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Health Care Professionals

Understand substance use disorder in health care professionals and find treatment.

As a health care professional, you provide essential, even lifesaving services to people of all ages and walks of life. Physicians, nurses, counselors, dentists, pharmacists, or other types of health care personnel have a demanding yet rewarding mission of treating the wounded, healing the sick, and promoting health and wellness.
 
Anyone can become dependent on alcohol and other drugs, including people who work in health care. And health workers may face some specific risks that can lead to substance misuse — such as job-related stress and access to prescription medications. If you or someone you know misuses alcohol or drugs, know that help is available.
 
Recovery is possible.

Risk factors for health care professionals

Doctors, nurses, and other health care professionals may misuse alcohol and other drugs because of the demands of their jobs, which often leave little time for self-care. Many medical professionals also have easy access to addictive prescription medications. These factors can put health care professionals at risk of developing a substance use disorder (SUD).
 
Here are some of the factors associated with SUD in health care professionals: 
 
Exposure to trauma. In general, people exposed to trauma may have a related risk of substance misuse and other behavioral health issues. During the COVID-19 public health emergency, doctors, nurses, and other health care workers risked their lives to treat millions of people with a highly transmissible virus, many of whom died in their care. A 2021 report from this period found that front-line health care workers were at higher risk of post-traumatic stress disorder, a condition that frequently co-occurs with SUD.
 
Occupational exhaustion, burnout, and other challenges. Health care work in the United States can lead to extreme stress and mental health issues. In September 2020, 76% of health care workers reported exhaustion and burnout (or chronic job-related stress). And among physicians experiencing burnout, 79% said the burnout predated the start of the COVID-19 pandemic. Health care professionals attribute their burnout to a variety of causes, including:

  • Long work hours, many of which are spent on tedious tasks.
  • Irregular shifts.
  • Physically and mentally taxing labor.
  • Exposure to people who are hurting, dying, or dead.
  • Greater risk of exposure to disease and violence.
  • Lack of control.
  • Lack of respect from other staff members.
  • Lack of emotional support for grief, loss, and fatigue.

People in all professions sometimes turn to alcohol and other drugs to try to cope with occupational stressors, and health care workers are no exception.
 
Knowledge of and access to drugs. Some health care workers have told researchers that because they know what drugs can do, they believe they are somehow protected from their addictive properties. One 2001 study found that more than half of physicians in training self-prescribed medications; however, newer research, from 2012, found this type of activity to be rarer.
 
History or pattern of alcohol and other drug use and mental health diagnosis. Like most people, doctors, nurses, and other health care workers with a family history of alcohol and other drug use and mental illness can be more likely to develop an SUD.

Statistics: Health care professionals and substance use

Statistics about the prevalence of drug and alcohol misuse among health care professionals vary.
 
A 2007 report estimated that 10% to 15% of health care professionals misuse alcohol or other drugs at some point during their career. 
 
A 2015 study, based on data from 2008–2012, estimated that 5.7% of full-time health care and social assistance workers had an SUD in the past year. The study also found that 5.5% of full-time health care and social assistance workers reported using illicit drugs in the past month and 4.4% of the workers reported using alcohol heavily in the past month.
 
A 2023 research article about this issue found that substance use disorder and mental health diagnoses among health care professionals rose during the pandemic and are likely to stay elevated after the pandemic.

Effects of substance misuse in health care professionals

Effects
 
First and foremost, doctors, nurses, and other health care professionals who misuse substances can inflict serious harm on their patients. An impaired or unfocused health care professional can make mistakes in medical paperwork, prescriptions, and procedures. Some mistakes can be serious and even life-threatening.
 
Apart from improper patient care, untreated substance use disorders can lead to:

  • Decreased physical and mental health.
  • Legal jeopardy.
  • Possible suspension or loss of medical license.
  • Loss of income if you are suspended or fired.
  • Stunted career growth or professional development.
  • Damaged relationships with your co-workers.

Signs

Signs of substance misuse or SUD in health care professionals include:

  • Being absent from work without clear reasons.
  • Being drowsy, falling asleep, or being unsteady at work.
  • Inability to concentrate, nausea, shaking, slurred speech, or weight gain or loss.
  • Diverting drugs from patients to personal use, changing orders for prescriptions, or manipulating pharmaceutical tablets or containers.
  • Exhibiting mood swings (e.g., veering from high to low energy and back again).
  • Having personal, family, and financial problems.
  • Making simple mistakes or bad decisions at work.
  • Overseeing patients who report that they have not received pain relief.

What if I suspect a co-worker has an SUD? 

Employers and employees must follow a complicated set of laws, regulations, and policies regarding substance use in the workplace. These rules balance the safety of the workplace with the protection of civil rights.  Most workplaces have supervisors who develop and manage policies related to substance use disorder reporting. Workplace policies may cover the reporting process, confidentiality issues, fitness for duty, and other topics.  Consult these supervisors and policies to understand your obligations for reporting on-the-job substance use.  

SUD treatment considerations for health care professionals

If you are a doctor, nurse, or other health care professional, you likely know many patients who have benefited from substance use treatment. Yet you may be reluctant to seek treatment for your own substance use issues, fearing professional, financial, and even legal consequences.
 
Even though there is a persistent stigma surrounding substance use disorders, today we understand that SUDs can be treated effectively, just like other mental health conditions. As attitudes about SUD change, health care workers and trainees today are less likely than those in the past to face disciplinary action or termination for misuse of or dependence on alcohol or other drugs. Studies also show that health care professionals undergoing evidence-based treatment can achieve long-term recovery while remaining on the job.
 
As more people recognize that addiction is a treatable health condition, the stigma surrounding substance use disorders is decreasing in the health community and society at large. The Federation of State Physician Health Programs, a leading medical society, recently released a position statement saying that Food and Drug Administration-approved medication for opioid use disorder should be available to all patients in need, including health care professionals.

Techniques for managing work-related stress in a healthy way

Implement a buddy system. A buddy system can help you manage occupational burnout and stress. This is when you and a trusted colleague agree to provide mutual support on issues such as communicating basic needs, encouraging self-care, managing workloads, and taking breaks.  

Practice self-care. Reduce burnout by taking care of yourself and setting boundaries. Examples of this include limiting the hours you spend on the job; talking to your trusted colleagues, friends, and family about how you feel; eating well and exercising; getting rest; breathing and meditating; and writing your thoughts in a journal.  

Avoid using alcohol and drugs to cope with stress. If your mental health is declining due to work-related stress, seek help from a trained professional.

As you take the first steps toward treatment and recovery, learn about available support:
 
Get advice from membership organizations. Seek advice from health care membership organizations to understand your rights to privacy and be referred to physician health programs and other types of treatment for health care professionals. For instance, the Federation of State Physician Health Programs endorses therapy programs instead of disciplinary actions and offers other resources on SUD treatment for health care workers. The National Council of State Boards of Nursing has similar resources for recognizing and treating SUD in nurses.
 
Explore professional support for SUD treatment. In some cases, health care professionals in physician health programs sign long-term treatment contracts with state-based medical program sponsors. These agreements outline the steps you need to take to successfully complete SUD treatment. This can include spending a specific period in inpatient and outpatient care, attending a certain number of recovery meetings, and agreeing to undergo drug testing.

Ready to start your recovery? Explore the resources on this website:

Find Support near You

Recovery from substance misuse is possible. Find treatment near you

Sources:

A Nurse Manager’s Guide to Substance Use Disorder in Nursing, National Council of State Boards of Nursing, 2018

 Diversion of Drugs Within Health Care Facilities, a Multiple-Victim Crime: Patterns of Diversion, Scope, Consequences, Detection, and Prevention, Mayo Clinic Proceedings, July 2012

 Federal Laws and Regulations, Substance Abuse and Mental Health Services Administration, July 18, 2022

 How Doctors With Addiction Heal and Return to Practice, Medscape, Aug. 12, 2022

 Impaired Healthcare Professional, Critical Care Medicine, 2007

 Position Statement: Safety Considerations for Medication Treatment of Opioid Use Disorders in Monitored Health Professionals, August 2022

 Substance Use Disorder in Nursing, National Council of State Boards of Nursing

Chapter 1: Trauma-Informed Care: A Sociocultural Perspective, Substance Abuse and Mental Health Services Administration, 2014

Common Factors Related to Illicit Substance Use Among Nurses in North America, Dominican University of California

Emergency Responders: Tips for Taking Care of Yourself, Centers for Disease Control and Prevention, March 19, 2018

Employee Assistance Program, Prescription Drug Toolkit and Fact Sheets, Substance Abuse and Mental Health Services Administration

Federation of State Physician Health Programs’ Response to Helping the Helpers, Journal of Addiction Medicine, Oct. 4, 2022

Health Worker Mental Health, Centers for Disease Control and Prevention, May 11, 2022

Physician Burnout & Moral Injury: The Hidden Health Care Crisis, National Institute for Health Care Management, March 22, 2021

Posttraumatic Stress Disorder and Co-Occurring Substance Use Disorders: Advances in Assessment and Treatment, Clinical Psychology, 2012

Prescription Drug Use and Self-Prescription Among Training Physicians, Archives of Internal Medicine, February 2012

Psychiatric Issues Among Health Professionals, The Medical Clinics of North America, January 2023

Recognizing Alcohol and Drug Impairment in the Workplace in Florida, StatPearls, Dec. 9, 2022

Risk Factors for Alcohol and Other Drug Use by Healthcare Professionals, Substance Abuse Treatment, Prevention, and Policy, 2008

Substance Abuse in Healthcare, EduMed, Aug. 30, 2022

Substance Misuse Among Health Care Workers, Current Opinion in Psychiatry, 2001

Substance Use and Substance Use Disorder by Industry, Substance Abuse and Mental Health Services Administration, April 16, 2015

The Prevalence of Post-Traumatic Stress Disorder Among Health Care Workers During the COVID-19 Pandemic: An Umbrella Review and Meta-Analysis, Front Psychiatry, 2021