Summary
Nurses with the dual challenge of a substance use disorder and
the need for a prescribed medication that puts their sobriety
at risk present complex issues for BONs. Such nurses must be
screened carefully before entering alternative or discipline monitoring
programs, and mechanisms must be in place to support
treatment and rehabilitation while ensuring patient safety. The
opinion of a professional evaluator regarding both pain and
chemical dependence issues can aid the BON’s decision on a
nurse’s suitability for these programs, and the BON can ensure
additional monitoring and surveillance.
However, the nurse must have insight into how the combination
of chemical dependence, pain, and pain treatment affect
his or her ability to practice safely. When this insight is lacking,
the final authority as well as the power to remove the nurse from
practice quickly rests with the BON.