Overdoses among nurses and doctors reflect growing substance abuse issues in the medical community.
Forced to deal with long hours in a stressful environment and with ready access to prescription drugs and clean syringes, a growing number of doctors and nurses are becoming drug addicts.
In December, a 32-year-old University of Michigan anesthesiology resident overdosed on fentanyl — a narcotic pain reliever used on otherwise untreatable chronic and severe pain — and fell into cardiac arrest. Approximately three-and-a-half hours prior, a nurse at the Cardiovascular Intensive Care Unit at the university’s Neuroscience Hospital died from an overdose of fentanyl and midazolam — a benzodiazepine used to induce sleepiness before surgery.
While health care professionals are just as likely as the rest of the public to abuse illicit drugs or alcohol, they are five times as likely to misuse prescription drugs. It is estimated that between 10 and 15 percent of America’s doctors are or have been substance abusers.
This reflects a psychological crisis among the nation’s doctors. In a 2000 study conducted by East Tennessee State University, the physician suicide rate, according to most research, is between 28 to 40 deaths per every 100,000 individuals, compared to 12.3 deaths for the general population. This represents one of the highest suicide rates among any profession.
Meanwhile, clinical depression has been reported among 30 percent of medical interns studied, with 25 percent reporting suicidal thoughts. Per one study cited in the East Tennessee investigation, 51 percent of all female physicians reported suffering through depression at one point in their lives.
Some of the doctors and nurses who self-identified as being addicts admitted to recreational use of prescription drugs, but most “self-medicate” to deal with crippling professional or personal stress. This untreated stress and the use of narcotic dampeners to mask it both place patients at grave risk.
“I was absolutely impaired, using narcotics while working. … And no one ever noticed,” said Anita Bertrand, 49, a nurse anesthetist in Houston who admitted to stealing surgical narcotics and self-administering them through an intravenous port in her ankle. “Did I make mistakes? I don’t know, and that’s the scary part. I’m not aware of any, but I certainly would not say I was immune to that.”
Grave ramifications can come of “drug diversion,” as the stealing of drugs by health care professionals is officially called. In New Hampshire and in seven other states, David Kwiatkowski, a hospital technician with hepatitis C, exposed nearly 8,000 patients to the virus, infecting at least 46. Kwiatkowski would inject himself with a patient’s medication, and — using the same syringe — inject saline into the patient. This marked the third time since 2009 that a health care worker was reported for using patients’ syringes, but there are countless unreported examples of medications gone missing, dosages turning out to be incorrect, or surgeries botched due to drug diversion.
This situation has sounded the alarm for increased psychiatric and counseling services for health care professionals, on-the-job drug testing and tighter controls of prescriptions and medications — including bans on physicians self-prescribing medications. However, in an environment in where such incidents go unreported to avoid increases in malpractice insurance and liability protection, financial considerations may ultimately outweigh the need to protect patients.
“The medical community thinks it’s immune from this disease, but that’s not true,” said Bertrand, who became addicted to pain medication after an abdominal surgery. “There are so many practitioners working impaired and we have no idea … We’re doing a terrible job addressing this problem.”