The Prevalence of Substance Use and Substance Use Problems in Registered Nurses: Estimates From the Nurse Worklife and Wellness Study

Background: Substance use (SU) or substance use disorder (SUD) prevalence among U.S. nurses has not been assessed foralmost 25 years. Purpose: The purpose of this current study, known as the Nurse Worklife and Wellness Study, is to generate population-based prevalence estimates for SU and related problems, including SUDs, among registered nurses and to examine other personal and work characteristics related to nurse SU. Methods: A mixed-mode survey of a nationally representative sample of randomly selected nurses in nine states, using a cross-sectional design, obtained 1,215 responses (30.6% response rate), with 1,170 usable surveys for analysis. Substance use and problems were assessed based on standardized criteria. Results: Past year illicit drug use was 5.7%, and prescription-type drug misuse was 9.9%, with nurses working in home health/hospice (19%) and nursing homes (15.8%) having the highest rates. Energy drink use was reported by 23.7% of nurses younger than 45 years, with emergency and multi-specialty nurses having three to five times the odds of use versus the reference group. Overall, 18.0% of nurses screened positive for SU problems, with one-third of those (6.6% of the total) screening positive for SUD. Staff, charge nurses/coordinators/nurse managers, and other administrators had 9 to 12 times the odds of having a SUD as opposed to educators and researchers. Conclusion: Prescription-type drug misuse rates exceeded the U.S. population rates, and rates varied by specialty. Energy drink use and SUD risk were significantly higher among nurses in certain positions and specialties. Focusing on higher risk groups can help target nurse prevention and treatment efforts and guide policy for identifying and addressing SU problems among nurses.