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What is Substance Use Disorder?

What is Substance Use Disorder: The Disease Concept


Substance use disorder is a controllable disease. The single greatest obstacle to the treatment of substance use disorder is the matter of attitudes; the attitudes of the person with the chemical dependency, the family, friends, employer and society at large. The misconception persists that substance use disorder is not a disease, but rather a behavioral problem that is either psychological, ethical or moral in nature.


The negative consequences of substance use disorder affect not only the nurse, but their family, friends, co-workers and employers. Though it is difficult to estimate the direct financial impact substance use disorder has on the nursing profession, we know the cost of drug abuse to taxpayers is about $535 billion dollars each year. This staggering amount is due to increased health care costs, lost productivity, premature deaths, crime and auto accidents (NIDA, 2007). More deaths, illness and disabilities result from substance abuse than other preventable health conditions (NIDA, 2007).


The American Nurses Association (ANA) estimates that six to eight percent of nurses use alcohol or drugs to an extent that is sufficient to impair professional performance. For instance - if you work with 10 nurses, at least one of these nurses is likely to have a problem with  substance use disorder. Substance use disorder is considered a treatable disease by the American health care system, but the concept and treatment is not widely extended to the health care professions. Nurses were denied the same non-punitive approach being offered to patients they served. Many nurses did not receive treatment until after they had been criminally charged.


Consider if you will: It is rare that neighbors increasingly avoid and mistrust a fellow human being simply because he has heart trouble or is a victim of crippling arthritis. Nor do families feel humiliated or do their best to conceal one of their own merely because he is ill. Nor do police commonly put such unfortunate persons in jail if their illness causes them to fall or to display other symptoms of an acute attack while in a public place. Yet, all of these are typical responses to the person with substance use disorder.


"Drug addiction is a brain disease that can be treated." Nora D. Volkow, MD National Institute on Drug Abuse


What about understanding for the  substance use nurse? What about the nurse who comes to work "so hungover it's hard to see straight?” Or, what about the nurse who takes long breaks and disappears into the bathroom, later returning to his/her unit glassy eyed with a noticeable change in their speech pattern, gait or ability to write legibly? Or what about the nurse who steals a patient's oral pain pills, allowing his/her patient to experience uncontrolled pain? Statistics show that one in seven nurses will experience a problem with alcohol or drugs. Understanding with "tough” compassion is what the GNA-PAP has to offer for the nurse who is active in their substance use issues.


Substance Use Disorder is a disease. Medical and nursing literature agrees that a disease can be identified by five specific characteristics;


1. A disease has identifiable signs and symptoms

2. A disease follows a predictable and progressive course, which, if untreated, may lead to death

3. A disease produces consistent anatomical and/or physiological alterations

4. A disease's cause or causes may not be known

5. A disease is a primary condition, not merely a symptom


Substance Use Disorder meets all the criteria of a disease. If a nurse or an employee has an issue with alcohol or drugs, the best and most important first step is to get a professional evaluation. Professional evaluations for nurses' substance use issues can be done at a number of resources/facilities throughout the state of Georgia.


Call the GNF-PAP Hotline for guidance (800) 462-9627.


3032 Briarcliff Road
Atlanta, GA., 30329-2655


P: (404) 325-5536
F: (404) 325-0407

Office Hours: 

M-F, 9:00AM- 4:30PM

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