It is common knowledge among health care professionals that a number of healthcare providers are struggling because of substance abuse. It is also common knowledge among this group of health professionals that a certain health specialty is prone to chemical dependency. A good example of a health specialty with a high incidence of chemical dependency among practitioners is anesthesiology. In this group of health care professionals, opioids and potent analgesics like propofol are some of the common drugs of choice (Wright, McGuinness, Moneyham, Schumacher, Zwerling, & Stullenberger, 2012). It is interesting to note that chemical dependency among nursing students and health care professionals is not easy to recognize until it is reported due to fatal or near-fatal overdose. Recovery is a difficult process for drug addicts, but it is more challenging for nursing students and health care professionals that work in the field of anesthesiology. Thus, there is a debate surrounding the prudence of allowing them to return to anesthesia practice.
Substance Abuse Among Anesthesiologists
It is an uphill battle to identify health care professionals and nursing students who are struggling to overcome substance abuse and chemical dependency. It is difficult to pinpoint those who are struggling with this problem because of the nature of the issue, legal factors associated with health care delivery practices, and the consequences linked to patient care. Nevertheless, the assertion that substance abuse among health care professionals and students specializing in anesthesiology is not a new one.
Researchers in the late 1980s and early 1990s discovered that in the study of chemical dependency among health care professionals, anesthesiologists were overrepresented (Wright et al., 2012). In that same group, young anesthesiologists, especially those who are younger than 35 years old accounted for a significant number of chemically dependent health care workers.
In 2002, the chairman of the American Association of Nurse Anesthetists admitted that there are more drug-related complaints and disciplinary actions made against nurse anesthetists compared to other nursing specialties. In 2005, an article appeared in the American Society of Anesthesiologists Review and the author that abuse in anesthetic drugs is prevalent among Certified Registered Nurse Anesthetists, anesthesiology assistants, and student assistants (Wright et al., 2012).
Causes of Chemical Dependency
Researchers trace the cause of chemical dependency to an area in the brain that affects the sense of pleasure in the individual. The specific area of the brain that affects the sense of pleasure is the ventral tegmental area and the nucleus accumbens. For those who are addicted to analgesics and opioids, the feeling of reward is greater. Therefore, the craving for the drug compels them to ingest the substance as soon as possible.
According to researchers, a certain type of personality is prone to drug addiction. For example, thrill-seekers and impulsive individuals are prone to chemical dependency. This assertion is supported by studies that say nurses struggling with substance abuse acquire higher scores in sensation-seeking scales. In a related study, high scores in sensation-seeking scales proved symptomatic of substance abuse (Euliano & Gravenstein, 2011).
Aside from personality traits and neurobiological factors, one of the significant predictors of substance abuse among anesthesiologists is occupational factors, such as access to drugs and work-related stress (Nace, 2013). It is important to point out that nurses and nursing students needed to contend with stressful situations on a regular basis. They perceive drugs as a way to relieve work-related stress. It is also a means for them to cope with anxiety and negative feelings generated by a stressful work environment. It can be argued that health care professionals and student nurses experience negative feelings and anxiety at home; nevertheless, working in a place affected by the high acuity of patient conditions creates feelings and emotions that compel many practitioners and nursing students to use opioids analgesics.
The stressful work environment provides the motivation to look for drugs and use it. them ever, it is easy to access opioids and analgesics which makes it harder to resist the temptation. Thus, researchers are in agreement that access to major opioids and potent analgesics is a major factor contributing to drug addiction among nurse anesthetists and nursing students specializing in anesthesiology.
Identification of Substance-Abusing Anesthesia Providers
It is important to identify substance-abusing anesthesia providers in order to initiate an effective intervention strategy. However, it is a difficult process, because the typical time frame for administrators to discover the divergence of anesthetic drugs may take one or two years. Nevertheless, it becomes easier to detect when patients start to complain about pain due to the diversion of opioids and analgesics from the workplace to the residence of the drug dependent.
It is important to track the use of pain medication in hospitals and other health care facilities. It is now common practice to develop better monitoring schemes of controlled substances. A good example is the use of computerized dispensing systems to enhance the accountability process.
Treatment and Prevention of Relapse
It must be pointed out that nurse anesthetists and nursing students experience an uphill climb when it comes to drug addiction interventions and treatments. It is more difficult for them to beat the drug abuse problem because the threat of relapse is greater for them. A major factor is an access to drugs and exposure to a stressful environment. Nevertheless, a significant number of substance-abusing anesthesia providers were able to kick the habit so to speak. The program’s success was attributed to a holistic approach that encourages health workers to work hard in order to prevent the cancellation of their licenses. Successful programs include the need for the patient’s anonymity as part of the strategies to encourage early intervention.
Those who were able to complete the program are oftentimes allowed to go back to work in a supervised setting. Nevertheless, researchers discovered that due to the high risk of relapse, recovering addicts were advised to stay away from work for a certain period of time.
There are many people protesting the reentry of substance-abusing health care workers. However, a compromise was made, and it was labeled as the “One Strike You’re Out” policy. Wn a former drug addicts were allowed to go back to work as health care professionals, they only need to commit one infraction and their licenses are revoked.
Recommendations
A significant number of studies targeted academic institutions and health care workers who are already in treatment for drug abuse. It is best to incorporate other research and data about anesthesia providers struggling with chemical dependency. It is also more practical to look into a research design that is less retrospective. For example, it is best to study how access to drugs, family history of substance abuse, and psychological disorder play a major role in the development of drug dependency in the life of an individual. The results of a new research design that incorporates the above-mentioned suggestions will help provide data on a program of research geared towards the development of risk identification and substance abuse prevention. As a result, a research design will be created that will help develop identification and counseling strategies.
It is also important to develop better testing methods to incorporate tests on mood-altering drugs and other substances. It is also helpful to develop a research design that incorporates information on revoked licenses as well as contract completion or occupational status of those who were able to go through the drug rehabilitation program designed for anesthesiologists and nurse anesthetists. The current article contains information about the occupational status of the substance-abusing anesthesia providers. Nevertheless, it was not made clear if they were practicing as anesthesiologists or nurse anesthetists. The new research design must incorporate data gathering strategies to find out if the substance-abusing anesthesia providers shifted to another specialty.
It is also important to consider the negative perception of the public when it comes to reentry of substance-abusing anesthesia providers. Many people believe that the possibility of relapse will hurt patients and the reputation of the hospital. It is therefore critical to develop a research design that looks into the treatment plans. Others are looking into the use of trigger management that takes the form of simulation in an operating room. The enhancement of innovative solutions is interesting opportunities for future research on this topic. It is imperative to highlight the continued dedication of professionals and stakeholders to help recognize the risk of drug abuse in nurse anesthetists and nursing students, in order to provide steps that will enhance prevention, early identification, and treatment.
References
Euliano, T., & Gravenstein, J. (2011). Essential anesthesia. New York: Cambridge University Press.
Nace, E. (2013). Achievement and addiction. New York: Brunner, Inc. Wright, L., McGuinness, T., Moneyham, L., Schumacher, J., Zwerling, A., & Stullenberger, E. (2012). Opioid abuse among nurse anesthetists and anesthesiologists. American Association of Nurse Anesthetists Journal, 80(2), 121-128.