Getting Help

Facts about Chemical Dependency and Addiction

Chemical dependency, like all addictions, is a chronic, progressive illness that can be treated effectively. As with all chronic illnesses, the earlier the identification, the better the prognosis.

Chemical dependency can be simply defined as the continued use of alcohol, prescription drugs, street drugs, or other mood-altering substance even after negative consequences have been experienced. Negative consequences can be in the form of work-related problems, damaged relationships, legal charges, break down of physical and/or mental health, and many others.

Approximately one out of every 10 health professionals has or will develop serious problems with some form of substance abuse or addiction at some point in their professional career.

Health professionals face a higher risk of addiction/dependency due to their knowledge of medicines, dosages, and effects, the stress of the job, the tendency to self-diagnose and self-prescribe, and the constant focus on other peoples' needs instead of their own.

Warning signs and symptoms may include, but are not limited to:

• Mood swings
• Inappropriate behavior at work
• Increased or unexplained absenteeism
• Deteriorating appearance
• Deteriorating job performance
• Increased errors in work output
• Poor judgment and concentration
• Frequent untruthfulness

The hallmark sign of addiction is DENIAL. Denial is a psychological defense mechanism used to avoid admitting that a problem is serious. Licensed health professionals are experts at minimizing the problem and convincing others that everything is under control.

Guidelines for TnPAP Participation

The Tennessee Professional Assistance Program (TnPAP) is designed as an alternative to licensure discipline for certain practitioners who professional practice may be impaired due to substance abuse, or a physiological or psychological condition. As long as the practitioner is willing to follow the guidelines set forth in the TnPAP agreement, the TnPAP will advocate for the practitioner with the licensure board.

In most cases, the practitioner is able to maintain a license in good standing while completing appropriate evaluation, treatment, follow-up, and monitoring. The regulator board may also require TnPAP participation of some practitioners as an adjunct to licensure discipline or as a condition of licensure reinstatement.

1. Upon the advice of TnPAP, the practitioner must agree to refrain from professional practice TnPAP return-to-practice criteria are successfully completed and the practitioner is cleared by the TnPAP to return to a specific position.
   
   
2. With the assistance of TnPAP, the practitioner is referred to an approved specialist for a complete evaluation that includes treatment and aftercare recommendations. The evaluation may take one visit or may involve up to three days of assessment, depending upon the needs of the practitioner.
   
   
3. The practitioner is asked to sign a TnPAP agreement that defines the responsibilities of the participant and of the TnPAP staff. Agreements are catered to the needs of each individual, but routinely include the following:
   
   
   • Successful completion of the recommended level of treatment
     
     
   • One time attendance at the TnPAP orientation including signing of agreement
     
     
   • Adherence to the recommended aftercare plan
     
     
   • Attendance at peer support group meetings
     
     
   • Attendance at the required number of Twelve Step Meetings, i.e. AA, NA, CA, etc.
     
     
   • Timely submission of random drug screens
     
     
   • Submission of periodic progress reports that may include but not be limited to (1) work performance evaluations, (2) verification of meeting attendance, (3) progress evaluations by treatment providers, and (4) written self reports
     
    
4. In order to receive TnPAP clearance to return to work in a professional practice setting, the participant must agree to the following:
    
• TnPAP must be notified in advance of acceptance of any position that requires a practitioner license.
  
  
• Employer(s) must be notified of involvement with TnPAP prior to accepting a position.
  
  
• Participant must not have access to or administer controlled substances for 12 months or as determined by TnPAP.
  
  
• Scheduling of work hours must not interfere with meeting attendance and must not include more than 40 hours per week.
  
  
• Employment may not include unsupervised practice, i.e. floating from unit to unit, employment by a staffing agency, home health agency, hospice or a registry.
  
  
• Participants authorize the TnPAP staff to release and/or exchange information with treatment providers, employers, family members, or any significant others.
   
5. The services provided by TnPAP are offered to participants without cost. The health licensing boards pay for all TnPAP services. Other financial obligations (treatment, evaluations, drug screens, etc.) are the responsibility of the participant.