Information about the Substance Addiction Recovery Program (SARP)

Learn about the Board of Registration in Nursing SARP structure and duty to report.

Table of Contents


Problematic substance use impacts nurses and other healthcare professionals in the same manner it can impact others.   

The Board of Registration in Nursing SARP is a confidential, voluntary, abstinence-based, alternative to discipline program for nurses. It is designed to protect public health, safety, and welfare by establishing safeguards to maintain professional standards of nursing by monitoring participants' ongoing recovery and their return to safe nursing practice.   

We recognize  the decision to enroll in SARP is challenging due to the  disruptions and uncertainty it may impose, ambivalence about participating, the novelty of participating in  mental health and addictions treatment, and  the worry of being stigmatized or feeling isolated. The structure of SARP  manages these challenges with the aim of facilitating recovery while prospectively returning the participant to nursing practice. 

Massachusetts General Law, Chapter 112, section 80F is the law that establishes SARP as a voluntary alternative to disciplinary program for nurses with a substance use disorder.

Duty to report

 A nurse living with a substance use disorder may have unique signs which may include:  

  • Abrupt changes in attitude or personality,  
  • Work habit changes that may include: change in appearance, tardiness, consistently being unprepared, and being hurried, coming in extra early, staying late, offering to give breaks or taking more breaks,  
  • Change in work performance,  
  • Varying levels of energy,  
  • Medication administration pattern changes,  
  • Patients report increasing pain/discomfort on healthcare provider's shift,  
  • Increased isolation,  
  • Pupillary changes (constriction or dilation),  
  • Physical illness such as nausea, vomiting, diaphoresis or anxiety (possible signs of withdrawal),  
  • Avoidance activities,  
  • Concerns from coworkers or patients 

Confronting and reporting the nurse and team member is difficult. Call for more information and assistance in the reporting process and to learn about SARP. We look forward to supporting you and your team. 

As outlined in the Code of Massachusetts Regulations 244 CMR 9.03 (26), a nurse with a valid license and who directly observes another nurse engaged in any of the following shall report that nurse to the Board in accordance with Board guidelines:

  • Abuse of a patient,
  • Practice of nursing while impaired by substance abuse,
  • Diversion of controlled substances.

SARP structure

The root cause of addiction may be the result of multiple factors. Work stressors, interpersonal challenges, limited community supports, and ineffective coping skills are some factors that may be contributing to a problematic pattern of substance use. SARP participants move through the program while adhering to elements of a Consent Agreement that are in place to support recovery by addressing the previously mentioned factors and promoting personal wellness with aim of having enduring personal and professional success. SARP Consent Agreements last a minimum of years and include elements including but not limited to: 

  • The attendance of at least four (4) group meetings per week to build community support,   
  • Attending individual therapy sessions to address the goals of a treatment plan established by you and your therapist,    
  • Submission of quarterly reports to report successes or challenges,    
  • Monitored nursing practice to return to work safely, and   
  • The submission of a minimum of fifteen (15) observed and randomized urine toxicology tests per year with provisions for alternative testing to build life experience time without the use of substances.   

SARP staff, the Substance Addiction Recovery Evaluation Committee (SAREC), and the Board of Nursing stand with you along your road to recovery and applaud your decision to enroll in SARP and the prospective achievement of your goals. Confidentiality in program is strictly maintained. 

Please review the SARP Resource Guide for a comprehensive description of the program.


The Substance Addiction Recovery Evaluation Committee (SAREC) is a nine (9) member committee that evaluates SARP participants participation. The SAREC meets to hear matters related to SARP and makes recommendations to the Board of Registration in Nursing regarding the SARP matters. 

Key Actions   for SARP structure

How to enroll

Learn how to enroll in SARP and find answers to common questions about the SARP process.

Help Us Improve  with your feedback

Please do not include personal or contact information.