If you are reading this page to address a current suspicion of impairment or drug diversion, review these important points. If there is concern due to risk of imminent harm, call 911 immediately.
Ideally, an intervention should be planned and in place prior to confronting the individual, which means swift and thorough coordination of a large number of variables. If there is time, see Conducting a Safe Intervention. Resources to help create a substance use disorder policy, including a planned intervention process, can be found at Substance Use Disorder Workplace Resources.
Important steps in safely addressing suspicion of impairment or drug diversion:
- Signs and behaviors to identify impairment and/or drug diversion
- Before any confrontation, see Crisis Intervention Essentials (below) and contact a resource for help:
- Peer Assistance Helpline* 800-654-5167
- Your state's AANA State Peer Advisor (SPA)
- Review treatment recommendations and links to centers specializing in anesthesia professionals
- In the workplace:
- Follow workplace policies
- Contact an Employee Assistance Program (EAP) representative; your Human Resource department can provide information on EAP availability
- See Substance Use Disorder Workplace Resources
Crisis Intervention Essentials:
In situations that may warrant conducting a crisis intervention (e.g. impaired during patient care and need to remove from clinical practice), be sure to follow these essentials:
- Do not let the person out of your sight! Do not let them drive!
- Obtain a properly collected drug test.
- Contact a treatment center to provide a trained interventionist, or at least guidance, and to have a bed ready.
- If possible, include a trained interventionist, family, spouse, and colleagues.
- Bring all evidence.
- Do not let the impaired individual determine treatment. Remember, they are sick.
- Only when all else fails, threaten to call the police. Often, this will cause the individual to admit that he/she has a serious problem.
The priority is to get the impaired individual evaluated and into treatment safely; reporting to the proper state and medical or nursing board can usually wait. If your workplace does not have a policy process for reporting, see Getting Help to contact your State Peer Advisor for state-specific information.
Post Treatment Resources:
- Ongoing peer support from Anesthetists in Recovery (AIR)
- Re-Entry to Work Recommendations and Resources
Source: Hamza, H. & Bryson, E.O. The Drug Seeking Anesthesia Provider, International Anesthesiology Clinics 49, no. 1 (2011): 157-171.
AANA's position statement and policy considerations: Addressing Substance Use Disorder for Anesthesia Professionals