What if I Have a Substance Abuse Problem—Can I Still Keep My License

You may still keep your nursing license if you have a substance abuse problem. Alternative-to-discipline (ATD) programs are potentially life-saving resources accessible to nurses throughout the United States. Nurses are widely regarded as heroes, but even they are susceptible to the struggles with drugs and alcohol that have become increasingly common nationwide. 

Though behaviors that coincide with substance abuse typically qualify as violations of Nurse Practice Acts, they are treated differently from other violations. Rather than sanctioning nurses as if their abuse-related behaviors were willful behaviors of choice, ATD programs often provide a confidential, non-punitive pathway to recovery. 

If you or a loved one suffers from substance abuse as a nurse or is recovering but faces possible discipline for alleged misconduct, allow us to help. Call the LLF National Law Firm Professional License Defense Team today at 888-535-3686 or contact us online.

Do Nursing Boards Consider Substance Abuse to Be a Form of Misconduct?

Yes, nursing boards generally consider substance abuse to be a form of misconduct and may specifically categorize it as unprofessional conduct.

For instance, Texas licensing boards consider “intemperate use of drugs or alcohol” a potential disqualifying criterion for licensure. Florida’s nursing-specific statutes cite “Being unable to practice nursing with reasonable skill and safety to patients by reason of illness or use of alcohol, drugs, narcotics, or chemicals,” as unprofessional conduct, which is a category of misconduct.

Understandably, nursing boards nationwide regard substance abuse as a form of unfitness, as a nurse who is struggling with drugs or alcohol may:

• Be impaired while caring for patients

• Lack the coordination necessary to complete tasks that require the utmost coordination and precision

• Make unsound judgments

• Lack the alertness necessary to monitor patients and react promptly to signs of distress

• Be more prone to absenteeism, tardiness, and other behaviors that impede the nurse’s ability to practice

• Be a danger to themselves and others

Nurses who are honest with themselves will admit as much. That being said, we can also recognize that substance abuse is not a choice for those suffering from it, and so nursing boards do not generally treat substance abuse in the same way as other forms of misconduct.

Many State Nursing Boards Take a Sympathetic Approach to Nurses’ Substance Abuse

Most state nursing boards have confidential channels for nurses to self-report substance abuse and receive treatment. As we stated, we can refer to these channels generally as alternative-to-discipline (ATD) programs.

An important note is that states may handle substance abuse issues differently based on:

1. Whether the nurse self-reports their substance abuse issue before causing harm (which generally means engaging in other forms of misconduct that are related to their substance abuse)

2. The nurse does not self-report the substance abuse until they have caused harm (or engaged in other forms of misconduct related to their substance abuse) 

Generally speaking, a nurse may be more likely to avoid formal discipline if they self-report their substance abuse before causing harm. There can be exceptions to this general rule, though.

Given compelling reasons to do so, nursing boards often take a sympathetic tack towards nurses whose struggles with alcohol or drugs have caused them to exhibit uncharacteristic behaviors unbecoming of a healthcare professional. The LLF National Law Firm gives nursing boards all the reasons necessary to treat nurses with mercy and compassion.

A Couple of Examples of State Nursing Boards’ Alternative-to-Discipline Programs

To better understand how state nursing boards’ ATD programs work, here are a couple of examples:

• New York: Nurses in New York may be eligible for the state’s Professional Assistance Program (PAP) if they have not caused harm to patients or clients before seeking admission to the PAP. Established in 1985, the program is a confidential way for nurses to get the rehabilitative resources they need. Depending on which pathway within the PAP a nurse is assigned to, they may need to petition for license reinstatement or may have their license automatically reinstated upon completion of the PAP regimen.

• Illinois: Nurses in Illinois can receive “care, counseling, and treatment” that is “privileged and confidential, unavailable for use in any proceeding, and not subject to disclosure.” Nurses can self-refer to the program, but may not be eligible if they have caused harm to a patient, have prior substance-related discipline on their professional record, have been arrested for certain substance-related criminal offenses, are unwilling to acknowledge a substance-abuse issue, or are unwilling to undergo a substance-abuse assessment. Under this program, “A licensee may continue to practice so long as they abide by the terms of the agreement.”

As you can see, nurses may have to temporarily surrender their license while enrolled in an ATD program—it depends on the state’s laws and nursing board practices.

However, even if a nurse has to surrender their license while receiving rehabilitative resources, they may be automatically reinstated upon completion of their program. This is a preferable proposition to other disciplinary outcomes, such as permanent or indefinite revocation without automatic reinstatement.

Who Qualifies for ATD Programs?

This varies state-by-state. Some of the standard criteria that we see nursing boards consider for admission to ATD programs are:

• No prior substance-related professional discipline

• No arrests (at least not in the recent past) related to your substance abuse issue

• No harm done to patients or others in the workplace as a result of the substance-abuse issue

• Self-reporting of the substance abuse problem

• Willingness to admit the problem

• Willingness to undergo an evaluation of the problem

• Willingness to abide by the various conditions and demands of the ATD program

• Willingness to surrender one’s license, at least temporarily, if the nursing boards demands

There can be exceptions to these criteria. Not every state adheres to these criteria, and even in those that do, a nursing board may be willing to consider exceptional circumstances.

This is one area in which the LLF National Law Firm’s personalized case-building delivers immense value, as we will lobby your state’s nursing board to hear your case for merciful handling of your substance-abuse issues,regardless of whether you meet the traditional criteria for admission to an ATD program.

Does Enrollment in an Alternative-to-Discipline Program Spare Me from Formal Discipline?

Many states’ ATD programs are, as their names suggest, alternatives to discipline. So, yes, in many cases, enrollment in an ATD program is the first step towards a nurse avoiding formal discipline related to their substance abuse problem(s).

That said, enrollment in an ATD program is distinct from successful completion of an ATD program. A nurse might not complete an ATD program if:

• They continue to use (or abuse) one or more substances while enrolled in the ATD program

• They do not comply with drug testing, the administration of breathalyzer or blood tests, or other measures to evaluate the nurse’s sobriety

• The administrators of the program determine the nurse to be disingenuous in their desire to rehabilitate themselves

• The nurse does not comply with any other demands of the ATD program, such as counseling or group activities

ATD programs come with conditions—in many cases, stringent ones. The slightest deviation from those conditions might end the nurse’s enrollment in the program and immediately expose them to discipline.

Some states, such as Oregon, note that their rehabilitation-focused programs can be applied “in lieu of or in addition to discipline.” This means that, in some instances, even successful completion of a substance abuse-focused program might not spare a nurse from discipline. That said, the hope is that, even if a nurse is disciplined, their license would not be revoked.

When Should a Nurse Notify Their Nursing Board of a Substance Abuse Problem?

Generally speaking, it is best for a nurse to report their substance abuse to their respective nursing board as soon as possible, especially if the nurse feels:

• They cannot immediately cease the substance abuse

• They require third-party assistance to address the cause(s) of their substance abuse

• Any rehabilitation they might pursue on their own would interfere with their nursing responsibilities (and therefore require them to explain the circumstances of a leave of absence to their employer anyway)

• Their substance abuse poses an imminent threat to patients, colleagues, and their own ability to perform capably as a nurse

In many states, a nurse can become ineligible for an ATD program as soon as they cause harm to a patient. This means that even an hour—or even a minute—of delay in reporting one’s substance abuse could be the difference between being eligible and ineligible for an ATD program. When you become ineligible for an ATD program, you become substantially more vulnerable to formal discipline, including license revocation.

You Should Speak with the LLF National Law Firm Right Away About Your Substance Abuse and Your Nursing License

While immediate self-reporting is often advisable, it is impossible to make reliable generalizations about all nurses. Your circumstances are truly unique. For this reason, your first order of business should be to speak with our Professional License Defense Team.

An experienced attorney from our team will:

• Learn how substance abuse is affecting you and your nursing career

• Discuss the severity of your substance abuse and whether you have plans to improve the condition without intervention from your nursing board

• Determine whether the substance abuse or related treatment would immediately affect your nursing career

• Consider how your state’s nursing board handles nurse substance abuse (including its criteria for enrollment in ATD programs)

• Explain whether immediate or eventual self-reporting of your condition to the nursing board is advisable

Our experience representing professionals suffering from substance abuse—including many nurses—is central to the advice we dispense. We have seen how nursing boards nationwide handle all kinds of substance abuse, and we can reliably advise you about how to proceed.

I Reported My Substance Abuse Struggles, But I Am Still Facing Discipline (or Was Already Disciplined). What Now?

As we have discussed, there are many cases in which a nurse might face formal discipline even if they self-reported their substance abuse. If a nursing board has the right to impose discipline in conjunction with enrollment in an ATD program, your nursing board determines you have already caused harm, or you are accused of failing to complete an ATD program successfully, you might face severe sanctions, including license revocation.

If you are currently facing potential discipline related to your substance abuse, you must:

• Recognize that revocation of your license and other severe forms of discipline are a realistic possibility

• Protect yourself from hasty, overzealous, and discompassionate discipline from your nursing board

• Acknowledge that nursing boards’ judgment is subjective and unpredictable—for instance, yours might determine that you already caused harm to a patient, even if you wholeheartedly disagree with the assertion

• Recognize that our Professional License Defense Team’s insights in these matters are truly priceless

Protecting professionals is our mission. We have experience dealing with nursing boards nationwide, and they recognize us as well-meaning, competent advocates for nurses who are facing life-changing challenges and, in many cases, sanctions.

Should I Engage an Attorney to Advise Me About the Professional Implications of My Substance Abuse Issue?

You should speak with the LLF National Law Firm Professional License Defense Team, whether you: 

• Have yet to report your substance abuse to your nursing board

• Are already enrolled in an ATD program (and do not think discipline is an imminent possibility)

• Currently face possible professional discipline related to your substance abuse

The moment you begin engaging in substance abuse as a nurse, your career is in jeopardy. Even if it seems like you are on the track to complete an ATD program and avoid sanctions successfully, substance abuse is a fickle beast. By retaining our firm, you prepare for unfortunate turns of events while continuing to work towards the best-case outcome.

Whether you need us to protect you from impending license revocation or just need us to watch your back as you work one day at a time towards recovery, you want the LLF National Law Firm on your side.

Call our Professional License Defense Team today at 888-535-3686 or contact us online for a no-stress consultation about how we can help you.