Many drugs and volatile substances are subject to misuse/abuse. 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: 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.
CARE SETTING
Inpatient stay on behavioral unit or outpatient care in a day program or community agency.
RELATED CONCERNS
Alcohol: acute withdrawal
Psychosocial aspects of care
Patient Assessment Database
Depends on substances involved, duration of use, organs affected.
TEACHING/LEARNING
Discharge plan
DRG projected mean length of stay depends on individual program, general health status.
May need assistance with long-range plan for recovery
Refer to section at end of plan for postdischarge considerations.
DIAGNOSTIC STUDIES
Drug screen: Identifies drug(s) being used.
Addiction Severity Index (ASI) assessment tool: Produces a “problem severity profile” of 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): Depends 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.
6. Plan in place to meet needs after discharge.
CARE SETTING
Inpatient stay on behavioral unit or outpatient care in a day program or community agency.
RELATED CONCERNS
Alcohol: acute withdrawal
Psychosocial aspects of care
Patient Assessment Database
Depends on substances involved, duration of use, organs affected.
TEACHING/LEARNING
Discharge plan
DRG projected mean length of stay depends on individual program, general health status.
May need assistance with long-range plan for recovery
Refer to section at end of plan for postdischarge considerations.
DIAGNOSTIC STUDIES
Drug screen: Identifies drug(s) being used.
Addiction Severity Index (ASI) assessment tool: Produces a “problem severity profile” of 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): Depends 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.
6. Plan in place to meet needs after discharge.
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