The abuse of prescription drugs—especially controlled substances—is a serious social and health problem in the United States today. People addicted to prescription medication come from all walks of life. The last people we would suspect of drug addiction are health care professionals-those people trusted with our well-being. Unfortunately, health care workers are as likely as anyone else to abuse drugs.
The vast majority of Drug Enforcement Agency (DEA) registered practitioners comply with the controlled substances law and regulations. However, drug impaired health professionals are one source of controlled substances diversion. Many have easy access to controlled substance medications. Some will divert and abuse these drugs for reasons such as relief from stress, self-medication, or to improve work performance and alertness.
Responsibilities of DEA-registered health practitioners
DEA-registered health practitioners have a legal and ethical responsibility to help protect society from drug abuse. They have a professional responsibility to prescribe and dispense controlled substances appropriately. They guard against abuse while ensuring that patients have medication available when they need it. They have a personal responsibility to protect their practice from becoming an easy target for drug diversion. They must become aware of the potential situations where drug diversion can occur and what to do to prevent it.
Recognizing a drug impaired coworker
Drug abusers often exhibit similar unusual behavior. The following signs and symptoms may indicate a drug addiction problem in a health care professional:
- Absences from work without notification and an excessive number of sick days used
- Frequent disappearances from the work site-frequent or long trips to the bathroom or to the stockroom where drugs are kept
- Excessive amounts of time spent near a drug supply
- Volunteering for overtime and working when not scheduled to be there
- Unreliability in keeping appointments and meeting deadlines
- Work performance which alternates between periods of high and low productivity; mistakes made due to inattention, poor judgment and bad decisions
- Confusion, memory loss, and difficulty concentrating or recalling details and instructions
- Ordinary tasks require greater effort and consume more time
- Strained or neglected interpersonal relations with colleagues, staff and patients
- Rarely admits errors or accepts blame for errors or oversights
- Heavy “wastage” of drugs
- Sloppy record keeping, suspect ledger entries and drug shortages
- Inappropriate prescriptions for large narcotic doses
- Insistence on personal administration of injected narcotics to patients
- Progressive deterioration in personal appearance and hygiene
- Uncharacteristic deterioration of handwriting and charting
- Wearing long sleeves when inappropriate
- Personality changes-mood swings, anxiety, depression, lack of impulse control, suicidal thoughts or gestures
- Patient and staff complaints about health care provider’s changing attitude/behavior
- Increasing personal and professional isolation
The decision to get involved
Health care professionals often avoid dealing with drug impairment in their colleagues. There is the fear that speaking out could anger the coworker, resulting in retribution, or could result in a colleague’s loss of professional practice. Many employers or coworkers end up being “enablers” of health care practitioners whose professional competence has been impaired by drug abuse. Drug impaired coworkers are often protected from the consequences of their behavior.
If you recognize signs or symptoms in a coworker, show your concern. Someone’s future could be jeopardized if you cover up or don’t report your concerns. By becoming involved, you may:
- Help someone who may be doing something illegal
- Protect the safety and welfare of an addicted employee or coworker
- Protect patients or other people who could suffer at the hands of a drug addicted individual
If drugs are being sold or stolen
If you suspect that a drug deal is in progress, do not intervene on your own. Contact security or notify the police. If you are a DEA registrant and become aware of a theft or significant loss involving controlled substances, you must immediately report the theft or loss. You should go to the nearest DEA office as well as your local police department.
What you can do to help
For some employees, a supervisor talking to them about their poor work performance is enough to help them change. Many drug abusers will seek help for their problem if they believe their job is at stake. This may be true even if they have ignored such pleas from other people important in their life. A referral to the Employee Assistance Program is often the supervisor’s course of action.
Drug addicts can recover, and effective help is available. Encourage your coworker or employee to seek drug treatment assistance. Treatment programs range from self-help to formal recovery programs. You may suggest they contact the Employee Assistance Program for help in determining the appropriate level of care. The EAP and the treatment programs will maintain the confidentiality of those seeking assistance to the greatest extent possible.
SOURCE: US Department of Justice, adapted by HealthGate Editorial Staff