Goal: Preventing Substance Use

Why focus on preventing substance use?

Substance use disorders and addiction are diseases of exposure. Unless an individual is exposed by ingestion, injection, inhalation, topical exposure through the skin or exposed as a fetus in the uterus, problems with a substance do not develop.  

Symptoms of Substance Abuse

Recognition of a Problem in a Nurse

Nurses are so engaged in assessing patients that they often do not notice substance abuse symptoms in a colleague.

Addiction & Overdoses Kill Nurses, Too!

Just as you would not hesitate to respond swiftly to a patient without a pulse, please do not hesitate in responding to suspicions that a colleague is in trouble.

Addiction & Recovery Articles

Newspaper & Journal Articles

September, 2012 - Mississippi Nurse Edition 17, "A Story Worth Telling" by Paula Davies Scimeca, RN, MS available athttp://epubs.democratprinting.com/article/A+Story+Worth+Telling/1184369/0/article.html

August, September, October, 2012 -  ANA MAINE Journal, "The Evidence Speaks But Are We Listening? An Urgent Call for Addiction Education" by Paula Davies Scimeca, RN, MS

June 2012 - Longwoods Publishing Corporation Essay "Speaking the Unspeakable: Nurses Abusing Drugs" by Paula Davies Scimeca RN, MS accessible online at http://www.longwoods.com/content/22928

February, March, April 2012 - ANA MAINE Journal, Guest Editorial, "Facing An Echo of Silence and Denial" by Paula Davies Scimeca, RN, MS accessible online at http://nursingald.com/uploads/publication/pdf/73/ME2_12.pdf

November, December 2011, January 2012 - ANA MAINE Journal "Nurse As Witness to Pain and Its Relief," by Paula Davies Scimeca, RN, MS accessible online at http://nursingald.com/uploads/publication/pdf/317/ME11_11.pdf

August 29th, 2011 - Staten Island Advance newspaper article "Rossville Resident Wants People to Associate Addiction With Recovery" by Andrea Boyarsky.http://www.silive.com/healthfit/index.ssf/2011/08/ rossville_resident_wants_people_to_associate_addiction_with_recovery.html

August, September, October 2011 - ANA MAINE Journal "Looking Beyond Telltale Signs of an Alcohol or Drug Problem" by Paula Davies Scimeca, RN, MS accessible online at http://nursingald.com/uploads/publication/pdf/316/ME8_11.pdf

May, June, July 2011 - ANA MAINE Journal, "Stigma: An Up-Close an Personal Look," by Paula Davies Scimeca, RN, MS accessible online at http://nursingald.com/uploads/publication/pdf/315/ME5_11.pdf

February, March, April 2011 - ANA MAINE Journal, "Preventing Substance Use Disorders in Nurses," by Paula Davies Scimeca, RN, MS accessible online at http://nursingald.com/uploads/publication/pdf/314/ME2_11.pdf

August 23, 2010 - Staten Island Advance article "Addiction: An Occupational Hazard in Nursing" by Andrea Boyarsky accessible online at http://www.silive.com/healthfit/index.ssf/2010/08/addiction_an_occupational_hazard_in_nursing.html

August 10, 2010 - Bangor Daily News article "Workshop to Examine Nurses With Substance Abuse Issues," by Meg Haskell. 

Invited Blogs

March 18th, 2016 blog co-written by Bill White and Paula Davies Scimeca, "Rethinking the Characterization of Addiction as a "Relapsing Condition" accessible online at http://www.williamwhitepapers.com/blog/2016/03/rethinking-the-characterization-of-addiction-as-a-relapsing-condition-bill-white-and-paula-davies-scimeca.html 

February 2nd, 2017 - "Out From Under the Bus" at https://blogs.cdc.gov/safehealthcare/out-from-under-the-bus/

November 3rd, 2011 - "What Does Thanksgiving Have To Do With Recovery?" at http://www.soberinfo.com/what_does_thanksgiving_have_to_do_with_sobriety/

October 19th, 2011 - "Offering Hope Regarding Addiction Recovery" with accompanying video available at http://www.soberinfo.com/offering_hope_reguarding_recovery_from_addiction_video/.

September 16th, 2011 -  "So THIS Is What Recovery Looks Like" at http://www.soberinfo.com/so_this_is_what_recovery_looks_like/

July 6th, 2011 - "Enhanced Recovery Outcomes & Monitoring Programs" at http://www.soberinfo.com/enhanced_recovery_outcomes_monitoring_programs/ 

SHUNT Self-Survey Research

Below are some pilot studies using the SHUNT Self-Survey for Nurses™   and other downloadable articles and White Papers related to nurses and drug diversion.

SHUNT SELF-SURVEY FOR NURSES: PILOT TEST STUDY RESULTS OF NURSES BETWEEN 44-58 YEARS OF AGE AND LICENSED OVER 15 YEARS by Paula Davies Scimeca, RN, MS © 2010. As nurses with substance use disorders (SUDs) pose a threat to themselves and patients in their care, a self-survey specifically designed to identify early indicators of risk for SUDs in nurses was developed. The purpose of this study was to compare the score of nurses in recovery from SUDs to the score of nurses who reported no issue with substance use, and to compare the current score of nurses in recovery to their score on the same items based on their recall of circumstances in the three months prior to sobriety. This pilot test demonstrated similar current scores for all nurses sampled while great disparities existed in the current score of nurses in recovery versus their score on the same items based on recall of their circumstances in three months prior to sobriety.  

SHUNT FINAL Nurses age 44-58.doc (pdf)


PRESCRIPTION MISUSE AND OTHER RISK FACTORS FOR SUBSTANCE USE DISORDERS AMONG STUDENT NURSES: RESULTS OF A PILOT TEST USING THE SHUNT SELF-SURVEY FOR NURSES by Paula Davies Scimeca, RN, MS Copyright ©2010.  Most nurses with SUDs report substance use began before or during nursing school. As nursing students are vulnerable to SUDs involving prescription drugs, it seems plausible that student nurses may be able to make modifications in their behavior and circumstances if they had a tool by which to measure their risk. The aim of this study was to identify acceptability and feasibility of a brief self-survey which identifies at-risk behaviors for SUDs in nurses that could also be used by student nurses. A pilot test of 26 senior baccalaureate nursing students found over 11% reported past misuse of medications and over 7% reported a negative consequence due to alcohol, drug or medication use.  

SHUNT_FINAL__Student_Pilot_Sample (pdf)


THE ROAD TO DECREASING SUBSTANCE USE DISORDERS AND DRUG DIVERSION IN NURSES By Paula Davies Scimeca, RN, MS Copyright © 2012. Building resilience in nurses and students to reduce substance use disorders and drug diversion can only be achieved by the inclusion of content in the curriculum and clinical experiences regarding this potentially lethal and career-ending disease. Individually and collectively, those of us who are in the profession have the responsibility to support the provision and development of exemplary educational initiatives regarding substance use disorders so that all nurses and nursing students are protected…

FINAL Decreasing_Substance_Use (pdf)


WHITE PAPER: UPDATING LANGUAGE TO ENHANCE NURSE NARCOTIC SAFETY Paula Davies Scimeca, RN, MS Copyright © 2011. Given the increasing rate of prescription addiction in all sectors of the population, the longstanding incidence of drug diversion by nurses in the workplace, and the erroneous inferences associated with the term “waste” in reference to medication, this term should be phased-out of use. Accurate language reflective of actual clinical situations, such as “partially non-administered dose,” “totally non-administered dose,” “expired dose,” “spilled dose,” and “contaminated dose,” should be adopted. Due to the ongoing risk of drug diversion as well as present ecological considerations regarding the deposition of medication into drain pipes contaminating ground water supplies, all non-administered controlled medication doses should be referred to as “collected doses”…