Professional License Lawyer in North Carolina

How will my nursing practice be impacted by a substance abuse issue?

How will my nursing practice be impacted by a substance abuse issue?

Substance abuse disorders can occur in any individual or within any profession, and nursing is no exception. Substance abuse issues in nurses can lead to several other issues that impact a nurse’s ability to do his or her job, such as drug diversion or impairment on duty. Drug diversion is when an individual takes a prescription medication without authorization for personal use or others. Some of the most frequently reported problems to the Board of Nursing are related DWI charges and drug diversion. These accusations tend to be reported by long term care providers and hospitals, and criminal charges related to these can result in action against a nurse’s license. Impairment on duty, whether under the influence of drugs (to include prescription medications) or alcohol, leaves the nurse unfit for duty. Impairment can also be related to any condition, illness, or fatigue. In addition, a nurse may also be reported to the Board for allegations relating to fraudulent prescriptions and positive drug screens. The Board offers programs for those with chemical dependency and can allow for a nurse to gradually return to work. This will occur in settings in which there is close supervision and Board monitoring.

What are the policies for the NCBON regarding substance abuse issues?

The NC Nursing Practice Act and the North Carolina Administrative code require the NCBON to investigate and intervene in cases of substance abuse in nurses. Out of concern for the safety of patients, the North Carolina Administrative Code states that NCBON has the authority to investigate and potentially discipline nurses if “drug or alcohol abuse or use of any substance or other agents while on duty or on call to the extent that such use impairs the nurse’s ability to practice nursing.” [21 NCAC 35 .0217]. This includes testing positive on a drug screen, accepting responsibility for the care of a client while impaired by alcohol or other substances, or any use that violates the North Carolina Controlled Substances Act (such as illegally obtaining, possessing, or distributing drugs or alcohol). If the Board finds evidence that a nurse does have a substance abuse issue, the Board may take disciplinary action such as placing the nurse on probation, imposing conditions on their nursing license, issuing a public reprimand or letter of concern, requiring completion of treatment programs, or even revoking their nursing license. [GS 90-171.37].

How are cases of substance abuse issues resolved with the NCBON?

According to the NCBON, case resolution can occur in a number of ways. Some nurses will be able to take part in remedial coursework (which can occur in a variety of settings) and is appropriate for those who have minor documentation errors or have exceeded the scope of practice to a minor degree. However, those with investigations related to drug diversion and impairment tend to lead to discipline against their license. This discipline can be a level of license suspension or probationary conditions on their license. These probationary conditions will allow the nurse to continue to practice while being closely supervised by a registered nurse.
While under investigation, the nurse’s license is typically not affected. In situations where there is risk to the public, the license is flagged as an alert to future employers when there is a significant matter under investigation. The Board is required to report any pending investigations and discipline related to a flagged license to national data banks that are maintained by the National Council of State Boards of Nursing. The nurse’s license will then reflect the history of disciplinary action for an indefinite period of time.
Nothing in this blog post is intended to be legal advice or establishes the attorney-client relationship. This is for informational purposes only. If you’d like to learn more about professional licensing issues in North Carolina check out our site at or our YouTube site here. North State Law can also be reached at 919-521-8810.