Helping an at-risk workforce

Art Zwerling’s never-dull life, ever busy in the face of health challenges, offers numerous examples of myth busting. First, his substance use history and that of his family shatter the mistaken notion that addiction bypasses the Jewish community. More recently, Zwerling demonstrated that someone with an addiction can in theory receive a safe administration of pain medication, though it took significant prodding from his addictionologist to convince him, given his own background in healthcare.

“I’ve seen too many disasters,” says Zwerling, 60. “I saw far more people fail than succeed.”

Zwerling’s understanding of addiction’s effects stems in part from his work in addiction counseling, as a physician assistant, and finally as a nurse anesthetist. In recent years he has served as a national leader in educating nurse anesthetists on their profession’s unique risks for addiction. He was instrumental this year in getting the organization that accredits training programs for nurse anesthetists to mandate the inclusion of addiction education in all training curricula for the profession.

In 2010 Zwerling was honored in the annual America Honors Recovery event by Faces & Voices of Recovery, where he was credited for “constantly developing new and innovative strategies for educating others, eradicating stigma, and advocating for better systems.”

“The major drugs of abuse in nurse anesthetists, once we get past alcohol, are IV opioids,” says Zwerling, who serves as chief anesthetist at a cancer center in Pennsylvania. “These drugs in some cases are up to 1,000 times more potent than morphine.”

Classic achiever

Zwerling describes his own substance use story as fairly commonplace, but with a somewhat unusual twist. He first was exposed to alcohol by sneaking swigs of what was left over from family poker games. In school he routinely would be suspended in the morning and reinstated by afternoon, his high test scores carrying the day.

“There was impermeable denial in my family,” Zwerling says. “Even though there are no Jewish alcoholics, all of my friends in AA were anomalies,” he adds sarcastically.

Zwerling would drop out of high school but then earn his GED and proceed to college, where at one point he decided to pursue the study of pharmacy—he admits to that not being the best choice. During this period in the mid-1970s he would meet up with some “shady folks” who tapped into his knowledge of medicinal chemistry. “I found out that the Philadelphia Fire Department had me under surveillance,” Zwerling says.

He would end up leaving the country for a year, having discovered that the Drug Enforcement Administration (DEA) also was familiar with him. Upon his return, he would say goodbye to past acquaintances and pursue treatment.

Zwerling worked at Eagleville Hospital in the late 1970s and early 1980s, then transitioned to working as a physician assistant before a pain issue led to a relapse in the mid-’80s. The founder of an association for recovering nurses in Philadelphia became his first sponsor, introducing him in a meeting by saying, “This is Art. He’s a PA, but he’s OK.”

He would be named to the recovering nurses group’s board of directors, using his intervention training from Eagleville to serve on the intervention team for a number of nurses and nurse anesthetists. “These folks were dying with regularity,” says Zwerling. “It piqued my intellectual curiosity about impaired professionals.”

Zwerling then decided to attend nursing school, and eventually would become a certified nurse anesthetist. In his efforts to highlight the particular risks this profession faces, he says that “one of our major struggles is that people lump in nurse anesthetists with LPNs and RNs who have different practice issues.”

No secrets

Zwerling remains very open about his personal story, including his current issues with back pain that for a period of several weeks required him to be carefully monitored on pain medication.  (At the time this interview was conducted, Zwerling was preparing to have a spinal cord stimulator implanted.)

“I’m a believer that keeping secrets is what kills people,” he says.

Zwerling credits the Peer Assistance Advisory Committee of the American Association of Nurse Anesthetists (AANA) for much of the effort to highlight addiction and recovery issues in the profession. The committee’s work encompasses peer assistance, education and research.

Now that academic programs will be mandated to teach nurse anesthetists in training about chemical dependency and wellness issues, a task force within the AANA is drafting a curriculum, Zwerling says. Expanded education is one of many marks that Zwerling has been able to leave on his current profession; he also has established web-based forums that allow nurse anesthetists to gain important insights about early recovery issues. All of this has been made possible through the strength of Zwerling’s own recovery.

“I’m kind of a typical story of an adolescent with early-onset addiction, who was pounded enough times to get sober,” Zwerling says.