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> Informational Brochures > Drug Addiction in Health
Care Professionals
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. However,
the last people we would suspect of drug addiction are health care
professionals—those people trusted with our well-being. Yet health care
workers are as likely as anyone else to abuse drugs.
Even though the vast majority of DEA registered practitioners comply
with the controlled substances law and regulations in a responsible and
law abiding manner, you should be cognizant of the fact that drug impaired
health professionals are one source of controlled substances diversion.
Many have easy access to controlled substance medications; and some will
divert and abuse these drugs for reasons such as relief from stress,
self-medication, or to improve work performance and alertness.
This guide will help you recognize the signs that may indicate that a
colleague or co-worker is diverting controlled substances to support a
substance abuse problem.
What are My Responsibilities?
You have a legal and ethical responsibility to uphold the
law and to help protect society from drug abuse.
You have a professional responsibility to
prescribe and dispense controlled substances appropriately, guarding against
abuse while ensuring that patients have medication available when they need
it.
You have a personal responsibility to
protect your practice from becoming an easy target for drug diversion. You
must become aware of the potential situations where drug diversion can occur
and safeguards that can be enacted to prevent this diversion.
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How Do I Recognize a Drug Impaired
Co-Worker?
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Drug abusers often exhibit similar aberrant behavior.
Certain signs and symptoms may indicate a drug addiction problem in a
health care professional. Have you observed some of the following signs?
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Work absenteeism –absences without notification and an
excessive number of sick days used;
-
Frequent disappearances from the work site, having long
unexplained absences, making improbable excuses and taking frequent or
long trips to the bathroom or to the stockroom where drugs are kept;
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Excessive amounts of time spent near a drug supply. They
volunteer for overtime and are at work when not scheduled to be there;
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Unreliability in keeping appointments and meeting
deadlines;
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Work performance which alternates between periods of
high and low productivity and may suffer from 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;
Interpersonal relations with colleagues, staff and
patients suffer. Rarely admits errors or accepts blame for errors or
oversights;
Heavy "wastage" of drugs;
Sloppy recordkeeping, 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 change - 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.
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Should I Become Involved?
Health care professionals often avoid dealing with drug
impairment in their colleagues. There is a natural reluctance to approach a
co-worker suspected of drug addiction. There is the fear that speaking out
could anger the co-worker, resulting in retribution, or could result in a
colleague’s loss of professional practice.
Many employers or co-workers end up being
"enablers" of health care practitioners whose professional
competence has been impaired by drug abuse. Addicted colleagues are often
given lighter work schedules, and excuses are made for their poor job
performance. Excessive absences from the work site are often overlooked.
Drug impaired co-workers are protected from the consequences of their
behavior. This allows them to rationalize their addictive behavior or
continue their denial that a problem even exists.
If you recognize the aforementioned signs or symptoms in a
co-worker, it’s time to demonstrate concern. You may jeopardize a person’s
future if you cover up or don’t report your concerns. Many well-educated,
highly trained, and experienced health care practitioners lose their
families, careers, and futures to substance abuse. Tragically, some health
care workers have even lost their lives to their drug addiction because the
people who saw the signs and symptoms of their drug use refused to get
involved.
By becoming involved, you can not only help someone who may
be doing something illegal, but more importantly, your action could affect
the safety and welfare of your addicted employee or coworker AND
those patients or the public who may come in contact with him or her.
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What If I Know That Drugs Are Being Sold
or Stolen?
Drug abuse and drug dealing are serious problems that should
be handled by qualified professionals. 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 to the nearest DEA office as well as your local
police department.
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What Can I Do to Help?
For some employees, the mere fact that their supervisor
talks to them about their poor work performance is enough to help them
change. For others, however, the problem may be more severe and require more
drastic measures. The threat of losing a job may have more influence on a
drug abuser than a spouse’s threat to leave or a friend’s decision to
end a relationship. Many drug abusers will seek help for their problem if
they believe their job is at stake, even though they have ignored such pleas
from other people important in their life.
Drug addicts can recover, and effective help is available.
Encourage your co-worker or employee to seek drug treatment assistance.
Treatment programs range from self-help to formal recovery programs. A
number of state licensing boards, employee assistance programs, state
diversion programs and peer assistance organizations will refer individuals
and their families to appropriate counseling and treatment services. These
services will maintain the confidentiality of those seeking assistance to
the greatest extent possible.
Department of Justice
Drug Enforcement Administration
Office of Diversion Control
Liaison and Policy Section
Washington, D.C. 20537
It is not the intent of this publication to
reduce or deny the use of controlled substances where medically indicated.
Nothing in this guide should be construed as authorizing or permitting any
person to do any act that is not authorized or permitted under federal or
state laws.
Additional information on DEA’s Diversion
Control Program is available at: www.deadiversion.usdoj.gov
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