patient safety & quality
15 %
5.7 %
9.9 %
patient safety & quality
By Kristina Pirollo-Ketchum, BA, AA, CHL, CRCST
Healthcare Professionals and Substance Abuse: The Implications for Patient Safety
Consequences of healthcare practice failure include negative effects for individual practitioner and patient outcomes, organizational reputation, and public health.
PHYSICIANS
15 %
of physicians have a drug or alcohol problem in a given period of their career
Approximately
100,000
healthcare providers are practicing while being impaired.
NURSES
The rate of illicit use among nurses is
5.7 %
and for prescription abuse,
9.9 %
Healthcare professionals’ substance abuse is a definite threat to patient safety and the quality of healthcare. This is a widespread problem, as The Grove Estate( 2024) indicates that about 15 percent of physicians have a drug or alcohol problem in a given period of their career, and approximately 100,000 healthcare providers are practicing while being impaired. The rate of illicit use among nurses is 5.7 percent, and for prescription abuse, 9.9 percent, according to Fisher( 2023). Consequences of healthcare practice failure include negative effects for individual practitioner and patient outcomes, organizational reputation, and public health. This article discusses substance abuse dangers in healthcare settings, clinical staff sobriety, support mechanisms for their addicted professionals, and cases of impaired staff that have presented threats to patient care.
Risk factors related to substance use are most prominent in the workplace of healthcare workers. Major sources of this risk factor include work-related stress, exposure to trauma and death, workload, and shift work. According to research-centered on the substance use problems within the physicians and other people in general, the root cause is a family history of alcoholism. In general, the rates of nurse substance abuse vary from one specialty to another; however, nursing homes and hospice areas seem to have higher rates of substance use than other populations. Most used substances are alcohol, opioids prescribed by a doctor, and easily obtainable from the healthcare setting, such as benzodiazepines and prescription drugs. Stigma worsens the experience of patients with addictions since the participants presented delayed help-seeking behaviour that results in poorer outcomes for both the patient and the provider.
Below are some examples of how substance abuse can lead to compromised patient safety. A Kentucky plastic surgeon was charged in 2018 after reporting to work with alcohol in his system. He was challenged by the hospital staff over the impairment before he left, and he was then arrested by police( Merriman, 2023). From July to October of 2020, a nurse at a Connecticut clinic that specializes in fertility treatments stole, in steps, 75 percent of the fentanyl intended for patients and replaced it with saline solution; more than 20 women given injections fused( Nyhus, 2021). An emergency department nurse with substance use disorder caused an outbreak of hepatitis C by practicing unsafe injecting while diverting medication in 2017 and 2018, affecting at least a dozen patients, as found by Nyhus( 2021).
Results from the evidence indicate that there is evidence of successful in-program treatment for early intervention and full recovery for healthcare professionals and other persons with substance use disorders.”
Comprehensive policies addressing substance use concerns need to be implemented in healthcare institutions along with supportive interventions for impaired staff. Results from the evidence indicate that there is evidence of successful in-program treatment for early intervention and full recovery for healthcare professionals and other persons with substance use disorders. Successful outcomes are geared toward continued care. If left unaddressed, the risks to patient safety and such expenses as legal penalties, loss of eligibility to serve patients under Medicare contracts, and loss of the public’ s trust can occur without preventative measures and supportive policies.
Healthcare professionals’ substance abuse poses myriad dangers to patient safety and care quality. The examples of documented cases show the serious consequences not only of impaired providers continuing their actions but also of not detecting them in time. At the same time, healthcare organizations must find the right balance between supporting staff who struggle with addiction while being rigorous in guarding against impaired practice. For substance abuse, a hospital must commit itself, go about with clear policies, and be vigilant enough to ensure the highest standards of patient care.
Kristina Pirollo-Ketchum, BA, AA, CHL, CRCST, is an independent consultant and principal of Ketchum Konsulting, LLC.
References:
Fisher P.( 2023). The Rise In Substance Addiction Among Nurses- Detox Rehabs. Detox Rehabs. https:// www. detoxrehabs. net / blog / substance-abuse-in-nurses /
Merriman A.( 2023). Kentucky Plastic Surgeon Arrested for Allegedly Arriving at Hospital Intoxicated. Outpatient Surgery; Association of periOperative Registered Nurses. https:// www. aorn. org / outpatient-surgery / article / 2018-January-kentucky-plasticsurgeon-arrested-for-allegedly-arriving-at-hospital-intoxicated
Nyhus J.( 2021). Drug diversion in healthcare. American Nurse. https:// www. myamericannurse. com / drug-diversion-in-healthcare /
The Grove Estate.( 2024). Statistics for Substance Abuse in Medical Professionals. The Grove Estate. https:// grovetreatment. com / addiction / statistics / substance-abuse-in-medical-professionals /
22 • www. healthcarehygienemagazine. com • may-june 2025