Mary Dallman, LMFT, CEAP, MAC WA Health Professional Services Program

1. The presentation that follows is provided by the Washington Health Professional Services Program (WHPS) and is intended to be a tool for speaking with professional healthcare groups regarding substance abuse and its effects in the healthcare work environment. Please take the time to review the presentation and its attached notes. Feel free to edit this presentation to meet your needs, or copy from it to add to your own presentation. For assistance, or to schedule one of the WHPS staff to assist in this presentation please contact us at whps@doh.wa.gov or by phone 360-236-2880. Thank you.

3. Addiction: Health Professionals are not Immune. Services Program Mary Dallman, LMFT, CEAP, MAC WA Health Professional Services Program

4. Agenda • Addiction : What it is and what it is not… • What to look for…. • Intervention… • What gets in the way? • W.H.P.S….Alternative to Discipline Programs

5. Addiction…True or False? • Willpower plays an important role in recovery from addiction. • A person does not seek help until hitting “rock bottom.” • Alcoholism and other drug addiction constitute a progressive and fatal disease. • The educational level of an individual is important when addressing “Denial.”

6. Addiction is NOT...s not… A MORAL ISSUE

7. Addiction Is…. • A Brain Disease • THE NATURE OF ADDICTION IS THE SAME NO MATTER WHAT THE SUBSTANCE. • IS A PROGRESSIVE DISEASE. • IS A TREATABLE DISEASE.

8. Addiction and the Brain… • All drugs of abuse affect the dopamine pathway. • Drugs of abuse affect parts of the brain that control pleasure , motivation, emotion and memory. • The “Craving Response”..

10. Addiction… • Loss of Control • Tolerance/Withdrawal • Attempts to “cut down” or stop • Impact on one or more areas of one’s life

11. Prolonged Drug UseChanges the BrainChanges the BrainIn Fundamental and Long Lasting Ways

12. Recognition

13. Nursing…Unique Risk Factors • Access to Pharmaceuticals • Self Treatment of Pain • Stressful Work Environment • Difficulty Admitting Personal Needs

14. Job Performance… • Safety • Behavior • Attendance • Quality and Quantity of Work

15. Concerning Behaviors… • Not following access, dispensing or wasting policies • Practicing beyond scope • Violation of standards of practice • Unsafe practice

16. Intervention…Seeking Help

18. Barriers to Intervention… • Lack of Knowledge • Denial, Rationalization, Minimization • Tolerating through the “Conspiracy of Silence” • What to do/ How to do it/ Available Resources

19. What Can You Do? • Tolerate through the “Conspiracy of Silence” • Enable through the “Voice of Complicity” • Deny, rationalize or minimize • Intervene

20. This slide is provided so you may add the policies of your specific organization

21. Intervene… Intervention… • Continue to observe behaviors • Speak to the individual • Discuss with supervisor • Consult…Contact monitoring program (W.H.P.S.)

22. Washington Health Professional Services Program(W.H.P.S.)

23. Background… • Boards and Commissions saw an increase in the number of impaired practitioners. • In many cases the result was loss of license. • In 1988 the Uniform Disciplinary Act was amended.

24. Uniform Disciplinary Act • RCW 18.130.175 • Identify and support rehabilitation programs • Allow treatment and safe return to practice • Establish alternatives to the traditional disciplinary process

25. Impaired Practitioners Programs • Play an important role in protecting public health and safety • Assists Boards and Commissions • Minimize the loss of highly trained health care professionals

26. Impaired Practitioner Programs • Washington Physicians Health Program • Washington Recovery Assistance Program for Pharmacy • Washington Health Professional Services Program

27. Washington Health Professional Services Program • Established in 1988 • Is a service within the Department of Health • Funded by the Boards and Commissions • Provides services to over 70 health care professions

28. W.H.P.S. … • Protect Public Health and Safety • Retain skilled highly trained practitioners • Encourage and promote recovery • Bring the professional safely back to practice

29. How Practitioners Get to W.H.P.S. • Voluntary…Confidential • Alternative to Discipline…No Public Record • Program Ordered…Public Record

30. Overview of the ProgramAbstinence • Evaluation (Develop Contract) • Treatment • Contract (Includes drug testing including alcohol, prescription monitoring, practice issues and restrictions, practice site monitoring etc.) • Monitoring (Ongoing recovery program)

31. PROVIDES STRUCTURE AND ACCOUNTABILITY IN RECOVERY

32. A New Beginning…..

33. Additional Resources… • International Nurses Society on Addictionswww.intnsa.org • National Organization of Alternative Programs (www.alternativeprograms.org) • WA State Department of Health in Olympia 360-236-4700 • W.H.P.S….360-236-2880, Olympia, WA

34. Discussion and Questions