Healthcare professionals are supposed to follow the highest ethical standards. However, the global wave of drug abuse leaves no sector of society unscathed, particularly in America. USA Today reports that more than 100,000 people who work in healthcare are abusing or addicted to prescription medication. Often the cause is the deep stress their occupations place upon them – and they don’t have the very support systems that their patients often fall back on.
Hepatitis spread among patients by addicted technician
These issues are difficult to notice because no one is tasked with watching healthcare professionals, and their knowledge of the system allows them to take advantage of it much more easily than anyone else. When they do get away with serial crimes, the repercussions can be tragically enormous. One example is the story of David Kwiatkowski, a hospital technician who routinely injected himself with patients’ pain medication and refilled the syringes with saline. He had hepatitis, and at least 46 patients caught it from his contaminated needles. 8,000 had to be tested in various states because Kwiatkowski had no long-term position in a single hospital: he was itinerant.
Similar situations developed in two American cities, making three such incidents in the past eight years. But as USA Today points out, most of the crimes of this nature are never spotted or officially recorded. What this means is that the approximate figure of 100,000 abusers per year (reported in 2007) is too low, and 1 in 10 practitioners will abuse drugs or alcohol at some point.
Who’s checking on the professionals?
The current system makes it far too easy for them to start and continue this abuse without interference. There are no standard drug-testing rules for healthcare professionals, and most institutions don’t test their own workers. Video surveillance and modern methods of tracking drugs are rarely used. Moreover, states don’t generally require institutions to report offenders to the police, so the transgressors simply get fired and move on to other jobs.
Addicted doctor escapes detection
Dr. Stephen Loyd dealt with work-related stress by stealing pain relievers until he developed an addiction that needed 100 pills each day to satisfy it. None of his patients or coworkers noticed he had a problem or that medication was missing. Loyd says that his work suffered: he cancelled appointments, avoided administrative work and checked patients at strange hours. He’s now free of addiction and working, thanks to a dedicated rehab program for healthcare professionals that can allow them to keep their careers as long as they are supervised – if they enrolled in the program of their own free will. Still, those who finish such programs don’t normally have disciplinary action taken against them and thus have no official record of their transgression. And the numbers who do enroll, voluntarily or not, are far below the probable rates of abusers within the field.
Virginia nurses suffer high addiction rates
The State of Virginia is one place that has seen worryingly high levels of drug abuse among nurses. The News Leader investigation found that 900 nurses were disciplined for drug abuse in less than seven years. One of them, Bonnie Zientek, had been stealing drugs for years before she was reported to the state nursing board. She was ordered into rehab but then continued to take drugs in a new job and even resorted to stealing from patients in a place she had been fired from. The board knew she was addicted but never revoked her license during the years in question.
A system not made to deal with the problem
Another problem is the lack of accountability among employers, who are not usually punished for failing to report abuse among employees. They are also reluctant to admit or discuss these problems, and the top state hospitals would not comment to the News Leader.
Kwiatkowski’s situation shows how wide the gaps in the system are. He was actually fired, disciplined by a state board, and checked up on by police. His drug addiction was clear to his colleagues, but there was no unified system to ensure he wouldn’t work again after his first offense – or at least enter rehab. This meant that his latest employer might never have known what happened in his previous position. Only an outbreak of hepatitis C among patients ended his career and sent him to jail for four decades.
Identify offenders and protect patients
It’s clear that there are two main aspects to this tragedy: the lack of surveillance and identification of troubled healthcare workers, and the disordered state of rehab programs and disciplinary actions. The first and immediate goal of any responsible medical board should be to implement firm guidelines for monitoring doctors and nurses, regardless of whether they have obvious problems. Once they’re identified, they have to be dealt with consistently and firmly so that patients’ rights are protected first. At the same time, the offenders should have every chance to resume their careers if they clear each hurdle. However, as long as there’s high stress in the hospital, there will be stressed-out professionals.