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Addiction changes people until they don't even recognize themselves. It has nothing to do with smart vs stupid. They were obviously smart and competent enough to be given a license. It's just that the person who did this doesn't even resemble the person who got their nursing license anymore. If they're able to get sober someday, they'll be horrified at having to live with this the rest of their life.
There's a reason addiction is considered a disease. The problem is when people mistake this explanation as an excuse for the things people do while in their addictions. It doesn't excuse it. I just wish more people would make an effort to understand how addiction actually works because if we made any effort as a society instead of constantly playing the bootstrap/blame game, we could deal with it more effectively and prevent shit like this.
Also I don't know anything about what's in tap water, but when addicts use IV drugs that's pretty much what they're mixed with. Obviously there's a lot of infections in that population, but also people who do it every day without tap water killing them.