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Nurses and Substance Use

RiverMend Health Centers offers comprehensive substance abuse and mental health assessments of nurses. With an accurate diagnosis, employers and licensing boards have the information they need to protect patients, and nurses can get the right level of treatment so they can restore their health and return to work.

The Vital Role of Nurses

Nurses are the backbone of the U.S. healthcare system. On the front lines of patient care, nurses are there when we enter the world as newborns, and when we leave it at the end of life. From assessing patients to managing care to comforting those who are frightened or in pain, nurses are indispensable throughout all aspects of healthcare.

But the stress of the job, difficulties at home and traumatic experiences either on the job or at any point in life can take a toll. Nurses may also suffer from chronic pain or co-occurring mental health disorders. These psychological, emotional or physical problems can lead some nurses to turn to drugs or alcohol to cope, to escape or to alleviate symptoms. Nurses also may have easier access to pain medications, raising their risk of substance use.

If a nurse is exhibiting erratic behavior or suspected to be struggling with a substance use disorder, it’s vital that that he or she receives a thorough and accurate evaluation to protect patients and employers.

There are more than 3 million nurses in the United States, compared to 87,000 physicians.

Mental and Physical Examination (MPE) for Nurses

RiverMend Health Centers’ full-day mental and physical examination (MPE) is offered in both our Atlanta and Augusta, Georgia locations. The evaluation is used by employers and licensing boards (such as the Georgia Board of Nursing) to diagnose substance use and mental health disorders in nurses, and to determine fitness for duty.

The assessment takes a full day and includes:

  • An evaluation by Stacy Seikel, MD, who is board certified in addiction medicine and anesthesiology and has many years of experience diagnosing and treating addictive disorders. (Atlanta location).
  • An evaluation by Dr. William S. Jacobs, a triple board-certified physician, medical director of Bluff Plantation (our partner facility) and chief of addiction medicine at the Medical College of Georgia at Augusta University (Augusta location).

  • Forensic drug, hair and peth testing conducted on site. Peth testing looks for biomarkers of alcohol that remain in the blood for three weeks and indicate binge drinking or chronic alcohol use.

  • A full medical evaluation, including blood work and EKGs, to assess overall health, chronic pain conditions and other medical problems that may contribute to substance use.

  • A detailed psychiatric history, gathered prior to the evaluation. We obtain collateral information from the employer, the board of nursing, family, physician and therapists.

  • A detailed substance use, pain, trauma and process addiction history. Process addictions include sex, shopping and gambling addictions.

  • Recommendations for next steps, including treatment and level of care.

  • Required reports to referral sources on fitness for duty and return to work provided in a timely manner.

“If a substance use diagnosis is made, we want to make recommendations for appropriate, evidenced-based and effective treatment so that they can get well and get back to work.” – Dr. Stacy Seikel, Medical Director, RiverMend Health Center of Atlanta

Helping Nurses Heal

RiverMend Health Centers offers comprehensive substance abuse and mental health assessments of nurses. With an accurate diagnosis, employers and licensing boards have the information they need to protect patients, and nurses can get the right level of treatment so they can restore their health and return to work. Substance use disorder is a progressive, chronic disease, but it can be successfully treated. Through addiction rehab and long-term monitoring programs, nurses can get the help they need to achieve long-term sobriety and return to work. Most states, including Georgia, have alternatives to disciplinary action, including peer assistance and recovery monitoring programs, which allow nurses to seek rehabilitation for substance use and prove sobriety without a loss of their license. These programs recognize the importance of treating, supporting and retaining nurses.

RiverMend Health Center of Atlanta and Augusta, in conjunction with our partner, Bluff Plantation of Augusta, Georgia, offer all levels of addiction treatment: inpatient or residential rehab, partial hospitalization programs (PHP), intensive outpatient programs (IOP) and aftercare.

We also work with employers on return-to-work requirements, including practice restrictions, drug and alcohol testing, and procedures in the event of relapse.

Prevalence of Addiction Among Nurses

Whether the rate of addiction among nurses is greater than in the general population isn’t known. But a study in the American Journal of Nursing found emergency department nurses were more likely to use cocaine or marijuana than nurses in other specialties.

Nurses also face work-related risk factors for drug and alcohol use, including:

  • Working the night shift.
  • Critical care work.
  • Excessive overtime.
  • Chronic pain due to musculoskeletal injuries and pain.
  • Access to opioids and powerful pain medications.

When to Take Action: Signs and Symptoms of an Impaired Nurse

Impaired nurses can be a danger to themselves and their patients. Nurses struggling with addiction also puts employers at risk. It’s imperative that when a nurse is exhibiting erratic behavior or suspected of being under the influence of drugs or alcohol, their loved ones and coworkers report the behavior and take action to get them help.

Educate yourself on your company policy and procedure for employee substance abuse and employee assistance programs. Document changes in the nurse’s behavior. Although it can be a difficult decision to urge a coworker to get help or to report the behavior to management, nurses have an ethical responsibility to patients, colleagues, the profession of nursing, and the community to take action.

Signs of Substance Abuse in Nurses

  • Changes in job performance, such as increased errors or oversights.

  • Changes in reliability, such as arriving late or leaving early, or frequently missed work.

  • Disruptive or erratic behavior.

  • Changes in personality.

  • Mood swings or inappropriate emotional responses.

  • Deteriorating personal hygiene or changes in appearance that worsen over time.

  • Changes in personal relationships, such as marital problems or increasing isolation from friends and co-workers.

  • Inability to concentrate.

  • Multiple driving under the influence (DUI) citations.

  • Frequent trips to the bathroom/unexplained absences.

Signs of Drug Diversion

  • Discrepancies in documentation of controlled substance administration.

  • Signing out controlled substances more often than would be expected.

  • Volunteering to give medications to other nurses’ patients

  • Patients reporting a lack of pain relief, despite pain medication administration.

  • Large amounts of wasted narcotics.

About Our Physicians

Stacy Seikel, MD, is the medical director of RiverMend Health Center of Atlanta. She has three decades of experience in diagnosing and treating substance use disorders. Dr. Seikel is board certified in addiction medicine and anesthesiology. She has worked on the state and national levels to develop programs to keep families intact while a parent achieves recovery and sobriety.

William S. Jacobs, MD, is a triple board-certified physician, chief of addiction medicine at the Medical College of Georgia at Augusta University, and medical director of our partner center, Bluff Plantation. Working out of our Augusta, Georgia location, Dr. Jacobs is nationally recognized for his expertise in addiction and pain disorders treatment.

Get Help Now

If you or someone you know would benefit from our mental and physical examination for nurses, please call us for a free, confidential assessment.

Call 1(844) 646-9313 to speak to a RiverMend Health Centers of Georgia addiction expert. Our compassionate, friendly staff will guide you through the next steps, schedule the evaluation and explain more about how we work with nurses, licensing boards and employers to get nurses into treatment if needed and back to work.


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