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programs Introduction There is limited data on the prevalence of impairment in the workplace; however, this issue has existed for decades. It is surmised that the prevalence of substance abuse in the workplace is the same as the prevalence in the public arena. Much of the reported data is from the early 2000s. Despite the lack of data, impairment of healthcare personnel threatens the health and well-being of the impaired healthcare worker, places colleagues at risk, compromises the integrity of the nursing profession, produces financial burdens on employers, and most importantly endangers the patients under the impaired healthcare worker’s care (Bostic, 2017). The American Nursing Association (ANA) estimates that 1 in 10 nurses suffer from substance abuse (DrugRehab.com, 2015). Throughout this course impairment and substance use disorder (SUD) will be used interchangeably. Statistics In a recent research study by Cares, Pace, Denious, and Crane, 2014, showed that nearly half of the 302 respondents reported substance abuse, 40% indicated that the substance abuse affected their competence, 2/3rds felt that their problem could have been recognized earlier, and the most indicated barriers to seeking assistance included fear and embarrassment and concerns about losing one's nursing license. Did You Know? Although the nursing profession is comprised of 97% women, male nurses represent the higher rate of substance abuse (DrugRehab.com, 2015). Workplace Impairment Costs Substance use disorders in healthcare results in billions of dollars in cost related to crime, lost productivity, and treatment. The following table shows a breakdown of the nearly $750 billion annual cost of substance abuse. Health Care Overall Year Estimate Based On Tobacco $168 billion $300 billion 2010 Alcohol $27 billion $249 billion 2010 Illicit Drugs $11 billion $193 billion 2007 Prescription Opioids $26 billion $78.5 billion 2013 Table courtesy of the National Institute on Drug Abuse, 2017 Material Protected by Copyright Besides the costs associated with impairment, impairment from substance use disorders, drug diversion, or other physical or psychological causes has far-reaching impact. It not only threatens the health and safety of patients but also creates serious consequences for the impaired professional, colleagues, and the healthcare facility that employs the impaired nurse. The following table depicts some of the potential consequences of healthcare worker impairment. Impacted Party Possible Consequences Patients • Victim of medical errors • Loss of trust in healthcare system • Undue pain, anxiety, and side effects from improper dosing • Allergic reaction to wrongly substituted drug • Communicable infection from contaminated drug or needle Colleagues • At risk for medico-legal liability secondary to shared patient-care responsibilities, resulting in adverse patient outcomes • Stress resulting from increased workload • Disciplinary action for false witness of leftover drugs disposal • Disciplinary action for failure to report an impaired professional Impaired Worker • Chronic adverse health effects • Communicable infections • Accidents resulting in physical harm • Familial and financial difficulties • Loss of social status • Decline in work performance and professional instability • Felony prosecution, incarceration, civil malpractice • Actions against professional license • Billing or insurance fraud Facility • Costly investigations • Loss of revenue from diverted drugs • Poor work quality or absenteeism • Civil liability for failure to prevent, recognize, or address signs of impairment or drug diversion • Civil liability for patient harm • Damaged reputation due to public knowledge Material Protected by Copyright • Increased Workers’ Compensation costs (Berge, Dillon, Sikkink, Taylor, & Lanier, 2012, & New, 2014) Definition The National Institute on Drug Abuse, 2016, defines addiction as a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences. It is considered a brain disease because drugs change the brain; they change its structure and how it works. These brain changes can be long lasting and can lead to many harmful, often