A WKYC investigation uncovered more than 150 doctors and other licensed medical workers who faced discipline between 2008 and 2013.
Anita Bertrand doesn't remember much about the first time she stole narcotics she was supposed to administer to surgical patients.
She doesn't remember exactly when she installed the intravenous port in her ankle so she could inject the drugs more efficiently.
And she doesn't remember how many patients she may have put at risk before getting into treatment.
But she remembers how easy it was to get away with it.
SPECIAL REPORT: Bad medicine, Ohio medical workers disciplined
"I was absolutely impaired, using narcotics while working. … And no one ever noticed," says Bertrand, 49, a nurse anesthetist in Houston. "Did I make mistakes? I don't know, and that's the scary part. I'm not aware of any, but I certainly would not say I was immune to that."
America's prescription drug epidemic reaches deep into the medical community.
Across the country, more than 100,000 doctors, nurses, technicians and other health professionals struggle with abuse or addiction, mostly involving narcotics such as oxycodone and fentanyl.
Their knowledge and access make their problems especially hard to detect. Yet the risks they pose -- to the public and to themselves -- are enormous.
SEARCH: Find my doctor in Ohio
A single addicted health care worker who resorts to "drug diversion," the official term for stealing drugs, can endanger thousands.
Nearly 8,000 people in eight states needed hepatitis tests after David Kwiatkowski, an itinerant hospital technician, was caught injecting himself with patients' pain medicine and refilling the syringes with saline.
He infected at least 46, mostly in New Hampshire.
It was the third hepatitis outbreak since 2009 linked to a health care worker using patients' syringes (the others were in Denver and Jacksonville, Fla).
And for each of those worst-case scenarios, there are countless more practitioners whose drug-related errors are more isolated -- a botched surgery, an incorrect dose of medication, a worrisome vital sign missed.
BAD MEDICINE: How doctors are punished
Much of the damage goes unnoticed or undocumented; oversight mechanisms to detect, report and address drug problems in health care settings are haphazard and limited.
Still, a USA TODAY review of state and federal records identified hundreds of cases in recent years in which physicians and other health care practitioners were disciplined or prosecuted for drug diversion or other medical misconduct related to substance abuse.
The toll also can be brutal for the medical professionals who suffer with addiction -- often in high-stress jobs with little help.
Many struggle with guilt and despair, physical and mental health ills, and indifferent professional environments.
Last year, New York's Supreme Court ruled that a hospital was not liable for the overdose death of a physician who, after returning from drug rehabilitation, was given operating room duty, where she had ready access to the propofol that killed her.
"Drug diversion affects so many people, and the systems for dealing with it are completely broken," says Lauren Lollini, 45, who was infected with hepatitis C in the Denver outbreak and now works with HONOReform, a patient safety group.
STATISTICS: Disciplinary actions in Ohio
Bertrand, who returned to practice after treatment, now counsels other health care professionals with drug problems.
"The medical community thinks it's immune from this disease, but that's not true," says Bertrand, who had no history of drug use until she got hooked on pain medication after an abdominal surgery.
"There are so many practitioners working impaired and we have no idea. ... We're doing a terrible job addressing this problem," she said.
USA TODAY reviewed an array of government data and independent studies on drug use among health care practitioners, including records on hundreds of doctors, nurses and others caught diverting drugs.
The newspaper also interviewed medical professionals, addiction specialists, regulators and law enforcement officials.
- Pervasive problem: The latest drug use data from the U.S. Substance Abuse and Mental Health Services Administration, released in 2007, indicated that an average of 103,000 doctors, nurses, medical technicians and health care aides a year were abusing or dependent on illicit drugs. Various studies suggest the number could be far higher; an estimated one in 10 practitioners will fall into drug or alcohol abuse at some point in their lives, mirroring the general population.
- Easily hidden: Safeguards to detect and prevent drug abuse in other high-risk industries rarely are employed in health care. No state has universal drug testing requirements, and hospitals, nursing homes and other facilities almost never do so on their own. Many institutions also lack video surveillance and high-tech systems to track dangerous drugs.
- Poorly policed: Many states lack rules to ensure that medical facilities alert law enforcement or regulatory agencies if they catch employees abusing or diverting drugs, so those staffers often are turned loose to find new jobs without treatment or supervision. Disciplinary action for drug abuse by health care providers, such as suspension of a license to practice, is rare and often doesn't occur until a practitioner has committed multiple transgressions.
"We certainly see gaps in the system; the examples are many," says Joseph Perz, an epidemiologist at the U.S. Centers for Disease Control and Prevention.
The challenge in addressing the problem is finding a "balanced approach," Perz adds. "We recognize that addiction is a disease and we recognize the value in … (rehabilitating) a provider. At the same time, we need to be thinking about the potential harm to patients. That balance is difficult." (READ MORE) -- Mobile users: http://usat.ly/1iVQd4o
IMPACT IN NORTHEAST OHIO
This graph illustrates the total number of disciplinary actions the Ohio Medical Review Board handed out against medical professionals between 2007 and 2012.
Use the search tool below the graphic to find a list of medical professionals in the Cleveland-Akron area that faces discipline.
INTERACTIVE: Discipline action in Ohio
The Ohio Medical Review Board takes action against medical professionals who are faced with complaints of things like substance abuse, sexual improprieties, or prescription drug issues.
WKYC's Bad Medicine investigation reveals disciplinary actions taken against medical professionals who are subject to review by the Ohio Medical Board.
Our investigation uncovers more than 150 doctors and other licensed medical workers who faced discipline between 2008 and 2013. Search our directory here: http://bit.ly/FindMyDoctor