A recent study has found that healthcare workers who use alcohol and illegal drugs believe their substance use reduces the quality of care they provide to patients. The research, which surveyed nearly 3,300 doctors and nurses in Sweden, indicates a correlation between substance use and perceived patient care quality.
The participants reported on their use of alcohol, cannabis, and psychostimulants, as well as how they thought this affected their work. According to the study, 15.9 percent of respondents said they provided low-quality care. Of those, almost 29 percent used illegal drugs and 25 percent had a problematic relationship with alcohol.
"Even small percentages matter. This is about patient safety and what we should be able to expect from a regulated and well-functioning healthcare system," said Josefina Peláez Zuberbuhler, associate professor at Kristiania University of Applied Sciences and lead author of the study.
The findings suggest that even low levels of illegal drug use are associated with negative perceptions about patient care among healthcare workers themselves.
Emma Brulin from Karolinska Institutet pointed out that factors like burnout can also make employees feel less capable at work. "Substance use is a problem where the working environment and working conditions in the healthcare system need to be improved," Brulin said. She leads the health personnel survey LOHHCS (the Swedish Longitudinal Study of Work Environment and Health in Healthcare), which provided data for this research.
Professor Siw Tone Innstrand at the Norwegian University of Science and Technology noted that substance abuse can impair attention, memory, decision-making abilities, and psychomotor speed. This may increase medical errors and reduce the quality of healthcare delivered.
Innstrand added that stigma or fear of job loss often stops individuals from seeking help for substance issues. These problems may only come to light after mistakes have been made.
The longitudinal observation study included mostly women (over 75 percent) with more than half having over 15 years' experience in healthcare services. In 2022, participants answered questions about their own alcohol consumption, illegal drug use—including amphetamines, cocaine, ecstasy, LSD, heroin, and cannabis—and rated their own patient care quality.
Results showed that 3.8 percent had a problematic relationship with alcohol while 1.3 percent used illegal drugs. One year later, these groups were about twice as likely as others to rate their patient care as poor.
The researchers note that access to drugs in medical workplaces could increase risks for misuse among staff members. The study was conducted after the COVID-19 pandemic—a period during which pressures on healthcare systems rose significantly worldwide.
"We know that substance use among health professionals increased during the pandemic. Since then, the pressure on healthcare services has only continued. Resources are decreasing, while the need for care is increasing. Substance use can serve as a maladaptive coping mechanism for doctors and nurses to manage high workloads. It is therefore important that we address this," said NTNU professor Innstrand.
Researchers concluded there is an important link between employee health and patient care outcomes. They recommend efforts focused on improving workplace environments along with prevention strategies, early detection measures for substance issues, and support for affected staff members.
"Healthcare workers are often under huge amounts of pressure involving high workloads, unfavourable working hours and emotional strain," explained Innstrand.
She added: "In other words, we must make sure that people 'are able to put on their own oxygen mask first before helping others.'"
