Substance abuse and addiction among healthcare professionals

Addiction Among Healthcare Professionals

Current Trend and Issue

Federation of State Medical Boards estimates for the year 2010 reveal that over 850,000 doctors with highly divergent demographic characteristics hold active medical licenses in Washington and the rest of the U.S. Their ages range from 70 years; some studied in America, whilst others studied abroad; and some are osteopathic doctors while others are allopathic doctors. They probably lead vastly different lives, and come across vastly divergent everyday challenges and individuals in their practice. To some, a key personal challenge was addiction to a substance, while to others, substance addiction in co-workers proved to be a great challenge (Futures Pal Beach, 2016).

According to scholars in the field, roughly one in ten healthcare workers is involved in substance abuse; this implies addiction rates in healthcare workers, in general, are comparable to those in the general population. But for healthcare providers, addiction-linked consequences are more serious. Addicted members of the general population may hurt their kith and kin, and colleagues, whereas addicted healthcare professionals can cause harm to their patients, and might even jeopardize their lives. For instance, a highly publicized 2012 healthcare worker case from 2012 involved a worker stealing narcotic-filled needles, administering them to himself, and replaced the needles with simple saline before put them back for patient utilization. The accused worker suffered from hepatitis, which his reckless act transmitted to a number of the healthcare facility\'s patients. The addiction didn\'t have only a personal consequence; it affected the whole hospital community. This is a clear example of the serious risks of addictions in healthcare staff. Their ability to cause hundreds of innocent patients harm, in the form of ill-health, death and loss of vitality makes addiction in this societal population a grave concern. Appropriately, medical circles respond very harshly to intra-healthcare-community addiction. This focus generally facilitates a complete recovery among healthcare professionals (Futures Pal Beach, 2016).

Considering the highly stressful healthcare work environment (partly on account of human resource scarcity), a growth in substance-triggered healthcare delivery impairment is to be expected. While recent research indicates that substance abuse rates among healthcare providers do not surpass those among the general public, in view of their great responsibility to citizens, even a small impairment can amplify public risks greatly (Kenna & Lewis, 2015).

Supporting Research

All healthcare workers are susceptible to substance addiction. Those employed in the emergency room are three-and-a-half as prone to abusing cocaine, marijuana and other substances as general practice, women\'s health and pediatric nurses, while administration and oncology personnel and were two times as prone to overindulging in drink. Meanwhile, psychiatric nurses tend to engage in chain smoking. Researchers have not observed any specialty differences with regard to ingestion/injection of prescription-type drugs. However, a few nursing specialties depicted greater likelihood, compared to others, to abuse drugs. Their differences aren\'t demographic. Considering that the comparison of physician and nursing staff results yielded significant consistency by specialty, prevention interventions must take into account interdisciplinary drug/alcohol-use educational approaches (Trinkoff & Storr, 2014).

The link between substance abuse risks and patient safety, healthcare worker discipline and wellbeing is an under-researched area. As stated earlier, rates of substance abuse in the general public and healthcare circles are similar. A majority of high-risk providers: are in active practice, do not seek therapy, and their employer is unaware of their condition. In case of the nursing profession, in particular, peers considered addiction a curable ailment, which could be aided through employer support and retention of confidentiality. Here, discipline wasn\'t considered vital to risk mitigation, consistent with co-worker views, or supportive of addicted co-workers. Healthcare leaders have a central part to play in dealing with providers\' addiction-connected problems, and can greatly influence their health outcomes (Kunyk, 2013).

Canadian Perspective

A qualitative, descriptive research in Canada, employing purposeful sampling of a total of twenty-six substance-addicted healthcare providers from two dozen agencies, followed by a secondary research for determining facts capable of offering better insights into decision-making via lived experience, revealed that:

1. A few healthcare personnel believe proofs from studies and lived experience are separate concepts, with the latter being more reliable as compared to the former;

1. Strict compliance with only a single evidential source results in intra-organizational conflict;

1. Treatment choices may be guided by individual experience with specific medications and therapies; and

1. Practice may be informed by the use of multiple evidential sources in the decision-making process.

Addiction treatment specialists can derive the advantages of a better understanding of the complex decision-making process that involves multiple proofs, including addicted healthcare providers\' addiction, withdrawal and recovery experiences (Novotna, et al., 2012).

A Global Perspective

On the whole, it is predicted that between eight and twelve percent of doctors worldwide will develop alcohol/drug abuse issues. Across the globe, anesthetists and emergency room physicians are unsurprisingly the healthcare worker population that exhibits the greatest risks of developing addiction. Benzodiazepine and opiate use are the red flags to be sought for identifying potential substance use issues in physicians. A study of substance use issues in the nursing profession revealed a certain degree of substance abuse in 32% of the 4,438 participants. Stress responses, trauma, and substance-abuse issues mustn\'t be overlooked; they require instant response. Timely intervention (before substance ingestion/injection transforms into addiction) can help prevent symptoms among patients (healthcare professionals, in this case) from worsening. Individualized trauma therapy is possibly the optimal treatment for such a serious issue. Presuming the individual has resorted to abusing drugs or alcohol because of traumatic life events, determining the stressor ought to aid in stopping substance necessitation for coping with the issue. But care must be taken not to underestimate the import of applying substance abuse medications and therapies for the healthcare worker in question. Quite frequently, successful treatment of the issue necessitates the administration of multiple treatments combined. Ideally, hospitals can organize special interventions targeted at addicted healthcare workers, or even healthcare profession-specific interventions for addressing the unique stress factors linked to individual healthcare jobs/departments. In this manner, hospitals can successfully deal with the unique traumas healthcare providers undergo and the stressors they come across on a daily basis. It is essential to have treatment programs in place for healthcare professionals, both for their benefit and that of their patients and the general public (Addiction Education, 2016).

Positives for People under Addiction

According to most experts on the subject of addiction, drug dependence and withdrawal represent clinically important symptoms, particularly in the population of healthcare professionals who are drug addicts. Healthcare sector personnel may be supported further by broader dissemination of current literature on drug dependence and withdrawal, in addition to more studies on the subject (Budney, Brown, Griffiths, Hughes, & Juliano, 2013).

1. For more than 30 years, mental health professionals have applied NRT (nicotine replacement therapy) in treating tobacco dependence. Although, initially, limited NRT choice was available to patients, the past decade has seen an appreciable growth in accessible nicotine delivery tools and devices (Shahab, Brose, & West, 2013).

1. Researchers have noted that family therapeutic interventions bring about improved outcomes, compared to comparison conditions, while the absence of treatment interventions results in poorer outcomes. The addicted healthcare professionals in nearly every kind of therapy decreased their drug/alcohol consumption. Nevertheless, the greatest outcome improvements were observed in case of group counseling, mixed counseling, and family therapy (Tanner-Smith, Jo Wilson, & Lipsey, 2013).

Difficulties in Treating Addiction

The DSM (Diagnostic and Statistical Manual of Mental Disorders), on whose authority recent animal models are based, emphasizes the word \'dependence\' (which is a vague word which may imply \'physical\' dependence as well as questionably-described \'psychic\' dependence) more than the word \'addiction\'. Hence, unsurprisingly, DSM-based diagnoses have consistently poor dependability (in fact, it is progressively worsening) (Wise & Koob, 2014).

Depression-linked symptoms of general distress (like low self-worth, melancholy, etc.) were predictive of increasingly more withdrawal-linked severe depressed affect. Anhedonic symptoms (such as a general lack of happiness, reduced interest, etc.) were predictive of greater withdrawal-linked reduction in no other aspect but sharp positive affect. Anxiety symptoms (like tremors, increased heart rate, etc.) were predictive of increasingly more withdrawal-linked in depression and fatigue affect. Hence, different depression and anxiety linked elements are linked to distinctive affective acute substance abuse withdrawal patterns (Leventhal, Ameringer, Osborne, Zvolnosky, & Langon, 324-329)

An improved grasp of the principal processes of withdrawal-linked cognitive shortfalls can help bring about improvements in treatments for drug addiction. Particular emphasis needs to be given to the following points (Ashare, Falcone, & Lerman, 2014).

1. Drug / substance abstinence gives rise to withdrawal-linked cognitive shortfalls.

1. Cognitive impairments apparent at the withdrawal phase predict relapse among patients.

1. Treatments will improve if healthcare professionals acquire a better grasp of neurobehavioral mechanisms.

Assessment, Intervention and Evaluation

Research findings reveal that healthcare providers\' individual health behaviors are linked to their patient-connected practices in the areas of weight control, smoking, drug/alcohol dependence, and physical exercise. A positive relationship was discovered between the individual substance-abuse linked attitudes of healthcare providers, their individual substance consumption behaviors and their drug-connected health promotion behaviors. These findings have key implications when it comes to professional education. Further studies into this area must revolve around the performance of well-formulated researches having larger samples for allowing well-grounded conclusions to be reached and a sound evidence base to be developed. Healthcare providers are positioned ideally to support and improve individuals\', communities\' and families\' wellbeing and health. They can effectively reach large population segments since typically patients consider them their role models; hence, society in general expects and demands that healthcare providers actually put into practice whatever they \"preach.\" But provider-patient communication and the degree of healthcare and intervention delivered to patients is normally governed by various elements, such as the professional and personal views, principles, addiction experiences and individual substance consumption of healthcare providers (Bakshi & While, 2014).

A person\'s individual health beliefs as well as individual behaviors\' significance in his/her view is also able to impact health-related behavior adoption. For instance, multiple healthcare worker groups admit to viewing drug/alcohol users in a negative light. They also admit to considering caring for alcoholics and drug dependents an unsatisfactory and distasteful experience. Further, drug ingestion/injection by healthcare professionals is also a potential significant factor affecting provider-patient interactions. For instance, Dorrian and Crothers discovered that alcohol-consuming nurses typically felt the substance, rather than the individual, posed a threat, and hence, established positive relationships with patients. Hence, such aspects can impact and mold therapeutic provider-patient relationships. On the whole, nursing staff held positive to neutral attitudes when it came to drug dependence issues, which is an encouraging find, as 80\'s and 90\'s studies reported largely negative attitudes. In spite of this, approximately 14% of respondents expressed negative attitudes with regard to caring for addicted patients. Age, personal beliefs regarding drugs/alcohol consumption and dependence, and personal drug consumption behavior are factors capable of influencing providers\' patient-care attitudes (Crothers & Dorrian, 2013).

Addiction Affecting the Family and the Community

Certain addictive habits such as the activity of smoking have numerous society-wide impacts including air pollution. However, the most governments do is: formulate novel smoking zone-related regulations, rather than outright cigarette bans (which would mean a cessation in the taxes that pour in from the tobacco industry). Smoking often leads to unhealthy social relationships between non-smokers and smokers. With premature deaths resulting from smoking, the activity is clearly an economic loss; smokers\' mortality rates are higher compared to non-smokers, and they often become victims of smoking-related ailments in their prime, thus making governmental spending on their educational attainment and career progress go to waste (Venkatesh, 2013).

Despite a few major variances in beliefs, different healthcare sector areas have unanimously agreed on the fact that various interventions prove beneficial for individual mental health issues. The responses of 1,536 healthcare professionals were gleaned by researchers. As compared to a 1996 study, the recent research found healthcare professionals endorsing a wider range of interventions, with physicians, psychologists, and psychiatrists more actively attempting to understand the problem, increasing their physical activity, reading about individuals suffering from similar issues and their coping mechanism, CBT (cognitive behavioral therapy) and psychotherapy. Various professionals, lifestyle activities, and therapies were recommended for the issue of addiction (Morgan, Jorm, & Reavley, 2013).

Psychiatric Nurse-plays and Involvement

Research results regarding doctors\' drug/alcohol use frequency depict an inconsistency. Gender constitutes a more consistent risk factor with regard to healthcare provider drug intake. Other factors research scholars have addressed include depression, anxiety and other causal psychiatric issues, in addition to doctors\' intrinsic personality traits. A large number of doctors participating in a particular study tested positive for substance addiction. Outcomes depicted in this study suggest that weak resistance and no stress relievers during leisure time can contribute to addiction symptoms among healthcare professionals. Hence, it follows from these outcomes that stress-reducing activities as well as activities geared at increasing physician resistance through improving coping mechanisms can positively contribute to addiction prevention efforts. Subsequent to result discussion and dissemination, the designing and execution of such initiatives (which include suitable evaluation procedures) ought to be taken into consideration (Unrath, Zeeb, Letzel, Claus, & Escobar, 2012).