Confronting Stigma Around Substance Use Disorders.
Across Canada, nurses are expected to be calm under pressure, compassionate in crisis, and endlessly resilient. But behind the professionalism and long hours, nurses are human—and like the general population, some experience substance use disorders (SUDs). Yet when nurses need help, stigma becomes a dangerous barrier. We are out there saving the lives of others. But who’s saving ours?
Substance use disorders are health conditions—not moral failures. Nurses are exposed daily to trauma, chronic stress, rotating shifts, and environments where medications are readily accessible. These are well-documented risk factors for developing substance use issues. When nurses struggle, it isn’t a betrayal of the profession—it’s a predictable human response to immense pressure.
The numbers tell a sobering story. Rates of substance use and addiction among nurses and allied health professionals mirror those of the general public: between 5% and 20% will experience issues related to substance use at some point in their careers. That’s what’s reported—imagine what’s not. Research also shows that the risks aren’t equal across all roles. Registered Nurses are 2.22 times more likely to die from a drug overdose than non–healthcare workers, while social and behavioral health workers face an even higher risk at 2.55 times that of the general public. The overdose crisis is not just happening outside hospital walls—it’s claiming the lives of those inside them, too.
In response, several provinces have created specialized substance use disorder (SUD) or “fitness to practise” programs for nurses. Ontario’s Nurses’ Health Program, for example, offers treatment referrals, recovery monitoring, and confidentiality protections for nurses who meet program requirements. These initiatives were built to help nurses recover safely and return to practice. But despite their existence, too many nurses still suffer in silence.
The fear is real: fear of losing one’s licence, being judged by colleagues, or being labelled unsafe instead of seen as someone in need of care. In a profession grounded in compassion, the shame surrounding SUDs remains one of its most unspoken contradictions.
And while these programs were designed to help, they often feel punitive. Some impose rigid, standardized monitoring plans or conditions that resemble disciplinary action rather than rehabilitation. Even “alternative-to-discipline” pathways are sometimes viewed with suspicion, leaving nurses unsure whether seeking help will protect their privacy or end their careers. This distrust drives silence—and silence drives risk.
If we want safer care for patients, we need safer systems for nurses.
Reducing stigma starts with changing how we think and talk about nurses’ health. We must normalize conversations about SUDs, burnout, and mental health as professional safety issues—not personal failures. Early help-seeking should be met with empathy, confidentiality, and individualized support, not with punishment or public exposure.
Regulators, employers, and unions share a responsibility to build trauma-informed, evidence-based pathways for nurses to access help before harm occurs. And as a society, we must stop treating nurses as superhuman. They cannot pour from an empty cup, and they cannot heal others while suffering in silence.
When nurses know they can seek help without being ruined by it, everyone benefits. Safety improves. Retention improves. Humanity improves.
A healthier healthcare system starts with healthier nurses—and that begins with dismantling the stigma that keeps them from stepping forward.
By Amie Archibald-Varley / The Gritty Nurse
https://www.grittynurse.com/