The Anesthetic Agent Substance Abusing Provider

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Transcript The Anesthetic Agent Substance Abusing Provider

The Anesthetic Agent Substance
Abusing Provider
Poonam Agarwal, RN, BSN, SRNA
Valentyna Groelle, RN, BSN, SRNA
York College of Pennsylvania
Nurse Anesthetist Program
Objectives
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Discuss statistics and risk factors for anesthetic
agent and substance abuse among Nurse
Anesthetists and Anesthesiologists.
Identify currently abused anesthetic agents, in
addition to patterns of behavior of the addicted
provider.
Discuss legal issues regarding reporting impaired
provider.
Examine current treatment and recovery
programs, as well as options for reentry into the
workforce.
Prevalence
Risk Factors
Factors Contributing to Development of
Chemical Dependency
Occupational
Factors
Neurobiological
Factors
Occupational
Exposure
Occupational Exposure
(Gold et al., 2006)
Occupational Exposure
(Gold et al., 2006)
Neurobiological Factors
Why Can’t Addicts Just Quit?
Non-Addicted Brain
Addicted Brain
Control
Control
Saliency
NO
Drive
GO
Memory
Saliency
Drive GO
Memory
Because Addiction Changes Brain Circuits
Adapted from Volkow et al., Neuropharmacology, 2004.
Most Commonly Abused
Substances
Propofol
Patterns of Behavior
Education and Prevention
Legal Issues
Legal Issues and Options
Treatment
Challenges of Reentry
Challenges of Reentry
Attitudes of Reentry
References
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Bryson, E. O., & Silverstein, J. H. (2008). Addiction and Substance Abuse in Anesthesiology. Anesthesiology, 109(5), 905917.
Collins, G. B., McAllister, M. S., Jensen, M., & Gooden, T. A. (2005). Chemical dependency treatment outcomes of
residents in anesthesiology: Results of a survey. Anesthesia and Analgesia, 101, 1457-1462.
Fitzsimmons, M. G., Baker, K. H., Lowenstein, E., & Zapol, W. M. (2008). Random drug testing to reduce the incidence of
addiction in anesthesia residents: Preliminary results from one program. Anesthesia and Analgesia, 107, 630-635.
Garcia-Guasch, R., Roige, J., & Padros, J. (2012). Substance Abuse in Anaesthetists. Anesthesiology, 25(2), 204-209.
Gold, M. S., Melker, R. J., Dennis, D. M., Morey, T. E., Bajpai, L. K., Pomm, R., & Frost-Pineda, K. (2006). Fentanyl Abuse
and Dependence: Further Evidence for Second Hand Exposure Hypothesis. Journal of Addictive Diseases, 25(1), 15-21.
Jungerman, F. S., Alves, H. N., Carmona, M. J., Conti, N. B., & Malbergier, A. (2012). Anesthetic Drug Abuse by
Anesthesiologists. Revista Brasilieira de Anestesiologia, 62(3), 375-386.
McHugh, M., Papastrat, K., & Ashton, K. C. (2011). Assisting the drug addicted nurse: Information for the legal nurse
consultant. Journal of Legal Nurse Consulting, 22(3), 11-14.
National Institute Of Drug Abuse (2008, July). Addiction Science: From Molecules to Managed Care. Retrieved February 1,
2013, from http://www.drugabuse.gov/publications/addiction-science/drug-use-changes-brain/exposure-to-some-drugsabuse-can-change-structure-neurons-in-brain
Quinlan, D. (2001). Peer Assistance: A Historical Perspective. Retrieved January 20, 2013, from
http://www.aana.com/peer/historical.asp
Skipper, G. E., Campbell, M. D., & DuPont, R. L. (2009). Anesthesiologists with substance use disorders: A 5-year
outcome study from 16 state physician health programs. Anesthesia and Analgesia, 109(3), 891-896.
Stocks, G. (2011). Abuse of Propofol by Anesthesia Providers: the Case for Re-Classification as a Control Substance.
Journal of Addictions Nursing, 22(1), 57-62.
Tetzlaff, J., Collins, G. B., Brown, D. L., Pollack, G., & Popa, D. (2010). A strategy to prevent substance abuse in an
academic anesthesiology department. Journal of Clinical Anesthesia, 22, 143-150.
Wilson, H., & Compton, M. (2009). Reentry of the addicted certified registered nurse anesthetist: A review of the
literature. Journal of Addictions Nursing, 20, 177-184.
Wright, E. L., McGuiness, T., Moneyham, L., Schumacher, J. E., Zwerling, A., & Stullenbarger, N. E. (2012). Opioid Abuse
Among Nurse Anesthetists and Anesthesiologists. AANA Journal, 80(2), 120-128.