Substance Abuse Nursing Diagnosis and Nursing Care Plan

Substance Abuse Nursing Care Plans Diagnosis and Interventions

Substance Abuse NCLEX Review and Nursing Care Plans

Substance abuse is the habit of detrimental substance use to influence mood. “Abuse” can also occur when an individual uses a substance in a manner that is not indicated or suggested or when used more than it was advised.

However, a person can use substances without becoming addicted or developing substance use disorder. For instance, substance use disorders (SUD) are generally chronic diseases associated with excess and unregulated consumption of lawful or illicit psychoactive substances.

Hence, the most common legalized substances that cause significant substance abuse are liquor and cigarettes in many countries.

Moreover, excessive intake of drugs, alcohol and other substances affects practically every organ in the body.  Substance abuse can cause irregular heartbeats and cardiac arrest, and intravenous drugs can cause vein rupture and infections in the heart valves.

Some substances can also prevent the bones from growing normally, while others might cause muscle cramps and general malaise. Substance use over a considerable length of time will gradually harm the kidneys and liver.

Risk Factors and Causes of Substance Abuse

The etiology of substance abuse problems is obscure, whereas genetics contribute 40% to 60% of a person’s risk. Substance use also frequently begins at an early age or early adolescence as a method to feel better or out of fascination. Hence, substance abuse and addiction develop due to recurrent use of the drug and growing tolerance.

On the other hand, some individuals who suffer from substance abuse also have co-occurring mental illnesses, such as depression, anxiety, or mood disorders, and they commence using drugs or alcohol to deal with their difficulties. Other risk factors for developing substance abuse are enumerated below:

  • Addiction in the family
  • Sleep difficulties
  • Chronic discomfort
  • Financial troubles
  • Divorce or death of a loved one
  • Stressful domestic situation
  • In childhood, there was a lack of maternal bonding.
  • Relationship problems

Related Factors to Substance Abuse

Substance abuse can happen to people of different origins and beliefs.

It can be hard to decipher why some people are more susceptible to it than others. However, numerous factors increase the odds of becoming enslaved to alcohol or other substances, regardless of upbringing or sense of morality. Genetics, environment, health history, and age are all risk factors. Some substances and modes of administration are also much more addictive than others.

Below are the risk factors for substance abuse:

  • Violent tendencies in childhood
  • Lack of self-control
  • Inadequate parental authority
  • Peer pressure
  • Competence in Academics
  • Availability of drugs
  • Poverty
  • Strong ties to the community

Risk factors are simply indicators of the possibility of a situation occurring. While they can be valuable in analyzing youngsters who are likely to develop alcohol or other drug issues, they are not always predictive for a specific child. Children in adversity generally grow up to be solid and well-functioning adults.

Furthermore, the use of risk factors to categorize children is fraught with danger. As a result, there is a growing focus on the characteristics that protect adolescents from acquiring alcohol or other drug issues.

Signs and Symptoms of Substance Abuse

It is beneficial to comprehend the signs and symptoms of substance abuse in order to treat and manage it properly. These symptoms are associated with physiological changes, conduct, and thoughts. Nevertheless, the detection of friends or family members who have gotten addicted to drugs has been made possible by analyzing the indicators of substance misuse in adults mentioned below.

  • Someone addicted to illicit drugs or alcohol commonly has constricted pupils, commonly called miosis. They may have red eyes as well.
  • Individuals who misuse substances may have reduced desire for food and, as a result, the weight drops quickly.
  • Insomnia (trouble getting to sleep at night) or hypersomnia (excessive sleepiness) are prevalent indications of substance misuse.
  • Individuals struggling with substance abuse may exhibit a significant loss of confidence in their abilities, cognition, appearance, or other parts of their lives.
  • Another manifestation of substance misuse is erratic mood swings and anxiety.
  • Various substances increase the probability of panic episodes.
  • Acne, pale complexion, and jaundice can result from repeated substance abuse. Skin lesions, scrapes, bruises, and track marks may also be present on the body.

Diagnosis of Substance Abuse

Diagnosis of substance abuse or dependence necessitates a thorough assessment, which frequently comprises an evaluation by a psychiatrist, psychotherapist, or professional drug and alcohol counselor. Blood, urine, and other lab tests evaluate drug consumption, but they are not diagnostic tests for addiction. These tests, however, may be used to evaluate therapy and treatment.

Treatment for Substance Abuse

Although there is no specific medication for substance abuse, there are many treatment options that can be beneficial in overcoming addiction and becoming drug-free. One of these is therapy, which will be determined by the substance taken and any related medical or mental health conditions the patients have. Hence, long-term follow-up is fundamental to avoiding recurrence.

Nursing Diagnosis for Substance Abuse

Nursing Care Plan for Substance Abuse 1

Denial

Nursing Diagnosis: Denial related to individual weakness and trouble adapting to changing circumstances secondary to substance abuse as evidenced by delay in obtaining or rejecting medical help that jeopardizes one’s well-being.

Desired Outcome: The patient will be encouraged to express understanding of the relationship between substance misuse and the present situation and will be able to participate in a therapeutic program.

Nursing Interventions for Substance AbuseRationale
Determine the name by which the patient prefers to be called.Displays kindness and compassion, and provides the patient with a sense of guidance and control.  
Explain the rationale for starting abstinence and participation in therapy.It will provide information about the patient’s ability to commit to long-term behavior interventions, including whether the patient perceives they can change.
Explain current living conditions as well as the consequences of substance abuse.The first step towards reducing the denial stage is for the patient to recognize the link between substance use and difficult situations.  
Maintain the non – judgmental approach. Observe any changes in behavior.It is important to remain non-judgmental since confrontation can cause more restlessness, jeopardizing the safety of both the patient and the health provider.  
Motivate family and friends to get treatment regardless of whether the abuser wants it.  This will support the patient in dealing with the circumstance responsibly.  

Nursing Care Plan for Substance Abuse 2

Ineffective Coping

Nursing Diagnosis: Ineffective Coping related to poor support networks and inappropriate behavior model secondary to substance abuse as evidenced by compromised problem-solving abilities and adaptive behavior.

Desired Outcome: The patient will be able to employ effective coping strategies and problem-solving approaches and implement necessary lifestyle modifications.

 Nursing Interventions for Substance Abuse Rationale
Determine the comprehension of the current circumstance, previous situations, and other strategies for dealing with life’s problems.This measure can determine the comprehension of the current circumstance, previous situations, and other strategies for dealing with life’s problems.  
Support the patient in learning and using mindfulness meditation, guided imagery, and affirmations.This approach will assist the patient in relaxing, developing new methods to cope with stress, and problem-solving.  
Encourage participation in rehabilitative writing. Commence journaling or drafting an autobiography for the patient.Rehabilitative writing or journaling can improve the therapeutic involvement, act as an outlet for sorrow, frustration, and anxiety, serve as a beneficial tool for assessing healthcare quality, and can be used to assess patient improvement.
Encourage the patient to express their emotions, fears, and worry.This strategy may assist the patient in coming to terms with long-unresolved concerns.
Implement appropriate steps under standard hospital policy.This technique will aid in the prevention of suicide attempts.  

Nursing Care Plan for Substance Abuse 3

Powerlessness

Nursing Diagnosis: Powerlessness related to drug misuse with or without abstinence phases secondary to substance abuse as evidenced by feeble recovery efforts and admissions of incapacity to cease behavior patterns for assistance.

Desired Outcome: The patient will learn to verbally express his acknowledgment about the need for counseling and his understanding that determination alone cannot govern abstinence.

Nursing Interventions for Substance Abuse Rationale
Employ crisis intervention approaches to induce behavioral change.This method will help the patient be more open in accepting the need for therapy.  
Inform the patient about the awareness of human behavior and relationships (transactional analysis).Acknowledging these notions can assist the patient in starting to deal with prior troubles or losses and prevent the patient from repeating unproductive coping practices and self-fulfilling expectations.  
Help the patient in conducting a religious and spiritual self-examination.Although not required for recovery, surrendering to and believing in power more enormous than oneself is effective for individuals who suffer from substance abuse.
Continuous therapy information must be provided.This strategy informs the patient about what to expect and allows them to be a part of what is happening and make educated decisions about involvement and consequences.  
Educate the patient and practice proactive communication skills.This technique helps patients abstain from substance use, cease contact with users and dealers, establish healthy connections, and regain control of one’s own life.

Nursing Care Plan for Substance Abuse 4

Imbalanced Nutrition: Less Than Body Requirements

Nursing Diagnosis: Imbalanced Nutrition: Less Than Body Requirements related to inadequate nutritional consumption to achieve metabolic requirements caused by psychological, physiological, or economic considerations secondary to substance abuse as evidenced by rapid weight loss and terrible muscle tone.

Desired Outcome: The patient will gain knowledge about demonstrating progressive weight gain toward the goal and preventing signs of malnutrition, verbalizing understanding of the effects of substance abuse, reducing dietary intake on nutritional status, and maintaining proper weight.

Nursing Interventions for Substance Abuse Rationale
Consider the patient height and weight, age, body type, endurance, exercise habits, and rest level. Take note of the state of the patient’s oral cavity as well.This method will provide data on which to base calorie requirements and dietary plans. Thus, the state of the mucous membranes and teeth may influence the type of diet or foods consumed.  
Discuss with a nutritionist.  This procedure is excellent for determining individual nutritional needs and plans and adding adequate learning resources.
Allow the patient to select foods and snacks that fit his or her nutritional needs.  This technique promotes patient engagement or a sense of control, may aid in the resolution of malnourishment, and aids in evaluating the patient’s awareness of dietary teaching.  
If needed, refer the patient to a dentist.  Teeth are necessary for proper nutritional intake. Therefore, oral cleanliness and maintenance are frequently overlooked in patients who suffer from substance abuse.
As indicated, evaluate the patient’s laboratory tests such as glucose, serum albumin, and electrolytes.This approach detects anemias, electrolyte disturbances, and other anomalies that may be evident and necessitate treatment.

Nursing Care Plan for Substance Abuse 5

Altered Family Process

Nursing Diagnosis: Altered Family Process related to addiction that runs throughout the family secondary to substance abuse as evidenced by the family situations that are disrupted, closed communication systems, inadequate marital interaction, and marriage troubles.

Desired Outcome: The patient will learn to communicate his or her comprehension of the complexities of supportive behaviors and will be able to participate in specific family programs.

 Substance Abuse Nursing Interventions Rationale
Examine the patient’s family background and investigate the involvement of family members, drug-related events, strengths, and opportunities for improvement.This strategy will identify the areas to focus on and the potential for change.
Educate both users and nonusers on good behavior and addictive illness characteristics.Individuals can begin the change process by being aware of and understanding their behaviors (avoiding and shielding, taking over duties, justifying, and subservience).
Address the following family members’ sabotage behaviors.Although family members express a willingness to be substance-free, the truth of interactive dynamics is that they may subconsciously not want the people to recuperate because it would compromise their place in the relationship. They may also receive attention and validation from others (secondary gain).
Give the patient and family accurate information on the consequences of unhealthy and addictive behaviors on the family and what to anticipate following discharge.  Most patients are unaware of the complexities of addiction. If a patient obtains medications lawfully, he or she may assume that this does not arouse abuse and dependence.  
Include family members in discharge planning and follow up.  Drug addiction is a family disease. Family members require assistance in transitioning to the unusual habit of recovery and abstinence because the family has been so involved in dealing with substance misuse. When the patient’s family is treated alongside the sufferer, the likelihood of recovery nearly doubles.

Nursing References

Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2020). Nursing diagnoses handbook: An evidence-based guide to planning care. St. Louis, MO: Elsevier.  Buy on Amazon

Gulanick, M., & Myers, J. L. (2022). Nursing care plans: Diagnoses, interventions, & outcomes. St. Louis, MO: Elsevier. Buy on Amazon

Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2020). Medical-surgical nursing: Concepts for interprofessional collaborative care. St. Louis, MO: Elsevier.  Buy on Amazon

Silvestri, L. A. (2020). Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier.  Buy on Amazon

Disclaimer:

Please follow your facilities guidelines, policies, and procedures.

The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes.

This information is intended to be nursing education and should not be used as a substitute for professional diagnosis and treatment.

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Anna C. RN, BSN, PHN

Anna C. RN, BSN, PHN
Clinical Nurse Instructor

Emergency Room Registered Nurse
Critical Care Transport Nurse
Clinical Nurse Instructor for LVN and BSN students

Anna began writing extra materials to help her BSN and LVN students with their studies. She takes the topics that the students are learning and expands on them to try to help with their understanding of the nursing process.

Her experience spans almost 30 years in nursing, starting as an LVN in 1993. She received her RN license in 1997. She has worked in Medical-Surgical, Telemetry, ICU and the ER. She found a passion in the ER and has stayed in this department for 30 years.

She is a clinical instructor for LVN and BSN students along with a critical care transport nurse.

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