Nurse Jackie depicts Edie Falco, of Sopranos fame, as a painkiller-addicted, high functioning ER nurse. Her day revolves around the moments when she can take Xanax, Vicodin, or Percocet to make it through another day. She can’t stop abruptly, because she’ll go through severe withdrawal. And yet, nobody seems to notice. And nobody will, either, because she is not required to undergo drug testing.

Whether it’s the close proximity to addictive drugs, the high-stress of the nursing profession, it’s not really known why it is becoming more common for those working in practice of medicine to become addicted. As we’ve seen from the ever-growing opioid epidemic, the medical system is seriously broken in the realm of prescription distribution. It’s also not terribly uncommon for pharmacists to sample the medication they distribute.

So Nurse Jackie is hardly an anomaly—addiction among medical professionals is at an all-time high rate. Just one of many troubling examples of this negligence that goes under the surface was the case of a woman whose hepatitis C was spread to 6,000 patients when she began stealing liquid painkillers and replacing them with her used syringes, filled with saline solution.

While there’s debate about whether Nurse Jackie is a realistic or fair depiction of addiction—some condemned her many violations of the Nursing Code on the show—it’s still evident that this degree of addiction has only gotten worse over the years. You’d like to have confidence in the medical professionals that treat you, and most do, but those professionals with a problematic substance use disorder disorder can go a long time without being noticed.

Did you know that medical professionals, specifically doctors and nurses, are not required by law to undergo drug testing? Even with evidence proving that substance use disorder does occur at significant rates in the professional medical community, there isn’t a single policy that requires this. While those rates are not as dire as those surrounding the opioid epidemic, for example, it’s still crucial that this lack of testing makes it too easy for addicts to be put into those positions, and farther and farther away from receiving the treatment they deserve.