18% of Nurses Screened Positive. Why Are We Still Waiting?18% of Nurses Screened Positive. Why Are We Still Waiting?
Drug Diversion Insights with Terri Vidals
Terri Vidals talks with IPN leaders Abby Migliore and Dr Shannon Opie about nurse impairment, alternative-to-discipline monitoring, and striking statistics on substance use among nurses. They discuss stigma, medication-assisted treatment, and why earlier, supportive intervention is crucial for both nurses and patient safety.
54:07•19 Aug 2026
18% of Nurses at Risk: Why Are We Still Waiting to Help?
Episode Overview
- Alternative-to-discipline programmes like IPN focus on protecting the public while helping nurses get treatment and keep their licences when possible.
- Most referrals come from workplaces, yet stigma and staffing shortages still discourage managers from reporting suspected impairment early.
- A national survey cited in the discussion found 18% of registered nurses screened positive for substance use problems, with one third meeting criteria for a disorder.
- IPN participants often have stronger safeguards than other nurses, including drug testing, work restrictions, support groups, and in some cases opioid-blocking medications with neurocognitive testing.
- The guests argue for earlier intervention, more education, and destigmising help-seeking so nurses can address risky substance use before patients are harmed.
“I thought you guys were the devil… and now I realised, you saved my life.”
How do people find strength in their journey to sobriety? This conversation zooms in on nurses, the pressures they face, and what happens when substance use starts to affect patient care. Host Terri Vidals chats with Abby Migliore and Dr Shannon Opie from Florida’s Intervention Project for Nurses (IPN), an alternative-to-discipline programme that helps nurses with substance use disorders and mental health conditions while still protecting the public.
Abby, IPN’s COO and a long-time nurse, explains that the goal is simple: “The core…of what we do is the goal is to save lives, protect the public… and also back to that nurse.” Shannon walks through what it’s actually like when a nurse is referred to IPN—often at their lowest point, sometimes after drug diversion, impairment at work, or legal trouble.
She stresses that IPN doesn’t diagnose or prescribe; instead, they coordinate independent evaluations, monitoring, and support so nurses can safely step away, get treatment, and, where appropriate, return to practice. The episode digs into a striking national survey where 18% of registered nurses screened positive for substance use problems, with a third meeting criteria for a full disorder.
Terri, Abby, and Shannon talk about what those numbers might mean for hospital policies, early intervention, and why waiting for a “smoking gun” incident is so risky. They also talk frankly about stigma: managers who see IPN as punitive, colleagues who say “I’d never want that nurse treating me,” and employers who hesitate to report because of staffing shortages.
Shannon counters that IPN nurses often have more safeguards than anyone else—drug testing, work restrictions, workplace monitors, and, in some cases, medications like naltrexone or buprenorphine with neurocognitive testing to ensure they’re safe to practice. If you work in healthcare—or care about the people who do—this episode asks a tough question: why are we still waiting until nurses fall apart before offering help?
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