Page 531 - Encyclopedia of Nursing Research

498 n SUBSTAnCe USe DISORDeRS In RegISTeReD nURSeS

and other opiates—which were nurses and mansfield compared 920 nurses with
(32.9%) and controls (31.5%). other female employees and found low use
S Anecdotal and survey findings in levels for illicit drugs and alcohol in all sub-
the 1980s sought the etiology of addiction jects. nurses had the lowest prevalence of
in nurses in small, convenience samples. smoking and 79% of them reported moderate
Although critical to motivating further alcohol use. The nurses’ Worklife and health
research, they generally provided little reli- Study, an anonymous, national survey of a
able data. In Bissell and haberman’s (1984) stratified sample (78% response), reported
research about recovering nurses in an smoking rates of 14% and cocaine/marijuana
Alcoholics Anonymous sample, Bissell and use at 4%, lower than in the general popula-
Jones (1981), Sullivan, Bissell, and leffler tion; binge drinking rates were comparable
(1990), and Sullivan and hale (1987) described (Trinkoff & Storr, 1998a, 1998b).
the characteristics of recovering nurses, seek- This study was the most comprehen-
ing to identify the nature and outcomes of sive in validating higher prescription drug
their dependence. newer theoretical and use rates for nurses. The prevalence of past-
scientific findings on the heritability, genetic year substance use for all substances was
and environmental etiologies, pathophysiol- 41%; for marijuana/cocaine, 4%; prescription
ogies, and responses to addiction treatment drugs, 7%; cigarette smoking, 14%; and binge
support their observations of addiction as a drinking, 16%. male nurses were more likely
complex, chronic, and treatable medical ill- to misuse prescription drugs, with opiates
ness (mclellan, lewis, O’Brien, & Kleber, abused most frequently (60.3%) followed by
2000). There is now strong scientific evidence tranquilizers (44.6%). The findings support
that the same factors that predispose the the link between ease of workplace access
general population to addiction also predis- and higher rates of prescription drug abuse
pose nurses. These include family history of and provided direction for further analyses
substance abuse, stress and trauma, or sex- of substance use by nursing specialty.
ual and/or emotional abuse, some of which The investigations of Trinkoff, geiger-
were noted in the above reports. Research by Brown, Brady, lipscomb, and muntaner
Burns (1998) and hutchinson (1986) mapped (2006) and Trinkoff and geiger-Brown (2010)
the trajectories of recovery for nurses with of workplace factors contributing to sub-
an eye toward understanding the origins of stance dependence continued on observed
their disorders. differences in substance use across spe-
professional risk factors for substance cialties providing statistical insights. later
use in nurses first emerged in the work of analyses suggest that nurses in certain spe-
haack’s (1988) on stress in nursing students. cialties were more likely to use substances.
Although recognizing that stress does not It was reported that critical care and emer-
precipitate substance dependence on drugs, gency nurses had higher rates of marijuana
a research trend has continued on work- or cocaine use, oncology nurses had higher
place and occupational factors that can pose rates of binge drinking, and psychiatric,
challenges in coping for practitioners with gerontology, and emergency nurses had the
established alcohol, tobacco, and other drug highest rates of smoking. little evidence
use patterns. Blazer and mansfield’s (1995) exists to support an increased prevalence of
randomized descriptive survey (N = 1,525) substance dependence among nurse anes-
and the nurses’ Work life and health Study thetists, although 10% of Certified Registered
(4,438 registered nurses) both explored how nurse Anesthetists in a small survey admit-
workplace factors, including stress, might ted to diverting controlled substances (Bell,
contribute to substance use and abuse. Blazer 2006, as cited in Wilson & Compton, 2009).