Re-entry Recommendations and Resources

Successful reentry to the anesthesia workplace is possible with supportive colleagues and an established department policy. Monitoring the recovery of nurse anesthetists and other healthcare professionals with a history of substance misuse and chemical dependency requires a well-informed reentry plan. The following is intended to provide information and education concerning these issues.  If you have any questions, please call the helpline (800) 654-5167

 PAA Recommendations for Re-entry

AANA Peer Assistance Advisors' Recommendations for Re-entry of Anesthesia Professional or Students with Chemical Dependency
Based on over 30 years of experience with CRNAs, the AANA Peer Assistance Advisors (PAAs) recommend that a good starting place for reentry is:
  1. Completion of treatment and comprehensive evaluation by an ASAM board certified addictionologist according to the PAA recommendations and compliance with all treatment center recommendations for continuing care after discharge, including relapse prevention techniques.
  2. Evaluation of suitability by an addictionologist for, and timing of, the return to anesthesia practice as CRNAs face unique obstacles and risks that can threaten their ability to maintain sobriety. 
    • A minimum of one year out of the clinical anesthesia arena for individuals with an IV drug addiction or major opioid history. 
  3. Achievement of the Talbott criteria for reentry:
    • Supportive spouse/significant other
    • No untreated psychological comorbidities
    • Acceptance of the chronicity of chemical dependency
    • Grounded in the recovery community (sponsor, etc.)
    • Supportive colleagues at the workplace familiar with history and needs for reentry
  4. Commitment to monitoring program including regular toxicology screenings on a random basis through a formal program, administered by a state board of nursing or alternative program, for a minimum of five years.  Voluntary monitoring through the professional lifetime is ideal.
  5. Regular attendance at recovery based meetings, and continuous follow-up and aftercare with an addictionologist.  
  6. We only support abstinence based recovery and strict avoidance of opioid replacement therapy (ORT) in CRNAs and student nurse anesthetists returning to clinical practice. We support the utilization of Naltrexone where the addictionologist has deemed it appropriate. 

 Re-entry Resources



Additional articles and research on anesthesia professionals and chemical dependency - see the Wellness Research and Education resources


 Health & Wellness Contacts

AANA Staff:
Julie Rice, AANA Health, Wellness, and Peer Assistance Program Manager 
(847) 655-1114 or

 Model Policies

​Follow this link to model policies and procedures for departments of anesthesia on chemical dependency, reentry contracts, and random screening for drugs and alcohol.

 Are you in recovery?


Are You In Recovery from Alcohol or Drug Problems?

Know Your Rights - Information brochure from the U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment

If you are in recovery and have chronic pain, see SAMHSA's managing chronic pain brochure.

See also Working with a Disabilty


 SAMHSA Wellness

​​Tp support recovery, the Substance Abuse and Mental Health Services Administration (SAMHSA) provides a Holistic Guide to Whole-Person Wellness to encourage people with mental health and substance use conditions to incorporate Eight Dimensions of Wellness into their lives.