While the prevalence of opioid misuse in the United States is a topic of much discussion, substance use disorder (SUD) among healthcare professionals is usually not part of the dialogue.
Jennifer Greenwood, PhD, CRNA, associate professor in the Nurse Anesthesia Department, is working to update and expand the available data about SUD trends within her profession, while also working to reduce stigma and create a culture of safety around identifying substance use and seeking help.
“Substance use disorder is not a problem that’s unique to anesthesia by any means. There are plenty of other specialties that also have access to medications that could put them at higher risk,” said Dr. Greenwood. “What’s really concerning is the risk of SUD when healthcare providers have access to drugs that are highly potent. This is particularly true for anesthesia providers, because we work with drugs that have the potential to be lethal in small doses, like fentanyl and propofol. So that’s why we’re focusing our research on SUD among anesthesia providers.”
Since 2021, Dr. Greenwood and students in RFU’s Doctor of Nursing Practice in Nurse Anesthesia program have turned to members of their own profession to gain a better understanding not only of the incidence of SUD, but also what accounts for low reporting rates or use of assistance programs. To gather these insights, Dr. Greenwood and students collected data over a two-year period using a survey that was distributed through the American Association of Nurse Anesthesiology, the professional group that represents CRNAs.
According to that survey data, 60% of respondents have personally known a colleague to be impaired at work over the course of their career, and 10% of those incidents occurred within the last 12 months. Of the respondents who knew of drug use at work in the previous 12 months, 38.5% of them did not take any action.
“Our research demonstrates that this is an ongoing problem, and identification and reporting are very low,” Dr. Greenwood said, noting that survey respondents frequently cited fear of licensure loss or wrongfully accusing a colleague as reasons they didn’t self-report or report a colleague.
“There is real fear related to accusing a colleague and being wrong,” Dr. Greenwood added. “That would destroy a relationship and might destroy that person’s career. But SUD is also a patient safety issue. If we suspect a colleague is working while impaired, we need to speak up.”
Most states have alternative to discipline (ATD) programs available to providers who self-report. These programs are confidential and allow the provider to avoid disciplinary action against their license provided they successfully complete the ATD program. ATD programs tend to be underutilized, but have high success rates of helping providers address SUD and continue working as licensed professionals.
Dr. Greenwood also sees an opportunity to educate all RFU students about recognizing SUD, and challenging preconceived notions about substance abuse, during the early stages of their training.
“We have trainees here in many different specialties, and we can educate them on best practices regarding identifying and reporting SUD, reducing the stigma around it and reducing SUD among providers to ensure patient safety,” she said. “We want to make sure that our graduates are going out into the world and providing the best care that they can for patients, and that means they have to be well themselves.”
If you or someone you know is struggling with substance use disorder, free and confidential help is available by calling 1-800-662-4357. Visit www.samhsa.gov/find-help/national-helpline to learn more.
Sara Skoog is a staff writer with the RFU Division of Marketing and Brand Management. In addition to writing for Helix and other university publications, she also produces Pulse, RFU’s monthly e-newsletter.