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Professional Recovery Network reports steady referrals; board members press PRN on monitoring nitrous‑oxide misuse
Summary
At the Feb. 21 TSBDE meeting PRN reported steady referrals and described monitoring options for clinicians with inhalant use issues. Board members questioned the limits of monitoring nitrous oxide misuse and PRN’s strategies for worksite monitoring.
The Professional Recovery Network reported a steady flow of referrals for potentially impaired dental professionals and described support mechanisms the program uses for clinicians with inhalant use, including nitrous oxide.
Why it matters: Board members pressed PRN for how it monitors inhalant‑use disorders because nitrous oxide cannot be detected by standard drug tests and misuse presents unique workplace‑safety and patient‑safety risks.
What PRN reported
Raquel Bridal, director of the Professional Recovery Network, told the board PRN’s second‑quarter fiscal‑year report showed “a steady number of referrals regarding potentially impaired dental professionals.” She summarized PRN services and educational events, noting a fall seminar and two speakers who addressed compassion fatigue and trauma‑informed care.
Bridal provided LBB numbers PRN submitted for the prior quarter, listing enrolled participants by category: six board‑ordered dentists, one compelled volunteer dentist, 18 volunteer dentists, zero board‑ordered or volunteer hygienists, zero board‑ordered or volunteer assistants and one volunteer assistant.
Board questions about nitrous oxide monitoring
Board members asked detailed follow‑ups about PRN’s approach for clinicians who have challenges with nitrous oxide. Miss Jones asked specifically how PRN handles respondents with inhalant problems. Bridal described PRN support options: assigning a worksite monitor (a coworker authorized to watch tank usage), engaging an on‑site supervisor or connecting the clinician with a local colleague who can provide supervision and reporting, and coordinating with therapists or psychiatrists involved in the clinician’s care.
Dr. Henderson and others pressed practical questions: nitrous oxide is not readily testable, tanks can be accessed by multiple staff members, and offices may not have independent oxygen supplies. Bridal acknowledged the challenge and said PRN is considering how to limit reliance on a single office staff member for reporting; PRN also relies on treatment providers to corroborate reported problems.
Dr. McNeil asked whether PRN treats inhalant‑use disorders similarly to alcohol‑use disorders. Bridal said PRN’s assessment and treatment pathways are the same, with individualized approaches once a diagnostic evaluation identifies a specific disorder.
What the board said and next steps
Board members emphasized the monitoring difficulty and noted concerns about staff reluctance to report supervisors or employers because of employment consequences. PRN told the board it will continue to refine protocols for worksite monitoring, therapist engagement and supervisory reporting and will provide follow‑up to the board if case compliance is not achieved.
Speakers quoted
- “We offer extra support in those cases where we'd get a worksite monitor to sign on, somebody who works with them, who has access, to be able to see if that person... how often they are accessing and for what purpose they’re accessing nitrous oxide specifically,” Raquel Bridal, PRN director.
- “Nitrous oxide is a very difficult drug to monitor because there’s no way to really test for it,” Dr. Henderson said, pressing PRN on monitoring limits.
Speakers and attendance
PRN’s presentation and the board’s follow‑up took place during the agency reports portion of the meeting. PRN said it will provide requested seminar materials and coordinate with PRN staff as needed.
