Alternative to Discipline Programs for Substance Use Disorder

If a substance use disorder is suspected from the evidence, BONs from most jurisdictions offer the nurse a non-disciplinary alternative to discipline program. These Alternative to Discipline programs enhance a BON’s ability to quickly assure public protection by promoting earlier identification and requiring evidence-based intervention for nurses with substance use disorder. The benefits to the nurse include the opportunity to demonstrate to the BON in a non-disciplinary and non-public manner that they can become safe and sober and remain so, while retaining their license.

Each state with an alternative to discipline program has specific rules and procedures for entry into the program.  The program links below are provided as information only.

Substance Use Disorder Manual

Various chapters in Substance Use Disorder in Nursing provide important information regarding alternative to discipline programs:

  • Regulatory Management of Nurse with a Substance Use Disorder (Chapter 4) 
  • Types of Alternative Programs (Chapter 7) 
  • Program Entry (Chapter 8)

NCSBN Checklist and Program Audit

The NCSBN checklist and program audit of Alternative to Discipline Program or Monitoring Program (ATD program) analyzes fourteen criteria to determine whether the ATD program is in alignment with NCSBN Guidelines for Alternative Programs and Discipline Monitoring Programs within Substance Use Disorder in Nursing. The checklist and audit will identify and inform, and then assist in the management and remediation of any deficiencies.