A USA TODAY review shows more than 100,000 doctors, nurses, medical technicians and health care aides are abusing or dependent on prescription drugs in a given year, putting patients at risk.
Anita Bertrand doesn’t remember much about the first time she stole narcotics she was supposed to administer to surgical patients. She doesn’t remember exactly when she installed the intravenous port in her ankle so she could inject the drugs more efficiently. And she doesn’t remember how many patients she may have put at risk before getting into treatment.
But she remembers how easy it was to get away with it.
“I was absolutely impaired, using narcotics while working. … And no one ever noticed,” says Bertrand, 49, a nurse anesthetist in Houston. “Did I make mistakes? I don’t know, and that’s the scary part. I’m not aware of any, but I certainly would not say I was immune to that.”
America’s prescription drug epidemic reaches deep into the medical community. Across the country, more than 100,000 doctors, nurses, technicians and other health professionals struggle with abuse or addiction, mostly involving narcotics such as oxycodone and fentanyl. Their knowledge and access make their problems especially hard to detect. Yet the risks they pose — to the public and to themselves — are enormous.
A single addicted health care worker who resorts to “drug diversion,” the official term for stealing drugs, can endanger thousands. Nearly 8,000 people in eight states needed hepatitis tests after David Kwiatkowski, an itinerant hospital technician, was caught injecting himself with patients’ pain medicine and refilling the syringes with saline. He infected at least 46, mostly in New Hampshire.
It was the third hepatitis outbreak since 2009 linked to a health care worker using patients’ syringes (the others were in Denver and Jacksonville, Fla). And for each of those worst-case scenarios, there are countless more practitioners whose drug-related errors are more isolated — a botched surgery, an incorrect dose of medication, a worrisome vital sign missed.
Much of the damage goes unnoticed or undocumented; oversight mechanisms to detect, report and address drug problems in health care settings are haphazard and limited. Still, a USA TODAY review of state and federal records identified hundreds of cases in recent years in which physicians and other health care practitioners were disciplined or prosecuted for drug diversion or other medical misconduct related to substance abuse.
The toll also can be brutal for the medical professionals who suffer with addiction — often in high-stress jobs with little help. Many struggle with guilt and despair, physical and mental health ills, and indifferent professional environments. Last year, New York’s Supreme Court ruled that a hospital was not liable for the overdose death of a physician who, after returning from drug rehabilitation, was given operating room duty, where she had ready access to the propofol that killed her.
“Drug diversion affects so many people, and the systems for dealing with it are completely broken,” says Lauren Lollini, 45, who was infected with hepatitis C in the Denver outbreak and now works with HONOReform, a patient safety group.
Bertrand, who returned to practice after treatment, now counsels other health care professionals with drug problems.
“The medical community thinks it’s immune from this disease, but that’s not true,” says Bertrand, who had no history of drug use until she got hooked on pain medication after an abdominal surgery. “There are so many practitioners working impaired and we have no idea. … We’re doing a terrible job addressing this problem.”