The Anesthetic Agent Substance Abusing Provider Poonam Agarwal, RN, BSN, SRNA Valentyna Groelle, RN, BSN, SRNA York College of Pennsylvania Nurse Anesthetist.

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Presentation transcript:

The Anesthetic Agent Substance Abusing Provider Poonam Agarwal, RN, BSN, SRNA Valentyna Groelle, RN, BSN, SRNA York College of Pennsylvania Nurse Anesthetist Program

Objectives 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 Occupational Exposure Neurobiological Factors

Occupational Exposure (Gold et al., 2006)

Neurobiological Factors

Adapted from Volkow et al., Neuropharmacology, Drive Saliency Memory Control Non-Addicted Brain NO GO Addicted Brain Drive Memory Control GO Saliency Why Can’t Addicts Just Quit? Because Addiction Changes Brain Circuits

Most Commonly Abused Substances

Propofol

Patterns of Behavior

Education and Prevention

Legal Issues

Legal Issues and Options

Treatment

Challenges of Reentry

Attitudes of Reentry

References Bryson, E. O., & Silverstein, J. H. (2008). Addiction and Substance Abuse in Anesthesiology. Anesthesiology, 109(5), 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, 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, Garcia-Guasch, R., Roige, J., & Padros, J. (2012). Substance Abuse in Anaesthetists. Anesthesiology, 25(2), 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), 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), 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), National Institute Of Drug Abuse (2008, July). Addiction Science: From Molecules to Managed Care. Retrieved February 1, 2013, from abuse-can-change-structure-neurons-in-brain Quinlan, D. (2001). Peer Assistance: A Historical Perspective. Retrieved January 20, 2013, from 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), Stocks, G. (2011). Abuse of Propofol by Anesthesia Providers: the Case for Re-Classification as a Control Substance. Journal of Addictions Nursing, 22(1), 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, Wilson, H., & Compton, M. (2009). Reentry of the addicted certified registered nurse anesthetist: A review of the literature. Journal of Addictions Nursing, 20, 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),

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