"We fired a girl at work today," my sister told me during one of our recent telephone conversations.

"Really? Why?"

"She was stealing drugs. Our medical director caught her on a surveillance video. Crazy, right? I thought she looked high at a staff meeting not too long ago, and I think others noticed, too, so I'm sure they were suspicious of her anyway."


My sister works for a veterinary practice.

A recent Trends magazine series examined the scope of addiction within the veterinary world, and the problem is widespread.

"I've become increasingly aware of and very concerned about the risk of addiction and diversion of controlled substances in the veterinary profession. I think we as a profession need to do much more to educate our colleagues and our team members about those risks in order to create safe and healthy work environments," says Heidi L. Shafford, DVM, PhD, DACVA, owner of Veterinary Anesthesia Specialists, LLC.

"We have ready access to medications that are potentially addicting. We work in very stressful environments. And many, many people are involved in administering these medications to patients, so there are many opportunities for these medications to get diverted."

How do you, as a practice owner or manager, address the issue of substance abuse with your team? According to Trends, begin by creating a safe space to talk about a condition that still has a powerful stigma attached to it.

"Substance abuse is probably the number one or number two preventable health care problem in the United States, but substance-abuse disorders are still considered moral issues. 'Pull yourself up by your bootstraps' and that kind of thing," says Elizabeth Pace, MSM, RN, CEAP, CEO of Peer Assistance Services, Inc. "All professionals--it doesn't matter who they are--tend to think, erroneously of course, that they know better, that they can manage better on their own. There's a sense that we understand drugs and can take care of our own problem. Talk about pharmacologic optimism. Substance-abuse disorder is a chronic, progressive, and life-threatening illness. It's a brain disease. It's altered neurochemistry.

"Stigma around addiction is alive and well. It's so discouraging to me. We have so much science around addiction, but there hasn't been a parallel path with attitudes," Pace says. "Ninety-nine percent of us know someone with a substance abuse problem. Maybe that person isn't an addict, but he or she abuses alcohol or abuses prescription medication. Maybe that person is a binge drinker who comes to work hung over. Most of the time, that individual is an excellent professional. Addiction is not about incompetence, but that doesn't mean he or she won't become incompetent and make errors when very sick."

"Addiction is usually a taboo subject. Bad people abuse drugs, and so on," Shafford says. "But it is an illness, and I think we, as a profession, need to embrace this as a health concern."

AAHA recently conducted an exclusive survey surrounding the subject of addiction and the results, shown in the below infographic, were eye-opening. More than half--56%--of AAHA members surveyed say they have worked with a veterinary professional who had a substance abuse problem. Of those who had worked with an addicted individual, 66% said the person used drugs or alcohol at work. In most cases (51%), the individual was fired. 

Many respondents to the survey said that stress, depression, and easy access to drugs add up to a recipe for increased risk of substance abuse. Compassion fatigue can also increase the likelihood for a veterinarian or technician to turn to drugs or alcohol.  

What are your thoughts? Have you ever worked with someone who abused substances? Is enough being done to combat this issue in the veterinary profession?

Check out the full stories on addiction in the April and May 2013 issues of Trends magazine.


Comments (3) -

Stephen Comer
Stephen ComerUnited States
6/30/2013 8:16:49 AM #

I did not find this article particularly helpful. Sure there is value in making people aware but the article said people were aware when it said 56% of us had worked with someone with a substance abuse problem. If that many worked with someone I can't help but believe many more were aware of the situation. We are a small community and word gets around.

The challenge is not awareness but what we should do about it. Here is where the article is lacking. Again, the article shows we are desperately seeking some thoughts on how best to manage such situations when 83% of us said AAHA and other veterinary organizations should be concerned about such matters. 79% of us thought our professional boards should be doing something. Doing something is what most of us appear to desire. The question is what should we be doing?

The article implied that what we are doing is wrong. It implies a lack of empathy and sensitivity with our current method of handling such matters. I think the article is wrong on this account. Most of us have small businesses. We know the substance abusers intimately. We feel the damage their addiction is causing not only on our business but their families as well. Even in larger veterinary hospitals the impact of substance abuse is personal.

None of these empathetic feelings remove us from our legal obligations. If we fail to account for missing controlled substances we risk losing our license to use them. Not having the ability to use controlled drugs would be crippling for a veterinary hospital. So we have an obligation to the rest of the team, our pet population and so on to protect our ability to prescribe controlled substances in a proper fashion. The most expedient and safest way to accomplish this is to remove the abuser from the environment, i.e. fire them.

Taking time to counsel them takes a lot of time and energy. Time and energy are resources that are in short supply in veterinary hospitals. Many other management tasks other than substance abuse aren't getting done because of a lack of time and energy. Adding something that demands so much time and energy such as counseling is something most practices can't do. I want to be clear, their not spending energy and time here isn't due to a lack of empathy, it is simply there are too many items on the plate.

Additionally, addictions are notorious for relapsing. So this means even if we spend the time and energy to help heal our colleague we can never fully trust them. As the article mentions, addiction is a disease. A disease without a cure. Therefore we can never let our guard down that our controlled drugs won't come up missing yet again. Such vigilance takes not only time but huge volumes of energy. It is very wearing to be on guard all the time. So again, for our own health's sake, we find it best to remove a person who has abused controlled substances from our work environment. This act of self-preservation should not be mistaken for a lack of empathy.

In the future please write articles that don't tell me what I already know. Don't write articles laying down a guilt trip on us. Write articles that gives us tools on how to do things better. Thanks.

[email protected]United States
7/3/2013 9:02:32 AM #

Stephen--thanks for your comment. The article was simply a rehashing of the Trends magazine series from the April and May 2013 issues, just getting the stats out there and making people aware of the scope of the problem. An issue addressed in this article, as well as the original Trends series, is the stigma surrounding addiction. Rather than it being seen as a disease, like cancer, it is viewed by many as a behavioral issue--something that weak people do because they have no self control. Diseases--whether cancer, diabetes, or addiction--all have to be dealt with in different ways, and addiction isn't the only one notorious for relapsing, or the only one that requires counseling or time away from work to recover. Yet it is treated much differently than other diseases. No one is blaming practice managers and owners for firing employees who steal controlled substances--obviously business owners have to protect their businesses. The question to be considered: Is that the only/best option? Are there better ways to deal with addiction in the practice? What about for employees who aren't stealing controlled substances, but are using drugs outside of work?

The point of the article was to provoke thought on the subject, not to provide all the answers or "lay down a guilt trip" on readers. Many articles written for Member Connection aim to give our members tools that help them do things better, but some are going to examine issues affecting the veterinary profession. This is certainly one of those issues.

SitcheyUnited States
3/28/2017 4:07:09 PM #

While I will agree that people need to address addiction with more empathy, I find it utterly offensive for you to compare drug addiction to cancer or diabetes. I won't be on your website in the future.

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