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Substance use disorders involve a pattern of using drugs more extensively than intended and continuing use despite harmful consequences. This includes legal substances like alcohol and nicotine, as well as illegal drugs. These disorders often involve both physical and psychological dependence, reflecting compulsive use of substances that significantly alter thoughts, feelings, and behaviors, contributing to a major public health issue.
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Substance Use Among Middle-Level Nurse Managers.

Yitong Wang1, Karen J Foli, Zachary Hass

  • 1Assistant Professor (Dr Wang), Mark and Robyn Jones College of Nursing, Montana State University, Bozeman, MT; Professor and Endowed Chair for Mental Health Nursing (Dr Foli), Louise Herrington School of Nursing, Baylor University, Dallas, TX; Associate Professor (Dr Hass), School of Nursing & Edwardson School of Industrial Engineering, Regenstrief Center for Healthcare Engineering, Purdue University, West Lafayette, IN; Associate Research Professor (Dr Adams), Regenstrief Center for Healthcare Engineering, Purdue University, West Lafayette, IN; Professor (Dr Lee), Brian Lamb School of Communication, Purdue University, West Lafayette, IN.

The Journal of Nursing Administration
|May 22, 2026
PubMed
Summary
This summary is machine-generated.

A significant percentage of middle-level nurse managers (MLNMs) report substance use. Factors like career stage and specialty influence alcohol and drug use, indicating a need for workplace wellness initiatives.

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Published on: August 25, 2014

Area of Science:

  • Nursing Management
  • Occupational Health
  • Healthcare Workforce Studies

Background:

  • Substance use (SU) among nurses is a persistent issue.
  • Middle-level nurse managers (MLNMs) are crucial but understudied regarding SU.
  • MLNMs face significant clinical and administrative demands.

Purpose of the Study:

  • To determine the prevalence of alcohol and drug use among MLNMs.
  • To investigate links between MLNM characteristics and substance use.
  • To identify workplace factors associated with substance use in this population.

Main Methods:

  • A national cross-sectional survey was conducted.
  • 234 middle-level nurse managers participated.
  • Binary logistic regression analyzed relationships between work factors and SU.

Main Results:

  • 13.42% of MLNMs screened positive for unhealthy alcohol use.
  • 75.63% of MLNMs reported some level of drug use.
  • Mid-to-late career, medical-surgical, and pediatric specialties were linked to higher odds of drug use. Master's-prepared nurses and those with more experience showed lower odds of SU.

Conclusions:

  • Findings underscore the prevalence of substance use among MLNMs.
  • Workplace factors and individual characteristics influence SU.
  • There is a need for leadership development focused on wellness and structural changes to mitigate work-related risks.