Further Reading

Help me get my nursing license back

Dear Dr. Stanton;

I am truly in a bind. Approximately 13 years ago, the Board of Nursing revoked my license for diversion of drugs. I hit rock bottom and decided on my own that this was over forever. I have been abstinent of narcotics since that time. I started a consulting business which has been fairly successful. I deal only with law firms. Last year, discussions with several law firms re medical/legal consulting prompted me to attempt to obtain my license back so that I could expand to include this new area.

The Board of Nursing agreed with the following stipulations: nursing refresher courses and enlisting in the nursing Peer Assistance Program. It would be on PAP's recommendation that I could get my license back. This is a 3 year contract with PAP. Attendance at 12 Step is mandatory with no alternatives. Random urine screens are also part of the PAP program as well as attendance at a nurses' support group. I have complied with everything they have asked. I have been in the program one year, and my nursing license was returned to "Inactive." I will complete my nursing refresher courses in 2 weeks. All I had to do was to wait on PAP's approval.

Three weeks ago I had a dental problem and took narcotics for pain with the dentist's approval until the pain was abated by a double root canal. I reported this incident to PAP as I am required. Because I did not contact them in a timely fashion (I did so one day following the dental procedures rather than before I took the drugs), PAP said that I have relapsed. I was asked to have another Psych evaluation done. This was performed my a non-credentialed person. He is studying to be a Social Worker. This man is also from a 12 Step modality. He recommended an Intensive Drug/Alcohol Treatment program. PAP has agreed and unless I attend (minimum 28 days, $12,000 cheapest program found), I will be dropped from PAP and reported to the Board of Nursing for non-compliance and breech of contract.

I have seen an attorney but he doesn't really seemed 'fired up' over this. I am indeed worried and in addition to any advice you may have, I severely need to ask for something you have said on your web site that you cannot provide. Do you know of anyone in the area who can help, legally and/or psychologically? I will understand if you cannot help.

Thanks for being there, for your life, your studies and your writings,

D.

P.S. While in compliance with PAP, I have since day one registered complaints about the 12 Step requirement. I have even used references from your literature, Charles Bufe and others to back my position. All urine tests, even the one following the dental problem, during this year have been negative. The coordinators of my nurse support groups (who have seen me regularly for one year) have written letters to PAP stating no evidence whatsoever of relapse.

Dear D:

Yours is a great case, or at least as good as they get. Let me state why:

1. The thing is that nurses and physicians who write me in a similar vein, even when they hate what they're asked to do vis-a-vis "recovery," are forced to go along with these 12-step, abstinence requirements, because theirs is the only game in town. I mean, who else is going to give you a medical/nursing license? You, although you obviously want your license back, have another way of making a living to tide you over for the duration.
2. You endeavored to go along with their program. In other words, it's not as though you've come in and said, "I disagree with this whole procedure and refuse to meet your requirements." Rather, only when their demands clearly veer off the charts of rationality (and I think most sensible people would agree this is the case), did you object. I think this gives you an opening. In other words, the question is, if this becomes public, will they be hurt by it? Of course, how bad would it be for you if this becomes public?
3. I am both a psychologist and an attorney, but I am not licensed to practice law in your state. An attorney may be granted a special dispensation to work in a state. Alternately, you can try to interview attorneys (you might try the ACLU) and tell them that you have an out-of-state attorney who can assist in this process. Make clear that you feel strongly about this and find an attorney who can go to the wall with you.
4. The law works for you when the government requires you to attend AA, since a series of cases at the State Supreme Court and Federal Appeals Court levels (with no diverging opinions) have held that a government body cannot require a person to attend AA because of its religious content (this violates the 1st Amendment's separation of church and state, called the "establishment"—no establishment of religion by the government—clause). The same does not apply with private employers, since the idea is you can go to another employer. A state agency with sole power for medical licensure parallels the government enacting requirements.
5. As a starter, you could commission me to write a letter attacking their actions (a) on a therapeutic basis (reviewing data of your case and in general about how this requirement is irrational and not justified by the evidence), (b) on legal grounds (as per point 4 above). I'll write such a letter, with a follow-up, for $500. If you want/need to pursue (3) above, we can work out a flat fee for my assistance, which you might also try to do with your local attorney, as opposed to an hourly rate. If/when you win, the attorney can then apply to the Court to seek his and my fees from the nursing organization. Of course, most legal cases do not proceed to court.

All of this has risks and can be stressful, but then, you've already experienced some stress over this, have you not? Moreover, what you are doing is so painfully right that you should take action.

All best,
Stanton