Empowering Nurses at the Bedside and in Business

Nurses Use Of Controlled Substances

What is the first thing that a physician orders when you work night shift and have trouble sleeping during the day?  The physician orders Ambien!

Maybe you’ve been working long hours; walking the hard floors of a hospital and it’s taking a toll on your back and other joints.  If you have pain, which cannot be controlled by non-steroidal anti-inflammatories, the physician prescribes hydrocodone!

Now, if you were then asked to take a drug screen, the hospitals are usually okay with positive results if you have a valid prescription for the medication.  However, if you don’t have a proper prescription … watch out!

And unexplained positive result on urinalysis can result in a referral to the State Board of Nursing.  For example, if you took an old prescription of hydrocodone for pain, that could be a problem if that medication was not prescribed for that use.

Should you take a hydrocodone from a friend or family member, that is also a problem as it is considered diversion: taking someone else’s prescribed medication for your own use.

As nurses, we are responsible for what we put in our bodies.  If we are taking someone else’s prescription, that amounts to practicing medicine without a license.

Now, if the controlled substances you take are properly prescribed and you are referred to the Licensing Board, some of those Boards do have concerns about nurses being on controlled substances for chronic problems.

For example, where I live, the Indiana State Nurses Assistance Program (ISNAP) is an abstinence-based program.  If you are required to participate in this program, you will not be allowed to take any controlled substances even if you have a valid prescription from your Physician.

What if you are taking Adderall and you’ve tried everything else to help you concentrate and focus on your job as a scrub nurse?  At least in Indiana, by regulation of the Indiana State Board of Nursing, you would not be allowed to continue in ISNAP and take Adderall.

What if you have narcolepsy and take Provigil?  Since Provigil is a controlled substance and, if you are in ISNAP, you would not be allowed to continue with that medication.

In Indiana, the Board, the Attorney General’s office and the ISNAP can access your INSPECT report to determine whether you have been properly prescribed any controlled substances.  This may also be true in other states.  So much for privacy …

If you have been taking controlled substances for a considerable period of time, I strongly suggest that you find ways to deal with the medical issue without taking those controlled substances.  The reason the substances are controlled in the first place is because there is a probability for addiction and potential abuse.

It certainly is not the Board’s job to usurp your medical care but they do have the right to license nurses.  If the Board has any concern that you’re taking controlled substances for a long period of time, they may consider that as impairment.

If you don’t need controlled substances, the best advice is to avoid taking them.



  1. anonymous

    Two points I’d like to make.
    First, you state “The reason the substances are controlled in the first place is because there is a probability for addiction and potential abuse.

    You should say “…there is a POSSIBILITY for addiction….” Not “…probability…”

    Secondly, it seems the overall point of the article is to tell us to protect ourselves from the board, because the board can make life changing decisions based on things they have very little information on (why I take a med) and pretty much zero idea if it impacts my work at all (unless there is an administrative action that has been taken). So, a different way of saying what you seemed to making a point about is, if you’ve been taking a pain med for a long time and haven’t really investigated if there was another way of dealing with the pain, if would be a good idea, because the boards have a lot of power that you may not even realize.

    You’ve only touched on one area were they have too much power. . A nurse gets a “driving under the influence” ticket 12 yrs previously. No injuries. On their day off. Satisfied all court and DMV mandated sentencing and penalties 9 yrs ago. Has been sober since. Then, the board finds out about it after 12 yrs, and puts the nurse on monitored probation (weekly AA meetings, weekly nurses group meetings, drug testing twice a month (at $155 a pop), quarterly reports that have to filed by any of their doctors for any meds they take, and reimbursement of investigation costs of $3400.

    Because its public record, now many many people can find out about it (far more than would notice just from the 12 yr old court records) than would have otherwise, including everybody up the chain in the company she works for because the board also requires quarterly evaluation reports by them as well!

    All for something that happened 12 yrs ago, had nothing to do with their work, and after satisfying everything the courts and DMV asked of them. I’d say the board has a bit too much power, don’t you?

  2. Sober Nurse

    I agree, the BON has way too much control, the privacy of my medical and mental health history is my personal information. You can be entered for any reason under the sun it seems. The truth is that both times i entered in voluntarily (which is not really voluntary at all you are under extreme duress and compulsion to participate). You can basically choose not to incriminate yourself or the board will susepend you 90 days until they complete their investigation–but who honestly on this earth has enough money set aside to not work for 3 months without STD, LTD, unemployment, or disability?? Certainly not me. I was even encouraged by my IOP councelor to re-write a believable misuse statement because the board would not believe that I was only taking my own prescriptions and that was why i went to rehab (to get off of my pain management medications after being on them for several months). Im currently involve in my own state because of my Post partum depression. My employer requested that i report to nursing board, and because of that the PHMP sent a letter stating that i needed to present for evaluation. i could not afford to be stuspended for 90 days pending their investigation so i had to enroll in order to receive short term disability while it took them 9 months to sign a contract, i will have served over 4 years by the time it is all said and done. its a horrible bullshit system that is really not impunative at all–the whole system is dirived at embarrassing and publicly shaming the involved party. my employer drug tested me, and i passed and then reported me to the board for evaluation when i passed a drug test–now im in the program… and they fired me after making it part of my employment conditions to enroll…tell me how thats an alternative to discipline?

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