Dealing with opioid addiction is one of the most significant issues the U.S. health system faces today, and nurses are playing a key role in our nation’s efforts to deal with the crisis.
For health care professionals, many aspects of opioid addiction and other Substance Use Disorders (SUD) present challenges – not least the danger that they themselves may have succumbed. To aid in managing and reducing the opioid epidemic, the American Nurses Association (ANA) has created a series of helpful resources outlining best practices, a more general overview of the role of ineffective pain management in fueling the opioid epidemic, and proposals for how the situation can be improved on a national level.
One thing you can't hide—is when you're crippled inside.
A host of treatment/deterrence options are available to health care practitioners when working with patients suffering from a Substance Use Disorder (SUD) including medication-assisted treatments, prescription drug monitoring programs, and voluntary monitoring programs. An understanding of the methodologies, benefits, and drawbacks of each approach is of critical importance for nurses.
The greatest evil is physical pain.
Ongoing chronic pain lasting more than three months is reported annually by between 11% - 40% of the U.S. population. While prescribed opioid use can be a very effective treatment to deal with acute pain, few studies have assessed the long-term benefits of opioids in reducing pain.
While clearly a society-wide issue, the effect of the opioid epidemic on the nursing profession has been profound, and ANA has made advocating top-level solutions to alleviate the situation a high priority. Law-makers are actively engaged in introducing legislation related to opioid dependence, and ANA is fully focused on ensuring that the interests of nurses are taken into account when deliberating new legislation. For more information on legislative priorities of ANA, visit RN Action
To learn more about state actions or plans, see Prescribing Policies.
Ours can be a challenging profession, and as nurses, we are in no less danger of being personally affected by opioid dependence than the patients we treat. We want to help our colleagues who face such challenges. To that end, ANA has made dealing with SUD a central aspect of our Health Nurse, Healthy NationTM campaign.
ANA recognizes that a nurse’s duty of compassion and caring extends to themselves and their colleagues as well as to their patients. Nurses who are challenged with substance use disorder not only pose a potential threat to those for whom they care; they are not caring for themselves.
According to the HHS, SUD refers to substance use and/or substance dependence. It is the damaging use of harmful substances, including alcohol, marijuana, opioids, and other drugs.
ANA and many of our organizational affiliates, including the International Nurses Society on Addictions (IntNSA), the Emergency Nurses Association (ENA), and the American Association of Nurse Anesthetists (AANA), strongly support alternative to discipline programs offered by nurses associations, state boards of nursing, and others. These programs offer comprehensive monitoring and support services to reasonably assure the safe rehabilitation and return of the nurse to her or his professional community. In 2017, ANA and AANA endorsed IntNSA and ENA’s position statement, "Substance Use Among Nurses and Nursing Students." Please view this statement in its entirety to gain valuable insight on the description and background on this issue. ANA thanks the members of ANA’s Substance Use Disorder Workgroup; which was a collaboration of subject matter experts, constituent/state nurses associations, organizational affiliates, and other interested parties engaged to assist with updating ANA SUD policy and resources. Additionally, the following three national nursing organizations contributed to these webpages with their policy and leadership:
Substance Use Disorder Resources - In 2017, ANA’s Substance Use Disorder Workgroup collected the following table of resources across a variety of media types. A brief description of each resource as well as authors and web addresses are provided. Resources include reference articles, pertinent directories, useful websites, and more to allow for an extensive exploration on substance use disorder in nursing and nursing students.
For Nurses with SUD
The National Council of State Boards of Nursing (NCSBN) offers an Alternative to Discipline Programs for Substance Use Disorder directory for nurses to locate alternative to discipline programs for SUD in their state if available.
For Nurses Concerned for a Colleague
This NCSBN online brochure, What You Need to Know About Substance Use Disorder in Nursing, informs nurses of their ethical and professional responsibilities about reporting suspected or know SUD in colleagues.
For Employers
Chapter 6 of NCSBN’s Substance Use Disorder in Nursing:: A Resource Manual and Guidelines for Alternative and Disciplinary Monitoring Programs offers a comprehensive examination of SUD in the healthcare workplace, particularly for nurse managers.
For Nursing Students
Although not specifically for nursing students, the NIH’s National Institute of Drug Abuse College-Age & Young Adults webpages contain resources for how and where to get assistance for substance abuse, as well as drug facts, infographics, and more. Currently, there is very little updated guidance for nursing students with substance use disorder. Nursing students may want to consult their health care provider, college health center, or employee assistance program.
Educational resources are available to nurses who want to teach or learn more about the dangers of the opioid crisis, as well as prevention and treatment strategies.
Hostetter, M. and Klein, S. (2017). In Focus: Expanding Access to Addiction Treatment Through Primary Care, The Commonwealth Fund. Retrieved from: https://www.commonwealthfund.org/publications/newsletter/2017/sep/focus-expanding-access-addiction-treatment-through-primary-care
Prescription Drug Monitoring Program Training and Technical Assistance Center (PDMP TTAC). (2017) Status of prescription drug monitoring programs (PDMPs). Retrieved from: http://www.pdmpassist.org/pdf/PDMP_Program_Status_20170824.pdf
Substance Abuse and Mental Health Services Administration. (2000). Drug Addiction Treatment Act of 2000. https://www.samhsa.gov/programs-campaigns/medication-assisted-treatment/legislation-regulations-guidelines
Substance Abuse and Mental Health Services Administration. (2017). Qualify for Nurse Practitioners (NPs) and Physician Assistants (PAs) Waiver. Retrieved from: https://www.samhsa.gov/programs-campaigns/medication-assisted-treatment/training-materials-resources/qualify-np-pa-waivers
