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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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The Anesthetic Agent Substance Abusing Provider

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

  2. 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.

  3. Prevalence

  4. Risk Factors

  5. Factors Contributing to Development of Chemical Dependency

  6. OccupationalExposure(Gold et al., 2006)

  7. Occupational Exposure(Gold et al., 2006)

  8. Neurobiological Factors

  9. Why Can’t Addicts Just Quit? Non-Addicted Brain Addicted Brain Control Control Drive GO Saliency NO GO Drive Saliency Memory Memory Because Addiction Changes Brain Circuits Adapted from Volkow et al., Neuropharmacology, 2004.

  10. Most Commonly Abused Substances

  11. Propofol

  12. Patterns of Behavior

  13. Education and Prevention

  14. Legal Issues

  15. Legal Issues and Options

  16. Treatment

  17. Challenges of Reentry

  18. Challenges of Reentry

  19. Attitudes of Reentry

  20. References • Bryson, E. O., & Silverstein, J. H. (2008). Addiction and Substance Abuse in Anesthesiology. Anesthesiology, 109(5), 905-917. • 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-drugs-abuse-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.

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