Drug Addiction in Health Care Professionals

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. Exces
sive 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.
Ifyou recognize the aforementioned signs or
symptoms in a co-worker, it's time to demon
strate 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 practi
tioners lose their families, careers, and fu
tures 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 em
ployee or coworker AND those patients or the
public who may come in contact with him or
her.
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.
Ifyou are a DEA registrant and become aware
of a theft or significant loss involving control
led substances, you must immediately report
the theft or loss to the nearest DEA office as
well as your local police department.
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 impor
tant 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 pro
grams, 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.
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 autho
rized or permitted under federal or state laws.
U.S. Department of Justice
Drug Enforcement Administration
Department of Justice
Drug Enforcement Administration
Office of Diversion Control
Liaison and Policy Section
Washington, D.C. 20537
Additional information on DEA's Diversion Control Program
is available at: www.deadiversion.usdoj.gov

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What Are My Responsibilities?
• You have a legal and ethical responsibil
ity 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.
How Do I Recognize a Drug Impaired Co-Worker?
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?
• Work absenteeism -absences without
notification and an excessive number of sick
days used;
• Frequent disappearances from the work
site, having long unexplained absences, mak
ing improbable excuses and taking frequent
or long trips to the bathroom or to the stock
room where drugs are kept;
• Excessive amounts of time spent near a
drug supply. They volunteer for overtime and
are at work when not scheduled to be there;
• Unreliability in keeping appointments
and meeting deadlines;
• Work performance which altemates
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 instruc
tions. 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 hand
writing 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.