NCP Substance Dependence Abuse Rehabilitation

DSM-IV

Alcohol Use Disorders

303.90 Alcohol dependence

305.00 Alcohol abuse

AMPHETAMINE (OR AMPHETAMINE-LIKE) USE DISORDERS

304.40 Amphetamine dependence

305.70 Amphetamine abuse

CANNABIS USE DISORDERS

304.30 Cannabis dependence

305.20 Cannabis abuse

COCAINE USE DISORDERS

304.20 Cocaine dependence

305.60 Cocaine abuse

HALLUCINOGEN USE DISORDERS

304.60 Hallucinogen dependence

305.30 Hallucinogen abuse

INHALANT USE DISORDERS

304.60 Inhalant dependence

305.90 Inhalant abuse

NICOTINE USE DISORDERS

305.10 Nicotine dependence

OPIOID USE DISORDERS

304.00 Opioid dependence

305.50 Opioid abuse

PHENCYCLIDINE USE DISORDERS

304.90 Phencyclidine dependence

305.90 Phencyclidine abuse

SEDATIVE, HYPNOTIC, OR ANXIOLYTIC SUBSTANCE USE DISORDERS

304.10 Sedative, hypnotic, or anxiolytic dependence

305.40 Sedative, hypnotic, or anxiolytic abuse

POLYSUBSTANCE USE DISORDER

304.80 Polysubstance dependence

(For other listings, consult DSM-IV manual.)

Many drugs and volatile substances are subject to abuse (as noted in previous plans of care). This disorder is a continuum of phases incorporating a cluster of cognitive, behavioral, and physiological symptoms that include loss of control over use of the substance and a continued use of the substance despite adverse consequences. A number of factors have been implicated in the predisposition to abuse a substance (e.g., biological, biochemical, psychological [including developmental], personality, sociocultural and conditioning, and cultural and ethnic influences). However, no single theory adequately explains the etiology of this problem.

This plan of care addresses issues of dependence and is to be used in conjunction with plans of care relative to acute intoxification/withdrawal from specific substance(s).

CLIENT ASSESSMENT DATA BASE

Refer to appropriate acute plan of care regarding involved substance(s).

DIAGNOSTIC STUDIES

Drug (including-alcohol) Screen: Identifies drug(s) being used.

Addiction Severity Index (ASI) Assessment Tool: Produces a “problem severity profile” of the patient, including chemical, medical, psychological, legal, family/social and employment/support aspects, indicating areas of treatment needs.

Other Screening Studies (e.g., Hepatitis, HIV, TB): Depend on general condition, individual risk factors, and care setting.

NURSING PRIORITIES

1. Provide support for decision to stop substance use.

2. Strengthen individual coping skills.

3. Facilitate learning of new ways to reduce anxiety.

4. Promote family involvement in rehabilitation program.

5. Facilitate family growth/development.

6. Provide information about condition, prognosis, and treatment needs.

DISCHARGE GOALS

1. Responsibility for own life and behavior assumed.

2. Plan to maintain substance-free life formulated.

3. Family relationships/enabling issues being addressed.

4. Treatment program successfully begun.

5. Condition, prognosis, and therapeutic regimen understood.