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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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- Denial
- Ineffective Individual Coping
- Powerlessness
- Imbalanced Nutrition: Less Than Body Requirements
- Low Self-Esteem
- Altered Family Process
- Sexual Dysfunction
- Deficient Knowledge
- 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 Interventions | Rationale |
|---|---|
| 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.
Disclosure: Included below are affiliate links from Amazon at no additional cost from you. We may earn a small commission from your purchase. For more information, check out our privacy policy.
- Nursing Care Plans: Nursing Diagnosis and Intervention (10th Edition)
An awesome book to help you create and customize effective nursing care plans. We highly recommend this book for its completeness and ease of use. - Nurse’s Pocket Guide: Diagnoses, Prioritized Interventions and Rationales
A quick-reference tool to easily select the appropriate nursing diagnosis to plan your patient’s care effectively. - NANDA International Nursing Diagnoses: Definitions & Classification, 2021-2023 (12th Edition)
The official and definitive guide to nursing diagnoses as reviewed and approved by the NANDA-I. This book focuses on the nursing diagnostic labels, their defining characteristics, and risk factors – this does not include nursing interventions and rationales. - Nursing Diagnosis Handbook, 12th Edition Revised Reprint with 2021-2023 NANDA-I® Updates
Another great nursing care plan resource that is updated to include the recent NANDA-I updates. - Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5(TM))
Useful for creating nursing care plans related to mental health and psychiatric nursing. - Ulrich & Canale’s Nursing Care Planning Guides, 8th Edition
Claims to have the most in-depth care plans of any nursing care planning book. Includes 31 detailed nursing diagnosis care plans and 63 disease/disorder care plans. - Maternal Newborn Nursing Care Plans (3rd Edition)
If you’re looking for specific care plans related to maternal and newborn nursing care, this book is for you. - Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client Care (7th Edition)
An easy-to-use nursing care plan book that is updated with the latest diagnosis from NANDA-I 2021-2023. - All-in-One Nursing Care Planning Resource: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental Health (5th Edition)
Definitely an all-in-one resources for nursing care planning. It has over 100 care plans for different nursing topics.
See also
Other recommended site resources for this nursing care plan:
- Nursing Care Plans (NCP): Ultimate Guide and Database MUST READ!
Over 150+ nursing care plans for different diseases and conditions. Includes our easy-to-follow guide on how to create nursing care plans from scratch. - Nursing Diagnosis Guide and List: All You Need to Know to Master Diagnosing
Our comprehensive guide on how to create and write diagnostic labels. Includes detailed nursing care plan guides for common nursing diagnostic labels.
Other care plans for mental health and psychiatric nursing:
- Alcohol Withdrawal | 5 Care Plans
- Anxiety and Panic Disorders | 7 Care Plans
- Bipolar Disorders | 6 Care Plans
- Major Depression | 9 Care Plans
- Personality Disorders | 4 Care Plans
- Schizophrenia | 6 Care Plans
- Sexual Assault | 1 Care Plan
- Substance Dependence and Abuse | 8 Care Plans
- Suicide Behaviors | 3 Care Plans
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]
3 Comments
How To Stop Drug Abuse?
December 31, 2022 at 4:17 am -Exactly what you need to succeed in sobriety, they are caring and very supportive
and non-judgmental. The ladies are so sweet and
welcoming and the therapist is very compassionate and understanding.
John Riley
January 20, 2023 at 1:33 pm -Glad you agree!
Francesco Mansergh
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