Skip to Main Content

Substance Use Disorder Among Practicing CRNAs in the United States

Samantha Tylka, RN, DNP, CRNA

DNP Nurse Anesthesia

Substance Use Disorder Among Practicing CRNAs in the United States

Project Category:  Original Research 

Project Team: Samantha Tylka, DNP, CRNA Amber Neil, DNP, CRNA Jennifer Greenwood, CRNA, PhD (Advisor)


Background: Substance use disorder (SUD) is considered a top occupational hazard among anesthesia providers. The high stress environment and access to controlled substances contribute to a provider’s susceptibility to use them. A landmark study from 1999 found that the prevalence of SUD among certified registered nurse anesthetists (CRNAs) was 10%. More recent data from a two-year study of CRNAs confirms that the incidence of SUD has not improved, while also investigating the barriers to self- or peer-referral, current protocols for drug access and disposal, and the incidence of workplace random drug testing (RDT).

Methods: This descriptive cross-sectional study was conducted via email invitation to 3,000 practicing AANA members in 2022. An additional 3,000 participants were sampled in 2021. Data from the two survey iterations and national AANA data was analyzed via one-way ANOVA tests and chi-squared tests.

Results: Data from 2021 and 2022 indicated the sample was highly representative of the population of practicing CRNAs. Of the respondents, 10% suspected a colleague abused drugs at work within the past year, and 63% knew of a colleague who abused drugs at work throughout their career. However, only 2.6% of respondents admitted to using drugs at work. Opioids were the most frequently abused drugs in the workplace.  RDT was supported by 70% of respondents, but only 18.6% have received a RDT apart from the pre-employment screenings. Additionally, the fear of being wrong about a colleague abusing drugs in the workplace remains the biggest barrier to reporting peers. 

Conclusion: The magnitude of harm that an impaired CRNA can cause during the perioperative period is immense. The safety of all members of the team, including the patients and anesthesia providers, must be a high priority in the workplace. 

Full Manuscript Slide Presentation Video

Presentation Slides