8 Substance Abuse Nursing Care Plans

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What is Substance Abuse?

Drug abuse and drug dependence represent different ends of the same disease process.

Drug abuse is an intense desire to use increasing amounts of a particular substance or substances to the exclusion of other activities.

Drug dependence is the body’s physical need, or addiction, to a specific agent. There is therefore virtually no difference between dependency and addiction. Over the long term, this dependence results in physical harm, behavior problems, and association with people who also abuse drugs. Stopping the use of the drug can result in a specific withdrawal syndrome.

Nursing Care Plans

Nursing care plan goals for patients who abuse substances includes providing support for the decision to stop substance use, strengthen individual coping skills, facilitate learning of new ways to reduce anxiety, promote family involvement in a rehabilitation program, facilitate family growth and development, and provide information about the prognosis and treatment needs.

Below are eight substance abuse nursing care plans and nursing diagnosis: 

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  1. Denial
  2. Ineffective Individual Coping
  3. Powerlessness
  4. Imbalanced Nutrition: Less Than Body Requirements
  5. Low Self-Esteem
  6. Altered Family Process
  7. Sexual Dysfunction
  8. Deficient Knowledge
  9. Other possible nursing care plans

Denial

May be related to

  • Personal vulnerability; difficulty handling new situations
  • Previous ineffective/inadequate coping skills with substitution of drug(s)
  • Learned response patterns; cultural factors, personal/family value systems

Possibly evidenced by

  • Delay in seeking, or refusal of healthcare attention to the detriment of health/life
  • Does not perceive personal relevance of symptoms or danger, or admit impact of condition on life pattern; projection of blame/responsibility for problems
  • Use of manipulation to avoid responsibility for self

Desired Outcomes

  • Verbalize awareness of relationship of substance abuse to current situation.
  • Engage in therapeutic program.
  • Verbalize acceptance of responsibility for own behavior.

Nursing Interventions and Rationale

The following are nursing interventions for substance abuse.

Nursing InterventionsRationale
Ascertain by what name patient would like to be addressed.Shows courtesy and respect, giving patient a sense of orientation and control.
Convey attitude of acceptance, separating individual from unacceptable behavior.Promotes feelings of dignity and self-worth.
Ascertain reason for beginning abstinence, involvement in therapy.Provides insight into patient’s willingness to commit to long-term behavioral change, and whether patient even believes that he or she can change. (Denial is one of the strongest and most resistant symptoms of substance abuse.)
Review definition of drug dependence and categories of symptoms (patterns of use, impairment caused by use, tolerance to substance).This information helps patient make decisions regarding acceptance of problem and treatment choices.
Answer questions honestly and provide factual information. Keep your word when agreements are made.Creates trust, which is the basis of the therapeutic relationship.
Provide information about addictive use versus experimental, occasional use; biochemical or genetic disorder theory (genetic predisposition; use activated by environment; compulsive desire.)Progression of use continuum is from experimental or recreational to addictive use. Comprehending this process is important in combating denial. Education may relieve patient’s guilt and blame and may help awareness of recurring addictive characteristics.
Discuss current life situation and impact of substance use.First step in decreasing use of denial is for patient to see the relationship between substance use and personal problems.
Confront and examine denial and rationalization in peer group. Use confrontation with caring.Because denial is the major defense mechanism in addictive disease, confrontation by peers can help the patient accept the reality of adverse consequences of behaviors and that drug use is a major problem. Caring attitude preserves self-concept and helps decrease defensive response.
Provide information regarding effects of addiction on mood and personality.Individuals often mistake effects of addiction and use this to justify or excuse drug use.
Remain nonjudgmental. Be alert to changes in behavior, (restlessness, increased tension).Confrontation can lead to increased agitation, which may compromise safety of patient and staff.
Provide positive feedback for expressing awareness of denial in self and others.Necessary to enhance self-esteem and to reinforce insight into behavior.
Maintain firm expectation that patient attend recovery support and therapy groups regularly.Attendance is related to admitting need for help, to working with denial, and for maintenance of a long-term drug-free existence.
Encourage and support patient’s taking responsibility for own recovery (development of alternative behaviors to drug urge and use). Assist patient to learn own responsibility for recovering.Denial can be replaced with positive action when patient accepts the reality of own responsibility.
Encourage family members to seek help whether or not the abuser seeks it.To assist the patient deal appropriately with the situation.

Recommended Resources

Recommended nursing diagnosis and nursing care plan books and resources.

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See also

Other recommended site resources for this nursing care plan:

Other care plans for mental health and psychiatric nursing:

References and Sources

The following are the references and recommended sources for substance abuse nursing care plans including interesting resources to further your reading about the topic:

  • Ackley, B. J., Ladwig, G. B., Msn, R. N., Makic, M. B. F., Martinez-Kratz, M., & Zanotti, M. (2019). Nursing Diagnosis Handbook E-Book: An Evidence-Based Guide to Planning Care. Mosby. [Link]
  • Black, J. M., & Hawks, J. H. (2009). Medical-surgical nursing: Clinical management for positive outcomes (Vol. 1). A. M. Keene (Ed.). Saunders Elsevier. [Link]
  • Carpenito-Moyet, L. J. (2006). Handbook of nursing diagnosis. Lippincott Williams & Wilkins. [Link]
  • Doenges, M. E., Moorhouse, M. F., & Murr, A. C. (2016). Nurse’s pocket guide: Diagnoses, prioritized interventions, and rationales. FA Davis. [Link]
  • Fisher, M. E., Moxham, P. A., & Bradshaw, B. W. (1989). U.S. Patent No. 4,813,422. Washington, DC: U.S. Patent and Trademark Office. [Link]
  • Gulanick, M., & Myers, J. L. (2016). Nursing Care Plans: Diagnoses, Interventions, and Outcomes. Elsevier Health Sciences. [Link]
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