The pill-popping habits of TV’s Nurse Jackie may amuse audiences, but picture the real-life paramedic who pockets the morphine and shoots you up with saline as you lie there writhing in pain. He doesn’t care about your bone-crushing accident. His mind is focused on his next fix.
As implausible as it sounds, health care workers routinely steal patients’ drugs, says New York anesthesiologist Dr. Ethan Bryson. The horrifying case studies in Bryson’s new book, Addicted Healers: 5 Key Signs Your Healthcare Professional May be Drug Impaired, are designed to help patients, colleagues and family members identify addicts and get them to rehab.
“There is a myth in our society that the people who choose to become doctors, nurses and other health care workers are somehow different from everyone else,” Bryson said in a phone interview from the Mount Sinai School of Medicine where he is an associate professor in anesthesiology and psychiatry. “We come to our profession with the same propensity for addiction as the general population.” In fact, he estimates 12 to 15 per cent are addicts. “Because they have access—and because there’s this false thought that because they’re medicines, they’re somehow safer—they are more likely to become addicted to prescription drugs, and when they do, the consequences are severe.”
Bryson interviewed one anesthesiologist who rigged up an intravenous line in his leg before surgery. “I taped the catheter so the injection port was just below the top of the boots I wore. All I had to do was reach down like I was pulling up my socks and inject a little fentanyl [from a needle] and I was good to go. Every time I gave some to a patient, I split the dose so we both got some,” he told Bryson. “That’s how it started out, but it wasn’t long, maybe a month, before I was using so much that I needed to keep all the fentanyl to myself.” Imagine waking up from surgery with no pain medication, suggests Bryson, who says the shock could cause a heart attack.
If you suspect a nurse or doctor is stealing drugs from you, speak to the hospital’s patient advocate. “If you think your pain is not being treated properly, you or your family member can go to this person who will advocate for you to get the pain medication.”
In some cases, an addict’s drug-seeking behaviour steers them toward a career in health care, as in the case of Kristen Parker, a former heroin junkie with hepatitis C who became a surgical technician in Denver. Parker also injected herself with fentanyl, a drug said to be 100 times more powerful than morphine, then filled the empty syringes with saline. The needles were used on patients in surgery; Parker exposed more than 6,000 people and infected 36 with the hepatitis C virus. In 2010 she was sentenced to 30 years in prison.
Bryson says colleagues are often in denial. “You make excuses for them.” He remembers one resident, pale and sweaty, asking to work an extra shift. “He looked like he had the flu,” said Bryson, who let him stay because he was short-handed. Two hours later, after his next fix, he was in no condition to work.
Some addicts turn to drugs to make them more productive. Propofol, the drug that killed Michael Jackson, induces unconsciousness that lasts about 10 minutes but leaves users feeling refreshed and euphoric when they wake up, so much so that some call it “pro-napping.” The problem is it’s difficult to self-administer. One doctor told Bryson he did a face plant in the operating room after a dose miscalculation. “I just slid forward off my chair and wound up flat on the floor. There was blood everywhere. I had a bloody nose and the IV I had placed in my arm had become disconnected, so blood was leaking out of that as well. I could have easily died, but I didn’t. When I woke up, I felt great. I loved the oblivion. I couldn’t get enough.”
Bryson believes random drug testing should be mandatory for health care workers. “I think it’s mind-boggling that I can walk into the Home Depot with my 12-year-old son and feel confident that the person who operates the forklift in this working warehouse is not on drugs. But we walk into the hospitals and they don’t have policies which require random testing.”