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B.C. nurses not immune from substance abuse problems, stigma

Nurses with substance use disorder may be more impacted by social marginalization and stigma due to their roles.
stressed nurse
Nurses with substance use disorder problems are encouraged to seek help before patients are put at risk.

Substance abuse issues for nurses who work in high-stress situations are far from unusual and something regulatory bodies and professional groups in B.C. are working to address.

While it’s the B.C. College of Nurses and Midwives (BCCNM) that deals with the public interest in investigating nurses and substance abuse issues, it’s the professional associations and unions that provide assistance to those practitioners who are in need of help, said college spokesperson Johanna Ward.

“They each have a unique role to play in dealing with this complex issue,” Ward said.

A 2019 BC Nurses Union report said Canadian estimates for substance use disorder (SUD) prevalence among health-care providers are lacking. But, it said a disorder prevalence rate of 7.9 per cent was found in Alberta nurses, similar to the general population. That figure is similar to U.S. numbers. Alcohol abuse numbers may be higher.

However, the report noted nurses may be more susceptible to social marginalization and stigma than substance users among the general public.

“Health-care providers with SUDs likely face additional challenges, including compounded feelings of stigma and guilt associated with working in a helping profession, as well as experiencing stigma in the workplace from colleagues and administrators as a barrier to disclosure,” the report said.

Glacier Media contacted union president Aman Grewal, who directed inquires to the communications department. That department did not respond to multiple requests.

A UBC, University of Ottawa and Fraser Health Authority 2021 report found some nurses burning out during COVID-19 resorted to alcohol use as a coping mechanism.

Meanwhile, the American Nurses Association has indicated that up to 10 per cent of working registered nurses may be dependent on drugs or alcohol. However, the most worrisome statistic suggested 14 to 20 per cent of all U.S. registered nurses might have a problem with drug or alcohol dependence or abuse.

Ward explained that when a nurse is reported to the college for diverting drugs or about a mental health concern, the college acts. That action is in both the public interest and with respect for the individual practitioner who may also be suffering a health challenge, she says.

Because the cases are considered health challenges, the college discipline decisions are anonymized to protect the nurses’ privacy.

“The college aims to address the challenging issue of substance use disorder in nursing sensitively, particularly given the specific stressors and other challenges associated with the profession,” Ward said.

“Registrants are encouraged to seek treatment for substance use disorder before diversion and impairment places patients at potential risk,” Ward told Glacier Media. “Outcomes for narcotics diversion matters vary, depending on the individual circumstances. “

Ward added the college recognizes “that each report we receive about a practitioner who is in active addiction needs to be treated with kindness and held to account if they have caused harm to others.”

Discipline can include suspension and supervision, and comes with recommendations for treatment and compliance.

Ward said nurses are commonly accommodated within employment and regulatory environments to pursue a medical leave of absence while completing treatment for substance use disorders and other diagnosed disabilities. 

With that done, the college works with all parties to create a return-to-work situation that ensures the safety of all involved. 

Angela Wignall, the Nurses and Nurse Practitioners of British Columbia (NNPBC) director of professional practice and health policy implementation, said the stressors nurses face could be immense. And that can lead to people seeking solace in substance use.

She said nurses are rated the most trusted professionals in Canada.

But, she added, “We have the highest rate of violence of any profession in the country.”

WorkSafeBC, the province’s workplace health and safety regulator, said there were 2,455 short-term disability, long- term disability or death benefit claims due to acts of violence for nurses, between 2018 and 2022.

And that can, in part, lead to the diversion of drugs from patients.

“The primary reason for diversion is self-medication,” Wignall said.

However, she said, having a diagnostic conversation isn’t something the NNPBC would be involved in. Again, that issue remains private as part of the treatment process.

Generally speaking, the college believes acknowledging a substance use problem and seeking treatment is viewed as a positive step in professional and personal recovery by the college, said Ward.

“BCCNM attempts to strike a balance between sanctioning and deterring conduct that places patients at risk and accommodating a registrant’s health condition while supporting a safe return to practice,” Ward said.