They show up before the sun rises. They miss meals, holidays, and sometimes their own family milestones—because someone else’s life depends on them. Nurses are the backbone of the healthcare system, the unsung heroes who hold the line in emergency rooms, oncology wards, and hospice beds. But even heroes get tired. Even healers need healing.
At Tony Hoffman, we know the weight nurses carry. We’ve seen how burnout, trauma, and compassion fatigue can take root in even the most dedicated professionals. And we believe in meeting that pain—not with shame, but with support. If you’re a nurse struggling with substance use, you are not alone. There’s a way forward.
Why Are Those in the Nursing Profession at Higher Risk for Substance Use Disorder?
Substance use disorder (SUD) can affect anyone, regardless of their background, education, or profession. However, individuals in the nursing profession—including registered nurses, nursing students, and advanced practice providers—face unique, high-risk conditions that make them particularly vulnerable to substance abuse and addiction.
1. High Stress and Emotional Burden Noted by The American Nurses Association
Nurses are routinely exposed to trauma, grief, and high-pressure situations that demand quick thinking and emotional regulation—often at the expense of their own well-being. The constant emotional strain, coupled with witnessing human suffering and death, contributes to chronic stress and burnout. Over time, without proper coping strategies, this stress can increase the likelihood of developing a substance use disorder.
The American Nurses Association (ANA) has long acknowledged the intense psychological toll the profession can take, advocating for wellness and mental health support as critical components of nurse retention and performance.
2. Easy Access to Prescription Medications
Unlike most professionals, nurses work in environments where they have direct and frequent access to controlled substances, including opioids and benzodiazepines. This proximity can increase the risk of medication diversion—when a nurse takes medications intended for patients—and misuse, whether out of curiosity, to self-medicate physical or emotional pain, or to maintain performance during long shifts. This is particularly concerning in cases of impaired practice, where substance use compromises a nurse’s ability to deliver safe, effective care.
3. Long Hours, Fatigue, and Physical Demands
Registered nurses often work 12-hour shifts—or longer—sometimes with inadequate breaks or back-to-back rotations. Nursing students also experience intense academic and clinical pressures. This combination of mental and physical exhaustion can push some toward stimulants, sedatives, or alcohol as a way to manage fatigue or decompress after a shift. Over time, what begins as occasional use may evolve into dependence, leading to a full-blown nursing substance use disorder.
4. Cultural Normalization and Silence Around Substance Abuse
In some healthcare settings, there’s a pervasive “tough-it-out” culture that discourages vulnerability and open discussion about mental health or substance abuse. Nurses may fear judgment, retaliation, or loss of licensure if they speak up about their struggles. This silence only deepens the stigma around nursing substance use disorder, making it harder for individuals to seek help early. Additionally, social behaviors—like heavy drinking to unwind after shifts—can blur the line between casual use and unhealthy dependence.
The Ripple Effect: Impaired Practice When Nurses Can’t Access Help
Nurses are trained to care for others—often at the expense of their own health. Whether they’re seasoned registered nurses, new nursing students, or educators shaping the next generation, the culture of the nursing profession often rewards self-sacrifice and silence. But when substance use disorder takes hold, the consequences ripple far beyond the individual.
Nursing substance use disorder is not a personal failure—it’s a medical condition that can escalate quickly in high-pressure environments. When impaired nurses are unable to access help, the entire healthcare ecosystem feels the impact.
The Cost of Silence
Substance abuse among nurses often goes unnoticed until it becomes a crisis. The signs—such as mood swings, inconsistent performance, or physical signs like drowsiness and weight loss—can be mistaken for burnout or stress. But beneath the surface, drug diversion and self-medication may already be underway. Impaired practice becomes a very real risk, and without early intervention, nurses may no longer be able to practice safely.
This endangers more than the nurse’s career. It can directly compromise patient care and safety. Nurses impaired by substance use may miss critical cues, administer incorrect dosages, or struggle to follow procedures—all of which put lives at risk.
Protecting Patients and Supporting Nurses
When substance use disorder is left untreated among nurses, it creates a dangerous cycle. Fear of losing licensure, professional standing, or even employment can prevent nurses from seeking help, especially if no clear treatment pathways are in place. However, treating nurses with compassion, confidentiality, and clinical support doesn’t just restore their health—it also protects patients and strengthens the profession.
It’s critical that hospitals, nursing education programs, and leadership teams recognize impaired practice not as a disciplinary issue alone, but as an opportunity for rehabilitation. Creating programs that support recovery, monitor return-to-work readiness, and prevent further diversion of controlled substances is key to helping nurses regain control and return to the field safely.
Tony Hoffman Believes in Second Chances
Addiction doesn’t mean the end of a career in nursing. It means it’s time for a new chapter—one rooted in honesty, healing, and hope. Tony Hoffman has spoken across the country about addiction, mental health, and second chances, and he believes that nurses struggling with substance use disorder deserve just as much compassion and support as anyone else.
In the nursing profession, the consequences of substance abuse can be serious—but silence is often the biggest danger of all. Many registered nurses, nursing students, and healthcare professionals fear seeking help due to stigma, disciplinary action, or fear of losing their license. But the longer substance use is ignored, the more it affects patient care, professional practice, and well-being.
Early Recognition Saves Careers and Lives
Spotting the warning signs early—such as frequent absences, mood swings, or drug diversion—is critical to both protect patients and support impaired nurses in getting the help they need. Left untreated, nursing substance use disorder can lead to impaired practice and put everyone at risk.
But there are real solutions.
Many state boards of nursing now support alternative to discipline (ATD) programs, which allow nurses to access treatment and re-entry support without automatic license loss. These programs, backed by organizations like the American Nurses Association and the National Council of State Boards of Nursing, offer rehabilitation, monitoring, and education while keeping the focus on keeping patients safe.
If You’re Struggling, Here’s Where to Start:
- Contact Your State Board of Nursing – Ask about ATD programs or recovery pathways that support competent care while receiving help.
- Look Into Support Groups – Programs like Nurses in Recovery, Alcoholics Anonymous, and Narcotics Anonymous provide free peer support.
- Educate Yourself – Knowledge is power. The ANA and state nursing associations offer resources to guide both individuals and colleagues navigating addiction in the workplace.
Breaking the Silence, Rebuilding a Life
In the nursing profession, silence can be dangerous. Many nurses struggling with substance misuse remain quiet out of fear—fear of disciplinary action, fear of being misunderstood by colleagues, and fear of losing the ability to provide competent care. But silence doesn’t protect anyone. It only delays healing and increases the risk of patient harm.
Whether it’s diverting drugs to self-medicate, hiding the signs of an addictive disorder, or making frequent trips to the medication cabinet without proper documentation, early behaviors tied to substance use can have serious consequences—both for the nurse and the patients they serve.
The truth is, substance use disorders are not moral failings. They are complex, treatable diseases that require understanding, early identification, and a path forward rooted in responsibility, not shame. Boards of nursing across the country now recognize the value of alternative programs—non-punitive recovery pathways that protect public safety while giving nurses a real chance to return and practice safely.
As Tony Hoffman says:
“Be careful what you do, because your actions become your habits. Be careful what you make a habit, because your habits become your character, and your character becomes your destiny.”
It’s never too late to take back your story.
Breaking the Stigma with Tony Hoffman
Stigma is one of the most powerful forces keeping nurses from getting help. The idea that asking for assistance is a sign of failure couldn’t be further from the truth. In reality, choosing treatment—whether for alcohol, prescription drug misuse, or another substance—shows a deep commitment to patients, self-care, and the integrity of the profession.
At Tony Hoffman, we believe in second chances. Through motivational speaking, education, and storytelling grounded in lived experience, Tony empowers healthcare professionals to move beyond stigma, seek the help they deserve, and protect what matters most—patient care, safety, and personal health.
If you’re part of a hospital, board, or educational institution seeking to spark real change among nurses, Tony is available to speak on topics like substance use awareness, early warning signs, and the importance of breaking the cycle of silence.
Because every comeback begins with courage—and courage starts with conversation. Contact Tony Hoffman today.
Works Cited
Substance Abuse and Mental Health Services Administration. Substance Use. U.S. Department of Health and Human Services, https://www.samhsa.gov/substance-use.
American Nurses Association. Nurses’ Mental Health. ANA Official Position Statement, https://www.nursingworld.org/practice-policy/nursing-excellence/official-position-statements/id/nurses-mental-health/.
National Council of State Boards of Nursing. Outcomes of Substance Use Disorder Monitoring Programs for Nurses. Journal of Nursing Regulation, vol. 11, no. 1, 2020, pp. 16–23, https://www.ncsbn.org/public-files/OutcomesofSubstanceUseDisorderMonitoringProgramsforNursesJNR.pdf.
