Drug and alcohol abuse and the licensed healthcare professional

For most people, that’s enough

Earlier this year, I needed to help a licensed health care professional obtain more treatment, so I spoke with his drug counselor, who was surprised at my inquiry.  From the drug counselor’s standpoint, my client had completed the requirements of his court-sanctioned diversion program with perfect attendance, consistently clean urine tests, and no withdrawal symptoms – so, what more was there to do?  For most people, that’s enough, and perhaps rightfully so.  But, if you’re a licensed healthcare professional, you will often be subjected to more scrutiny and more will be expected of you.

More is expected of a licensed healthcare professional

If you are licensed by the Oregon State Board of Nursing, the Oregon Board of Pharmacy, or the Oregon Medical Board, your licensing board will want to know whether your substance abuse incident (often involving a police report, arrest and conviction, or a drunk driving arrest and conviction) is an isolated incident, or part of larger problem.  If part of a larger problem, even if your practice hasn’t been affected, your licensing board may want to intervene, to gather more information, to ensure there are no public safety concerns.  If this happens to you, you need to be prepared, and this is no time to learn on the fly.

Experience gained – the truth about honesty

Two tough cases with “easy” resolutions

I have represented licensees facing allegations involving alcohol.  Two stand out favorably for lessons learned.  One had a significant alcohol history and the other a significant alcohol-related incident.  Both, however, were fully forthcoming and painfully honest when interviewed by their licensing boards, and both fully embraced and responded to their treatment.  Although both had significant issues with alcohol, the investigator, and eventually the licensing board, trusted them and their treatment.  Both licensees were treated respectfully, and both licensing boards joined in the search for solutions tailored to the individual.  Neither licensee lost much time from work, and revocation was never the issue, an optimum result for both licensees.

Three tough cases with “hard” resolutions

Two other cases stand out for lessons learned, but these were painful lessons for the licensee.  One licensee had a significant drug history, the other a significant alcohol history, but both were in denial until one was caught by testing and the other threatened with revocation of his license.  A third case stands out because the licensee had a minor alcohol history but, in the investigator’s mind, the licensee’s explanation of the incident in question was suspect.  In all three cases, the investigator did not trust the situation, which is always problematic, because investigators have resources.  In all three cases, the investigator pursued his or her suspicions until confirmed, at least in part.  These are mistakes to be avoided.

Lessons learned:

  • If you know you have an alcohol or drug problem that can be verified and warrants treatment, the sooner you accept the truth of your situation and get in front of your treatment needs, the easier it will be to maintain your medical license and restore your health.  Why wait to be caught?
  • If you have been caught, but you are forthcoming and honest about your drug or alcohol abuse, you will gain the trust of the investigator and eventually your licensing board, and your life will be easier.  Treatment and return to practice will be the goal.
  • If you have denied a known drug or alcohol problem and your explanations are suspect, you will be pursued until caught (remember, investigators have resources).  Once caught, a convincing and genuine 180 degree course-reversal will be necessary to save your medical license.

What to expect – the “balancing act”

That you may have a drug or alcohol problem alone, without more, is not enough to lose your license.  If you are a nurse, pharmacist or physician licensed by the Oregon State Board of Nursing, the Oregon Board of Pharmacy, or the Oregon Medical Board, you own your license as much as you own your car; it is your personal property, and it cannot be taken without a specified process, aka due process.  It is important to know, however, what you must concede to your licensing Board, and what you must do, to keep your license.  If you do the right things, the power to keep your license shifts to you, but if you do the wrong things, the power to revoke your license shifts to the Board.  An experienced lawyer can help you make decisions that will keep you in a defensible position.

Remarkably, even if you have received a “notice of revocation” of your license, it may not be too late.  I can think of two cases in which I was retained after a notice of revocation had issued but we were able to turn both cases around by quickly doing the right things in a genuine way (sometimes the notice of revocation is the final wake-up call).  In a third case, however, I was not able to help – the problem was inexcusable dishonesty and the board did not see any way to fix that kind of problem.

One final thought: be forthcoming with your lawyer too

I am not gullible, but I can be mislead and, unlike your investigator, I will not fact-check you except in the rare case.  As I write this, I can think of three licensees that misled me and their licensing boards, until they were caught.  I believed all three.  In two of the cases, the licensee denied a drug or alcohol problem and denial was recognized as part of the disease.  I understand that dynamic and your licensing board will too.  There will be some sympathy, so long as no further mistakes are made.  In the third case, however, no such luck. I was present with the licensee when, during a tape-recorded board interview, the licensee was confronted with evidence that disproved the licensee’s prior answers.  It was a painful moment for me, and certainly for my client, and there was no disease to blame, just dishonesty. Ouch.

The bottom line is that if you are honest, your licensing board will do much to work with you, but if your board thinks you can’t be trusted, you’ve made your situation much worse.  Finally, if saving your license is your most important objective, be honest with your lawyer too.  Your lawyer can help you to make the right decisions, present difficult problems in the best light, accept responsibility where you must, and defend the rest.