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Substance Abuse Among Nurses

admin — Sun, 20 Mar 2011 03:24:49 +0000

Brent McNutt asked:

Introduction

Substance abuse among nurses has not fully documented, but it is estimated that about 10% of the current nursing population is addicted to drugs and/or alcohol, with about 6-8% of those having a serious enough problem that it interferes with job performance.

Specifically, nurses as a population seem to be prone to addiction to prescription medications more than to alcohol or illicit drugs, as compared to the rest of the population. This may be due to the fact that they have easier access to prescription medications than does the general population. It’s also heartening to note that once in treatment, nurses are much more likely to remain sober and to avoid relapse or return to abuse than the general population is.

What causes substance abuse among nurses?

As a population, nurses tend to be highly caring individuals who have chosen to devote their lives to others in a caretaking role. Unfortunately, however, nurses who abuse drugs and/or alcohol seem to come from families that have had significant emotional turmoil, resulting in low self-esteem, and a struggle to “make things better” by becoming an overachiever and falling into unhealthy caretaking roles of other troubled family members (such as “taking care of” alcoholic parents, as one example). As an illustration of this, one study has shown that up to 80% of nurses come from families with at least one alcoholic member.

The fact that these individuals are already highly sensitive individuals who care deeply about the needs of others and who are vulnerable to falling into caretaking roles, whether healthy or unhealthy, draws them to the nursing profession. However, with this type of background, it also makes them vulnerable to substance abuse themselves. They see substance-abuse behavior (such as drinking to excess) as somehow normal, since that’s what they’ve grown up with, and they have become used to enabling this behavior by ignoring it, minimizing it, or even participating in it. And again, certainly, they may very well “take care of” addicted family members suffering from the symptoms and consequences of their illnesses.

Environmental factors on the job

Environmental factors on the job may well start an active addiction or exacerbate it. The health care profession is unique because it creates a particularly conducive environment to addiction. As may also be true of other professions, nursing has very stressful working environment, and long workdays. However, nursing has other pressures and factors other nonmedical professions may not have. As death and illness are often ever present, this is emotionally difficult to deal with, and the recent work environment is one of mandatory overtime, incredibly stressful work shifts, and the necessity to switch shift times often so that one can never quite get into a rhythm of working a regular schedule. Nursing also has an added disadvantage to drug addiction not present in other non-healthcare professions, because prescription medications are readily available on the job site and as part of the job itself.

Indeed, one of nursing’s duties is to dispense medication to patients; medications are also seen in the nursing culture as a way to cure ills very legitimately. All of these factors can make it very easy for someone in the nursing profession to become an addict if the propensity is there. And because nurses are so familiar with drugs, they may think (erroneously) that their expertise gives them the ability to self medicate without becoming addicted.

Ways the medical profession is dealing with addiction in nursing

Nurses are legally and ethically required to report colleagues they suspect may have an abuse problem. This is necessary for a number of reasons. First among them, of course, patients are entitled to proper and “sober” care by the medical health profession, and they are entitled to receive the full and proper dosage of the medications they need to manage their own pain and cure their own ills. (Nurses who abuse drugs often “short” patient dosages and then give themselves the excess.) Second, nurses who are under the influence may make mistakes that are life threatening if not fatal. And third, of course, is that the abuser needs help and intervention to save his or her own life.

Although still a problem to some extent, administrators and other officials are increasingly NOT turning a blind eye to the problems of abuse and are getting them addressed. This is contrary to previous nursing culture, which often had an unspoken “don’t talk” rule when it came to notifying others about drug abusing colleagues’ behavior.

Finally, drugs themselves are much more carefully kept track of and monitored than they were previously. Most often, they’re kept under lock and key and strict records are maintained so that if any shortages should occur, they are immediately noticed and the reason for the shortage is found. If it is because someone on the nursing staff has been taking it for his or her own use, measures are put in place to address the problem through intervention and help, and if necessary to remove the nurse from his or her job.

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Am I A Drunk?

admin — Sat, 27 Nov 2010 17:21:42 +0000

Trevor Kugler asked:

For years and years, I used to ask this question to myself. I wondered if I was a drunk. Every morning, I would get in the shower, and during the course of that shower I wondered to myself if I drank too much. After all, I drank everyday, and waking up in the morning, I normally felt as if I had been hit by a truck. So was I a drunk? I don’t know, probably, but I did come to the conclusion that I most certainly drank too much.

I’ve heard addiction described as: never getting enough of that which you don’t want in the first place. It’s probably the best definition that I’ve ever heard of addiction, and it fit me to a tee. At the end of the day, I didn’t really want to drink and I surely didn’t want to wake up most days feeling as if I had been hit by a truck. In my case, I was most certainly caught in the vicious cycle of that definition. I was never getting enough of that which I didn’t want in the first place. So I began to “cut down”.

Through doing this I soon realized how stupid this was. Cutting down? My philosophy has always been that you either do something or you don’t, but whatever you choose, just do it. Don’t complain, don’t bitch, just do it. So I did what I wanted to do for quite a long time…..I walked away from alcohol forever. Did I go to meetings? Or substitute some other form of “medication”? Nope. I just walked away and it was the single best decision that I’ve ever made. The world seems so much clearer now, imagine that! I’m able to get so much more accomplished in a twenty four hour period that it seems kind of sickening that I haven’t accomplished more in my life. It literally feels as if I’ve been given a new life.

So how much did I actually drink and for how long? I drank for the better part of 15 years. The last 10 of those years drinking was an every day occurrence. And as to the question o how much I drank, I obviously didn’t keep a running count, but I could buy an 18-pack of beer and drink it by myself without a problem. The average had to be a 12-pack a day.

So if you ask yourself the question posed in this article, as I did for so long, it’s probably worth answering. And if you’re asking yourself the question, the answer is probably yes, as it was with me. Don’t be like me and assume that it’s not possible, because you’re on time for work everyday and a responsible citizen. All this denial does is waste time that you could actually be enjoying your life, which incidentally is the path I chose….To waste 15 years before coming to these conclusions.

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Tramadol (ultram) and Gelonida – Potent Painkillers

admin — Thu, 12 Nov 2009 07:25:02 +0000

Tramadol (Ultram) is prescribed to relieve moderate to moderately severe pain, to treat pain caused by surgery and chronic conditions such as cancer or joint pain. It works by decreasing the body’s sense of pain.

Gelonida is a narcotic analgesic used to treat or prevent moderate to severe pain.

* Most important fact about Tramadol (Ultram)

You should not drive a car, operate machinery, or perform any other potentially hazardous activities until you know how Tramadol Ultram affects you.

It’s important to take Tramadol exactly as prescribed. Do not increase the dosage or length of time you take Ultram without your doctor’s approval.

Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Ultram.

Side effects may include:

Agitation, anxiety, bloating and gas, constipation, convulsive movements, diarrhea, dizziness, drowsiness, dry mouth, feeling of elation, hallucinations, headache, indigestion, itching, nausea, nervousness, sweating, tremor, vomiting, weakness.

Avoid Tramadol Ultram if it has ever given you an allergic reaction. Also avoid Tramadol Ultram after taking large doses of sleeping pills such as Halcion, Dalmane, and Restoril; narcotic pain relievers such as Demerol, morphine, Darvon, and Percocet; or psychotherapeutic drugs such as antidepressants and tranquilizers. And do not take Tramadol Ultram after drinking excessive amounts of alcohol.

If you have stomach problems such as an ulcer, make sure your doctor is aware of them. Tramadol Ultram may hide the symptoms, making them difficult to diagnose and treat.

Tramadol Ultram can cause mental and physical addiction. If you’ve ever had a problem with narcotic painkillers such as Percocet, Demerol, or morphine, you should avoid Tramadol Ultram. Withdrawal symptoms may occur if you stop taking Tramadol Ultram abruptly. Such symptoms include anxiety, sweating, insomnia, pain, nausea, tremor, diarrhea, and respiratory problems. A gradual decrease in dosage will help prevent these symptoms.

Do not take more than the recommended dose of Tramadol Ultram, since larger doses have been known to cause seizures, especially if you have epilepsy or are taking medications that also increase the risk of seizures. Among such medications are almost all antidepressant drugs, plus narcotics and major tranquilizers such as Loxitane and Stelazine.

If you have liver or kidney disease, be sure your doctor knows about it. Your dosage may have to be reduced.

Before you have any kind of surgery, make sure the doctor knows you are taking Tramadol Ultram.

If you have any kind of breathing problem, use Tramadol Ultram with caution or take a different kind of painkiller. Tramadol Ultram can impair respiration, especially if taken with alcohol.

If you have experienced a head injury, consult your doctor before taking Tramadol Ultram. The medication’s effects may be stronger and could hide warning signs of serious trouble.

Tramadol Ultram may increase the drowsiness caused by alcohol. Do not drink alcohol while taking Tramadol Ultram.

There have been reports of serious harm to developing babies when Tramadol Ultram was used during pregnancy. If you are pregnant or plan to become pregnant, tell your doctor immediately.

Tramadol Ultram appears in breast milk and may affect a nursing infant. If Tramadol Ultram is essential to your health, your doctor may advise you to discontinue breastfeeding until your treatment is finished.

Avoid Tramadol Ultram, too, if you are taking the seizure medication Tegretol.

Symptoms of Ultram overdose include:

Difficult or slowed breathing, drowsiness, coma, seizures, cardiac arrest. Tramadol can be habit-forming. Do not take a larger dose, take it more often, or take it for a longer period of time than prescribed by your doctor.

***** Gelonida *****

Gelonida – generic name is parecoxib sodium. It is used to treat or prevent moderate to severe pain.

* Side effects

That may go away during treatment, include drowsiness, dizziness, constipation, or nausea. If they continue or are bothersome, check with your doctor.

Check with your doctor if you experience vomiting, skin rash, itching, slowed or difficult breathing, difficulty urinating, or fainting.

Don’t take this drug if you are also taking Quinidine. Inform your doctor of any other medical conditions, allergies, pregnancy, or breast-feeding.

If overdose is suspected, contact your local poison control center or emergency room immediately. Symptoms of overdose may include cold and clammy skin, slowed breathing, slowed heartbeat, drowsiness, dizziness, lightheadedness, deep sleep, and loss of consciousness.

Avoid alcohol while you are using this drug. This drug will add to the effects of alcohol and other depressants.

Don’t drive, don’t operate machinery until you know how you react to this medicine? Using this medicine alone, with other medicines, or with alcohol may lessen your ability to drive or to perform other potentially dangerous tasks.

Don’t take this drug if you have had a severe allrgic reaction to Codeine, Hydrocodone, Dihydrocodeine, or Oxycodone (such as Tylox, Tylenol with Codeine, Vicodin).

A severe allergic reaction includes a severe rash, hives, breathing difficulties, or dizziness.

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How Do Diet, Medications, and Alcohol Affect Breastfeeding?

admin — Mon, 28 Apr 2008 03:35:16 +0000

Food
If you are eating a balanced diet, you shouldn’t have to deny yourself the foods you like. However, if you notice that your baby reacts badly after you have eaten something it may be best to leave that food out of your diet for a few days then try again to see if you get the same reaction. Because peanut allergies are a big problem in later life, some are suggesting that you avoid heavy consumption of peanuts/peanut butter while breastfeeding.

Preventing rapid weight loss
Breastfeeding burns up a lot of energy, and can actually help a woman “get her body back” quicker. However, some women will need to eat extra snacks to prevent rapid weight loss. Most experts agree that a woman should up her daily caloric intake approximately 600 calories while breastfeeding to insure that she is getting all of the necessary nutrients.

Note to Vegetarian mothers
A vegetarian diet can meet the nutritional needs of a breastfeeding mother as long as it includes a variety of foods and adequate calories, including:

Legumes
Eggs, milk, cheese and yoghurt
Wholegrain breads and cereals
Fresh fruit and vegetables.

Drinks (Alcoholic and Non-Alcoholic)
Milk is a wonderful source of calcium, vitamins, and minerals. If you have a hard time digesting milk, don’t worry. It doesn’t take milk to make milk; but, you need to be sure that you are getting plenty of water, fruit juices and other liquids as well as a good source of calcium.

Occasional alcohol intake while breastfeeding can be acceptable. Typically, alcohol intake should be not exceed 8 ounces of wine, 2 ounces of spirits, or 2 regular-sized beers in a 24-hour period.

Caffeine
Though dietary caffeine appears in breast milk, nursing mothers can safely consume small amounts of caffeine without passing on a significant amount to the baby. Higher caffeine amounts could potentially cause problems such as poor sleeping, nervousness, irritability, and poor feeding, so limiting your caffeine intake makes sense.

Caffeine tends to build up in babies’ systems because their bodies cannot get rid of it very easily. Try using decaffeinated coffee and tea, and avoid colas and other carbonated drinks that have added caffeine. The American Academy of Pediatrics recommends that nursing women limit consumption to the caffeine equivalent of 1 to 3 cups of coffee per day.
Smoking

The mother who smokes
Smoking, especially while breastfeeding, is dangerous. Nicotine is present in breast milk and will easily be transferred to baby. For your health, as well as the health of your baby, quit smoking.

Second hand smoke
All babies need a smoke-free environment no matter how they are fed. Secondhand smoke is dangerous to all children, but especially to newborns. Among other things, it increases the risk of Sudden Infant Death Syndrome (SIDS). Insist that smokers in your household smoke outside or far away from your baby.

Drugs/Medication
Take no chances. Discuss all medications with your health care professional. While most medications are safe to take during breastfeeding, there are a few that can be dangerous for the baby. It helps, however, to take the medication just after you nurse rather than just before. Most over-the-counter medications are compatible with breastfeeding, but play it safe by consulting a trusted health care professional.

Read more here about medicines during pregnancy.

Breastfeeding No-No’s
There are very few reasons a health care professional would advise against breastfeeding, but there are some situations when bottle feeding must be seriously considered.

Breast implants or breast reduction surgery: Women who have these surgeries should be counseled at the time of the surgery that these procedures may interfere with their ability to produce milk or deliver the milk to the nipple. Women who have had these procedures should certainly try to breastfeed.

If you are infected with HIV or have active tuberculosis that is not being treated; have herpes with active lesions on your breasts; take illegal drugs; are addicted to prescription narcotics or have an untreated breast abscess, you must receive treatment and special counseling.

Mothers with primary herpes with active lesions (not on their breast) should discuss with their health care provider whether or not they should breastfeed.

Women with Hepatitis C should understand that it is theoretically possible to pass the infection to their infant while breastfeeding, although this has not been documented and maternal Hepatitis C infection is not considered to be a contraindication to breastfeeding.

However, women with Hepatitis B infection can breastfeed if their newborn has received the appropriate vaccine within 12 hours of birth.

Scheduled for surgery? Most moms will be counseled to store breast milk prior to surgery, pump and discard breast milk for a few days, then resume breastfeeding.