Helping the helpers: Incidence of drug use among healthcare professionals

Naeem Aslam

National Institute of Psychology, Quaid-i-Azam University, Islamabad

0322 5120866:

Key words: Substance misuse; Addiction

Citation: Aslam N. Helping the Helpers: Incidence of Drug Use among Health Care Professionals (Correspondence). Anaesth Pain & Intensive Care 2014; 18(4):470-71


Drug addiction in Pakistan is one of the major causes for concern. It is not only prevalent in general population but also among individuals associated with medical profession; for example nurses, nurse anesthetists and anesthesiologists.1 The prevalence of substance abuse in the nurse population is believed to be parallel to that in the general population (which is approximately 10%).2 Current estimates place rates of substance misuse, abuse and dependence rates as high as 20% among practicing nurses. The American Nurses Association estimates that 10% to 20% of nurses have drug abuse problems and that 6% to 8% of registered nurses are debilitated due to their abuse of alcohol and other drugs. Nurses had the higher ratio of abusing benzodiazepines as compared to pharmacists.3 A survey among health professionals reported frequency of substance abuse among anesthesia personnel to be 1.0% among faculty members and 1.6% among residents.4 The most common drug abused by anesthesiologists is opioids such as fentanyl and sufentenil and ketamine.4,5 Overall, health care professionals endorsed opioids twice as often as alcohol as a preferred substance. Family history of addiction, sex, and psychiatric problems are some other factors among healthcare professionals.3

A large number of empirical studies have been conducted in western countries. However, there is dearth of literature and there are hardly any empirical studies about the drug use in medical and paramedical staff in Pakistan. Drug use may be associated with numerous health problems,such as, skin-related problems, abscesses and leg ulcers which eventually prompt to long-term health problems. The reasons for this use include the ease of drug availability, stressful environment,1 curiosity, peer pressureand recreational use. The drug use persists due to craving. In a case study of an OR technician, he with four of his colleagues used heroin in injectable form. He revealed that Avil™, dexamethasone, Kinz™ (nalbuphine), Dormicum™ (midazolam), and ketamine, are more abused drugs among nurses and staff associated with operating rooms. He also shared that he would procure vials of ketamine from prescription of patients.

Early identification and control of the chemically dependent healthcare professionals is important for the safety of the public and for the well-being of the profession. The most frequently reported prevention strategy is wellness promotion education6.The role of paramedical staff is important in recognizing, reporting, and preventing substance abuse and the anesthesia provider requires a high level of awareness and constant vigilance. Many territories and countries throughout the world now offer confidential, non-punitive assistance for nurses suffering from addictions.7 Fear of punishment and disciplinary action may keep them from seeking help for themselves or from reporting a colleague or friend who is in need of help.  Education is an important part of prevention, and medical and nursing school curricula ought to cover topics relating to substance abuse among the profession.


  1. Bryson EO, Silverstein JH. Addiction and substance abuse in anesthesiology.  Anesthesiology. 2008; 109:905–17.[PubMed][Free Full Text]
  2. Griffith J.Substance abuse disorders in nurses. AORN J. 2005 Oct; 82(4):573-82.[PubMed]
  3. Rojas JI, Jeon-Slaughter H, Brand M, Koos E. Substance abuse patterns and psychiatric symptomatology among three healthcare provider groups evaluated in an out-patient program for impaired healthcare professionals. Journal of addictive diseases. 2013; 32(1):99-107. Epub 2013/03/14.[PubMed][Free Full Text]
  4. Booth JV, Grossman D, Moore J, Lineberger C, Reynolds JD, Reves JG, et al. Substance abuse among physicians: A survey of academic anesthesiology programs. Anesth Analg. 2002; 95:1024–30. [PubMed] [Free Full Text]
  5. Kintz P, Villain M, Dumestre V, Cirimele V. Evidence of addiction by anesthesiologists as documented by hair analysis. Forensic Sci Int. 2005; 153:81–4.[PubMed]
  6. Bozimowski G, Groh C, Rouen P, Dosch M. The prevalence and patterns of substance abuse among nurse anesthesia students. AANA journal. 2014; 82(4):277-83. Epub 2014/08/30.[PubMed]
  7. Monroe T, Kenaga H. Don’t ask don’t tell: substance abuse and addiction among nurses. Journal of clinical nursing. 2011; 20(3-4):504-9. Epub 2010/11/03.[PubMed]