In Demand Healthcare Jobs: Addiction Nurses

When there’s a need, nurses fill it. The specialty field of addictions nursing is responding to a “horrific epidemic,” says Colleen T. LaBelle, BSN, RN-BC, CARN and executive director of the Massachusetts chapter of the International Nurses Society on Addictions (IntNSA). Labelle is also director of opioid treatment at Boston Medical Center.

“More people are dying every day from drug overdose—the leading cause of injury death in the United States,” she says, citing other riveting statistics that underscore her point. If you’ve considered addictions nursing, consider that:

• In 2005, more people died from drug overdose in 10 states than in motor vehicle accidents.
• Then in 2010, the number of states increased to 37.
• Every day in the United States, 120 people die as a result of drug overdose.
• Another 6,700+ are treated in emergency departments.
• Nine out of 10 poisoning deaths occur from drugs.
• In 2013, more than 35,000 of nearly 44,000 drug overdose deaths were unintentional, 5,400 were of suicidal intent, and just over 2,800 were of undetermined intent.

“We know people have legitimate pain, but addiction is everywhere in healthcare and at every level of care,” says LaBelle. “We also know nurses touch every level of care. It’s so important for us to understand the disease of addiction—that it’s chronic, relapsing, and when we don’t treat it, people die. It costs us money, trips to the ER, and more patients in hospital and nursing home beds.”

Understanding addiction is also the key to developing more compassion and more empathy and being better able to treat this challenging, complex disease, she says. The National Institute on Drug Abuse defines addiction as a chronic, often relapsing brain disease that causes compulsive drug seeking and use, despite harmful consequences to the addicted individual and to those around him or her. Research shows that combining addiction treatment medications with behavioral therapy is the best way to ensure success for most patients.

More Care for More People

Founded in 1975, IntNSA is “committed to the prevention, intervention, treatment, and management of addictive disorders including alcohol and other drug dependencies, nicotine dependencies, eating disorders, dual and multiple diagnosis, and process addictions such as gambling.”

Changes in healthcare are enabling more people to seek care for their addiction problems. “It’s actually a paradigm shift that the Affordable Care Act has opened up coverage for people with substance abuse,” says IntNSA President Dana Murphy-Parker, MS, CRNP, PMHNP-BC and CARN-AP. She’s also assistant clinical director of Drexel University College of Nursing and Health Professions.

“Stigma still exists even though people with addictions have better access, and it even still occurs in healthcare,” she says. The process of treating addiction typically involves early screening, brief intervention and referral to treatment. “We can help people understand what kinds of negative consequences they’ll encounter later on if addiction continues.”

She points to measurable forward momentum within her field, since for a very long time addictions nursing was considered a subspecialty of psychiatric and mental health nursing. “Now, if you read our mission statement, it says that people who have addictions enter into many different healthcare settings. We are for all nurses practicing clinically who want to know what to do when a patient comes in with a substance abuse problem,” she says.

Those patients may also present with other problems including high blood pressure, liver disease, and cognitive changes—conditions familiar to all nurses.

Why They Can’t Stop

“We understand that substance abuse is a healthcare problem in itself,’ says Murphy-Parker. “For a long time we thought patients ‘could just say ‘no’ and pull themselves up by the bootstraps if they had enough willpower. Now we know a neurobiological addiction occurs in the brain, causing people to crave the substance and not be able to stop.”

Stopping a problem before it starts is the goal, before a patient receives their DSM diagnosis—per the Diagnostic and Statistical Manual of Mental Disorders. “If we catch this earlier, we can educate patients about how much they’re using, whether it’s alcohol or recreational drugs,” she says.

Helping people fight against the odds and succeed continues to be an immensely rewarding component of addictions nursing, Murphy-Parker says. She recalls a patient who’d been to treatment five times and measured a dangerously high alcohol level of .3 the last time she saw him. After finally agreeing to go to the ER yet another time, he asked her, “Before I go, can I have a few more beers?” Once there, he remained in detox for five days.

When he left, it was finally to become a productive member of the community, get a job and enter into a committed relationship—a real success story.

“We have an opportunity to work with so many people one-on-one, and to work with their support systems—families and friends,” Murphy-Parker says. “And we have an opportunity to make real change.”

What You Need to Do

The Addictions Nursing Certification Board (ANCB) administers twice-yearly exams in a variety of locations. You may sit for two certifications, both of which require candidates to hold current, full and unrestricted RN licenses.

• Certified Addictions Registered Nurse (CARN): Must have a minimum of 2,000 hours (one year) of nursing experience related to addictions as an RN and 30 hours of continuing education related to addictions nursing within the last three years.
• Certified Addictions Registered Nurse – Advanced Practice (CARN-AP): Must have a master’s degree or higher in nursing and a minimum of 500 hours of supervised, direct client contact in advanced clinical practice working with individuals and families impacted by addictions/dual diagnoses. All 500 hours may be earned while in the master’s program.

Many addiction nurses also hold dual certification, Murphy-Parker says, including family practice or pediatrics. She also hopes you’ll mark your calendar for IntNSA’s annual conference, this year slated for Oct. 21 – 24 in Charlotte, N.C.

Find your ideal nursing job here on Monster, including one in addictions nursing.