The Addicton 'Disease' Leading to Theft, Professional Betrayal

"[The care home had a duty to accommodate the nurse's unquestioned diagnosis of severe opioid use of disorder and  mild to moderate sedative-hypnotic use of disorder, a disease that left her with] a complete inability or a diminished capacity [to resist the urge to feed her addiction]."
"[Two addiction experts testified addiction is viewed as a health condition and that] to view [addictions] as bad habits stigmatizes these conditions and makes it harder for people to get help."
Labour Arbitrator Larry Steinberg

"[Addiction is not a disease but more like a bad habit though it is] acknowledged that this was a minority view in the psychiatric profession and that it was contrary, for example to the DSM-5 [manual of psychiatry]."
Lawrie Reznek, professor of psychiatry, University of Toronto

"[Addiction is a result of] the motivated repetition of the same thoughts and behaviours until they become habitual."
"[Addiction is not a disease, but rather a] developmental cascade [as in a form of learning]."
Marc Lewis, Canadian neuroscientist, author

"The ability to make some choices[about drug use] does not negate the trial judge's findings that addiction is a disease in which the central feature is impaired control over the use of the addictive substance."
Supreme Court of Canada

An ampoule of morphine

The issue of nurses addicted to narcotics who have, through the course of their employment stolen painkillers for their personal use is not rare. One nurse took painkillers from an elderly terminal cancer patient whose well-being she was in charge of. The nurse was convicted of theft, had a five-month suspension imposed, and resigned after the College stated she had shamed the profession. Yet another nurse had stolen medication from a dying teen and was stripped of her nursing license, then was  sent to prison for 18 months on conviction of theft, drug charges, breach of trust and impaired driving.

In 2016, a nurse employed at a long-term care facility in Waterloo, Ontario came across one of her nursing peers holding in her mouth an ampule of Hydromorphone painkiller which she had injected herself with. This was part of the evidence, that nurse DS had been stealing opioids for her own use and in the process falsifying medical records to conceal her thefts, over the past several years. The 50-year-old nurse denied, when confronted by the nursing home management, the charges against her.

Finally she admitted that she had acted as charged after she had become addicted to painkillers when she was being treated for a kidney condition. Sunnyside Nursing Home fired her for gross misconduct and theft. The nurse, identified only by her initials, testified at a subsequent labour hearing that she had entered residential rehabilitation that weaned her off her addiction. Her nursing license was reinstated with a series of conditions, among them that she have no access to controlled substances and be at all times supervised.

A decision was handed down by the labour arbitrator that hinged on the issue of whether addiction is a medical disease. That arbitrator held that it is and ordered the regional Municipality of Waterloo to restore DS to her job at the nursing home and that she be compensated financially for unfair dismissal. That compensation to include general damages for "injury to dignity, feelings and self-respect". Obviously that the nurse had herself of her own volition through her choices caused 'injury' to her dignity and self-respect, was not entertained by the arbitrator.

She was -- according to his acceptance of the now-prevailing view that addiction is a disease that overcomes one's self-agency -- accorded the respect of the injured, not the ignominy earned by someone who, tasked by her profession to ease the suffering of the ill and the elderly, made the decision to avail herself of the medications used to offer them relief from their suffering and pain. The care home had argued that DS had been fired not because of her addiction but for theft and record falsification, abuse of residents and breach of trust.

The arbitrator stuck to his definition of the situation, that the nurse had been discriminated against unfairly because her actions represented symptoms of addiction disease. And as such it is clearly discriminatory to fire someone because they suffer from the effects of a disease. Addiction, argued, neuroscientist and recovered addict Marc Lewis whose book The Biology of Desire, where he argues addiction is more similar to racism than to cancer; more like violence or domestic abuse than cystic fibrosis and that to consider addiction a disease is wrong for it is actually a "very bad habit".

The reward for such a very bad habit is a return to duty, but the nursing home must be prepared to accommodate a health professional whose qualifications come with the proviso that she must be denied access to narcotics and monitored at all times, so how, one might logically wonder, would she be enabled to fulfill her obligations to the vulnerable patients, many of whom suffer from advanced dementia.

Her incapacity for independent work in an environment requiring such, means that constant supervision will take time and attention away from patients; in whose best interests is such an adjudication made?

Toronto Sun files