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TPAPN Participants
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The majority of TPAPN participants are nurses with an identified substance use disorder, mental health condition or both. TPAPN participants have the common goal of wanting to demonstrate, document and return to safe nursing practice. After a referral to the program, participants get an evaluation to determine their needs, and then are enrolled into a individualized monitoring plan, which includes working with a peer advocate. 

TPAPN provides participants with guidance, support, monitoring and accountability. Case managers work with participants, advocates, employers and providers to facilitate recovery and promote safe nursing practice. Like any chronic disease, substance use disorders and mental health conditions can be managed with the right treatment. 

Participants can use this form to request a copy of their records. 

The process of enrolling and participating are detailed below. This graphic provides a high level overview. Click for high-resolution version. 



Participation in TPAPN is initiated using a TPAPN Referral Form or a Board of Nursing Complaint Form. Referrals can come from:

  • Oneself (self-referral)
  • 3rd-Party (employer, healthcare provider, coworker etc.)
  • The Board of Nursing

All 3rd-Party referrals are reviewed with the BON. TPAPN also accepts BON Complaint Forms. Referral sources are kept confidential, but anonymous referrals are not accepted.


After a referral, nurses need to obtain a comprehensive behavioral health (substance use and mental health) evaluation. TPAPN Case Managers help potential participants identify an appropriate evaluator. Diagnostic toxicology testing (drug tests) may also be required as part of the evaluation process. The evaluator list here is updated frequently. 

After the evaluation, nurses are offered the opportunity to participate. Participation is voluntary and potentially an alternative to BON discipline. Eligibility is based on a number of factors including but not limited to the number of previous participations, the referral reason and details, direction from the BON, etc.

Eligible nurses are sent a letter with enrollment instructions including to call their assigned case manager within ten days. The evaluation helps determine the enrollment process, track placement, and individualized participation requirements.

Nurses referred by third-parties (employer, healthcare provider, coworker, etc.) have 30 days from the date of the enrollment letter to enroll. Nurses Ordered by the BON have 90 days to enroll. 

In most cases once the time limit has been reached and the referred nurse has not completed the TPAPN enrolled process, their case is referred to the BON. Nurses who receive License Suspension Orders from the BON have their licenses suspended until they enroll in TPAPN. They have an indefinite time period to complete the process.


Participation requirements are individualized and based on referral information, diagnosis, severity, remission, individual needs and license type. The requirements are determined by a participant’s case manager in collaboration with the participant’s evaluator(s), treatment provider(s), employer and the BON.

TPAPN participant requirements are modifiable and may include random drug testing (urine, hair, nail, blood). The frequency of screens varies and can be adjusted downwards or upwards depending on adherence. Abstinence from all abusable drugs including alcohol, in general, is a requirement for participation in TPAPN. Participants are responsible for their own expenses, which vary and may include an evaluation(s), treatment, recovery support services, mutual aid groups, drug testing, and misc. fees.

To adhere to the program, participants are expected to: 

  • Obtain or maintain recovery from substance use, mental health conditions or both.
  • Obtain a behavioral health evaluation or reevaluation (when applicable).
  • Obtain an initial diagnostic toxicology test (drug test).
  • Obtain, participate in and complete treatment.
  • Participate in or utilize recovery support services (mutual aid groups such as AA, NA, Caduceus groups, etc.)
  • Obtain, maintain and demonstrate sobriety and mental fitness.
  • Communicate regularly with TPAPN and submit required reports.
  • Practice nursing safely.

TPAPN participants may be referred to specialists (addiction psychiatrists, pain-management specialists, addictionologists, ADD/ADHD specialists, etc) to determine a nurse’s safety to practice or as part of evaluation’s treatment requirements. For example, a recovering TPAPN nurse being referred to an addiction psychiatrist for medication management. Or a referral to an addictionologist to evaluate the nurse’s use of potentially abusable or impairing medications.

Find a specialist: 

Social Peer Support

Peer support services are based on common life experiences. In TPAPN, peer advocates do not have to have lived experience with substance use or mental health conditions. Rather they are peers by virtue of being registered nurses. 

SAMSHA describes how peer support facilitates a significant role in recovery and treatment success. TPAPN a
dvocates use peer support methods that are person centered, encourage autonomy, respect diversity, are non-judgmental and inspire hope. 

Learn more or contact TPAPN to be connected with an advocate. 

Consequences of behavior inconsistent with recovery or non-adherence with TPAPN participation requirements

TPAPN participants demonstrating behavior inconsistent with recovery or who are non-adherent with TPAPN participation requirements may need:

  • A new or updated behavioral health evaluation
  • Participation length adjustment (extension or restart)
  • Track conversion to a higher level of monitoring
  • Adjustments to the
    • Frequency or type of drug testing
    • Type or amount of treatment
    • Type or amount of recovery support utilization
    • Nursing practice restrictions
  • Referral to the Texas Board of Nursing
  • Track conversion
  • Discharge from TPAPN

Wellness Resources

Find treatment 

Find Support (mutual aid groups, recovery support groups) 

Free RN Support GroupEvery Tuesday night at 7 p.m. at the Dallas Medical City Green Oaks Hospital Annex ( 7808 Clodus Fields Dr, Dallas, TX 75251). Interested nurses should contact Leonard at 940-841-2486.

Maintain Wellness


Upcoming Events

Texas Peer Assistance Program for Nurses
Phone: 800-288-5528
Fax: 512-467-2620
Office Hours: 8 a.m. to 5 p.m. M-F

Texas Nurses Association

Texas Affiliate of ANA | 4807 Spicewood Springs Rd., Bldg 3, Suite 100, Austin TX 78759

800.862.2022 | 512.452.0645 |