Substance abuse nurses, or addiction nurses, specialize in the care of patients who are addicted to substances (i.e., drugs and alcohol). They often act as a lifeline to those who relapse or who reach out for help with recovery. While substance abuse nurses intend to help patients recover from substance abuse and live healthy lives, sometimes patients are unsuccessful and in some cases, overdose.

Substance abuse nurses struggle themselves when patients relapse. Some nurses feel as though they have failed their patients, and many times they feel guilty. But what about the legal ramifications for nurses?

Unfortunately, there is not a clear-cut answer. It depends on the situation. For example, let's say a substance abuse nurse follows all the organizational policies and procedures, assesses and documents that a patient is on the right track with recovery, and administers prescribed medications (for example, methadone) correctly. Then the patient ends up relapsing and overdosing on street drugs. That nurse is likely not going to be held liable. However, if the nurse fails to accurately monitor, assess, evaluate and document a patient's care, or administers the wrong dose or drug, then yes; that nurse could be held liable in the event of an overdose.

Basically, any violation of the state's nurse practice act could place the nurse at risk. For example, let's say a substance abuse nurse fails to document an assessment or progress note on a patient. Or, perhaps the patient failed to complete a routine drug screening, and the nurse administered methadone anyway, and the patient overdosed. The nurse would likely be found negligent and legally liable for the overdose.

Cases such as this are why nurses are responsible for knowing their state's nurse practice act, as well as their organization's policies and procedures. Nurses could be held accountable for negligence or malpractice. It may also benefit nurses who work in the specialty of addiction to contact their facility's legal department, or their liability insurance carrier (if they have one).

Nurses get into the field of healthcare to help others and tirelessly strive to give the best possible care to their patients. Unfortunately, we live in a litigious society. Nurses should be well informed and do all they can to protect their license and their practice.

Amanda Bucceri Androus RN, BSN
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