation
Physical Signs:
- Shakiness, tremors of the hands
- Slurred speech
- Falling asleep
- Watery eyes, dilated or constricted pupils
- Diaphoresis
- Unsteady gait or staggering
- Runny nose
- Nausea, vomiting, diarrhea
- Weight loss or gain
- Change in dress or grooming – i.e., suddenly wears long sleeves/lab coats
Self-Test for Drugs or Alcohol Dependence
Ask yourself the following questions:
- Do you lose time from work due to drinking/drug use?
- Is drinking/drug use making your home life unhappy?
- Do you drink/use drugs because you are shy with other people?
- Is drinking/drug use affecting your reputation?
- Have you ever felt remorse after drinking/drug use?
- Have you gotten into financial trouble because of drinking/drug use?
- Do you turn to people you normally don't associate with when drinking/using drugs?
- Does your drinking/drug use make you careless of your family's welfare?
- Has your ambition decreased since drinking/drug use?
- Do you crave a drink/drug at a definite time daily?
- Do you want to drink/use drugs the next morning?
- Does your drinking/drug use cause you to have difficulty sleeping?
- Has your efficiency decreased since drinking/using drugs ?
- Is drinking/drug use jeopardizing your job or business?
- Do you drink/use drugs to escape worries or troubles?
- Do you drink/use drugs alone?
- Have you ever had a memory loss as a result of drinking/drug use?
- Has a physician ever treated you for drinking/drug use?
- Do you drink/use drugs to build up your self-confidence?
- Have you ever been to a hospital or institution because of drinking/using drugs?
Scoring: If you answered "yes" to:
1 of the questions, you may have an alcoholism/drug addiction problem.
2 questions, chances are that you have an alcoholism/drug addiction problem.
3 or more, you have the disease of alcoholism/drug addiction.
If you think you may have a problem with alcohol or drugs, call NCADA at (314) 962-3456 and speak with one of their counselors. If treatment is recommended, please be advised that the Georgia Board of Nursing requires assessment and treatment through a participating treatment provider.
Guidelines for Aftercare
The Georgia Board of Nursing requires nurses who are dealing with substance abuse/dependence to be involved in an aftercare group.
- Peer Support – An aftercare group consists of other nurses or professionals who are coping with the same problems or illness. This can make participants feel less alone and more understood. Members often act as role models for each other. Seeing others face the same adversity and making progress in their lives is both inspiring and encouraging.
- Provides structured monitoring
- Provides education on Substance Use Disorder
- Focuses on sharing each other’s experiences, strengths, and hopes for a sustainable and stable recovery
- Provides additional resources
- Must have a professional or volunteer facilitator who will submit quarterly reports in a timely manner and be willing to communicate with compliance staff in the Board office.
- Must conduct random drug screenings.
- Must be a group that consists of other professionals who are recovering from substance abuse/dependence.
- Must meet on a weekly basis.
- Must be a support group, not a therapy group.
- Must be a support group other than AA/NA or Celebrate Recovery.
- May choose any support group around the state of Georgia, as long as it meets the above requirements
- Must be adhere to all the rules and expectations of their group
- Must have permission from the Board to change groups
Download a list of board approved aftercare providers. >>
Download the Quarterly Report Form >>
Prescription Drug Monitoring Program
Beginning July 1, 2018, all prescribers with a DEA number in Georgia will be required:
- To check the Georgia Prescription Drug Monitoring Program (PDMP) before prescribing opiates or cocaine derivatives listed in Schedule II drugs or benzodiazepines.
- The PDMP can help eliminate duplicative prescribing and overprescribing of controlled substances and provide a prescriber or pharmacist with critical information regarding a patient’s controlled substance prescription history and protect patients at risk of abuse.
Appriss – PMP Aware is the data analytics system that Georgia uses for its PDMP.
- They have prepared a “How To” video and written instructions to assist you with using the PDMP. The information will help you log in, reset your password and navigate the system.
- We encourage you to watch the video, review the instructions and log in and search patient records to become familiar with the PDMP before July 1, 2018.
If you need additional help or if you have questions regarding the Georgia PDMP, please call 404-463-0772 or send an email to [email protected].
When to Report
If a nurse’s performance is suggestive of a Substance Use Disorder, consider the following information:
- Review your facility’s policies and procedures before initiating action unless patients and/or staff are in imminent danger
- Use your facility chain of command in addressing the issue
- If drug screening is requested, assure adherence to strict chain of custody protocols
- Use the 5 W’s Test in organizing your thoughts:
- Who made the complaint? (i.e., patient, family, peers, colleagues)
- What is the nature of the complaint? (i.e., under-medicating, documentation discrepancies, excessive wasting patterns, impaired on duty)
- Where was the location of the incident?
- When did the incident occur?
- Why did the incident occur? (i.e., possible motivations, causes)
Referrals should be made to the Board of Nursing when any one of the following situations arise:
- Positive pre-employment drug screens.
- Positive results on a “for-cause” drug screen.
- Signs and symptoms of impairment including the smell of alcohol on the breath, regardless of whether the impairment is alleged to be as a result of the nurse’s own prescription medications.
- Reports of excessive use of controlled substances, increased wastage, sloppy or careless wasting, consistent failure to follow facility policies for wasting controlled substances, documentation discrepancies, manipulation of medication dispensing systems.
- Any time there is a violation of the Nursing Practice Act.
If patient safety is an immediate concern, the staff should intervene immediately to protect the patient and remove the nurse from the situation until the chain of command can be activated to assist in the management of the situation.
Mandatory Reporting
How To Report
The Georgia Board of Nursing is charged to protect the health, safety and welfare of the general public and licensed professionals through early recognition and intervention for nurses who may abuse drugs and/or alcohol, or be otherwise chemically dependent.
To that end, this packet is available for nurses who have:
1) Abused or become chemically dependent on drugs or alcohol;
2) Tested positive (without a valid prescription) on a drug screen for alcohol and/or any drug contained in Schedule I through Schedule V of the Controlled Substances Act;
3) Completed or enrolled in substance abuse treatment (alcohol, illegal drugs/substances and prescription drugs [with or without a prescription]); or
4) Diverted medications from patients or workplace.
Please download the self-report packet, review and follow all instructions and submit your information to the Board.
Reporting a Nurse:
Any person who has reasonable cause to suspect misconduct or incapacity of a licensee or who has reasonable cause to suspect the person is in violation of the Nurse Practice Act should report relevant facts to the Board.
Please view the Nurse Practice Act (link to Georgia Code) and applicable Board rules.
The Board has no regulatory authority over employment issues, rudeness to peers, co-worker disputes, personality conflicts, absenteeism, tardiness, refusal of assignment or labor management disputes such as work schedules/wages and termination.