Addiction / Substance-Related Disorders

Substance-related disorders involve maladaptive patterns of substance use leading to impairment, dependence, tolerance, and withdrawal, affecting physical health, cognition, behavior, and social functioning. These disorders carry high risks for overdose, withdrawal complications, psychiatric comorbidity, and relapse. Nurses play critical roles in screening, withdrawal monitoring, safety management, medication administration, relapse prevention, and patient education across acute and community settings.

1️⃣ Substance Use Disorder (SUD) Core Features

🧠 Core Pattern

🔷 Compulsive substance use despite harmful consequences

🔷 Tolerance → need increased amount for same effect

🔷 Withdrawal → physiologic symptoms when stopping

🔷 Loss of control → unsuccessful attempts to cut down

🔷 Craving → strong desire or urge to use

🔷 Continued use despite social, legal, health problems

🔎 Assessment Findings

🔷 Ask type, amount, frequency, last use

🔷 Identify tolerance and withdrawal history

🔷 Impact on work, relationships, legal issues

🔷 Physical signs → tremor, slurred speech, track marks

🔷 Mental status → agitation, sedation, confusion

🔷 Screen tools → CAGE, AUDIT

💊 Management

🔷 Detoxification → medically supervised withdrawal

🔷 Maintenance therapy → prevent relapse

🔷 Behavioral therapy → CBT, motivational interviewing

🔷 Support groups → AA, NA

🔷 Treat comorbid psychiatric disorders

🔷 Long-term recovery planning

🩺 Nursing Priorities

🔷 Establish nonjudgmental therapeutic relationship

🔷 Assess withdrawal risk early

🔷 Monitor VS and mental status

🔷 Promote safety → overdose, seizures, delirium

🔷 Encourage treatment adherence

🔷 Educate on relapse prevention

2️⃣ Alcohol Use Disorder

🧠 Effects

🔷 CNS depressant → sedation, impaired judgment

🔷 Chronic use → liver disease, neuropathy, cardiomyopathy

🔷 High risk → withdrawal complications

🔷 Tolerance develops with prolonged use

🔷 Blackouts → memory impairment

🔷 Nutritional deficiency → thiamine deficiency

🔎 Assessment Findings

🔷 Slurred speech, ataxia, impaired coordination

🔷 Elevated liver enzymes → AST > ALT

🔷 Poor nutrition, weight loss

🔷 Withdrawal risk if heavy daily use

🔷 History of seizures or delirium tremens

🔷 Social/occupational impairment

💊 Management

🔷 Thiamine before glucose → prevent Wernicke encephalopathy

🔷 Benzodiazepines → lorazepam, diazepam for withdrawal

🔷 Naltrexone → reduces craving

🔷 Acamprosate → relapse prevention

🔷 Disulfiram → aversive therapy (ETOH → severe reaction)

🔷 Electrolyte correction → Mg²⁺, K⁺

🩺 Nursing Priorities

🔷 Monitor CIWA-Ar scale

🔷 Prevent seizures → seizure precautions

🔷 Monitor confusion, hallucinations

🔷 Maintain hydration and nutrition

🔷 Educate avoid alcohol with disulfiram

🔷 Provide emotional support

3️⃣ Alcohol Withdrawal Syndrome

🧠 Withdrawal Timeline

🔷 6–12 hrs → tremors, anxiety, insomnia

🔷 12–24 hrs → hallucinations (visual, tactile)

🔷 24–48 hrs → seizures risk

🔷 48–72 hrs → delirium tremens (life-threatening)

🔷 Caused by CNS hyperexcitability

🔷 Severity depends on duration and amount of use

🔎 Assessment Findings

🔷 Tremors, diaphoresis, tachycardia, HTN

🔷 Anxiety, agitation, irritability

🔷 Hallucinations → visual or tactile

🔷 Seizures → generalized tonic-clonic

🔷 Confusion, disorientation → DTs

🔷 CIWA score guides treatment

💊 Management

🔷 Benzodiazepines → lorazepam, diazepam first-line

🔷 Thiamine, folate, multivitamins

🔷 IV fluids → dehydration correction

🔷 Beta-blockers PRN → tachycardia, HTN

🔷 Antipsychotics PRN agitation → haloperidol

🔷 ICU care for severe DTs

🩺 Nursing Priorities

🔷 Monitor VS frequently

🔷 Seizure precautions

🔷 Maintain quiet, low-stimulation environment

🔷 Reorient frequently

🔷 Prevent injury during agitation

🔷 Document withdrawal progression

4️⃣ Delirium Tremens (DTs)

🧠 Severe Withdrawal

🔷 Life-threatening complication of alcohol withdrawal

🔷 Occurs 48–72 hrs after last drink

🔷 Severe autonomic instability

🔷 High mortality if untreated

🔷 Medical emergency

🔷 Requires ICU-level care

🔎 Assessment Findings

🔷 Severe confusion, delirium

🔷 Hallucinations → vivid, frightening

🔷 Severe agitation, combativeness

🔷 Tachycardia, hypertension, fever

🔷 Diaphoresis, dehydration

🔷 Seizure risk

💊 Management

🔷 High-dose benzodiazepines → lorazepam

🔷 IV fluids, electrolyte correction

🔷 Thiamine, glucose

🔷 Antipsychotics PRN agitation

🔷 Continuous monitoring

🔷 Airway support PRN

🩺 Nursing Priorities

🔷 Monitor airway, breathing, circulation

🔷 Frequent reorientation

🔷 Maintain safety → restraints PRN

🔷 Reduce environmental stimuli

🔷 Prevent complications → aspiration, injury

🔷 Rapid response if deterioration

5️⃣ Opioid Use Disorder

🧠 Effects

🔷 CNS depression → respiratory depression risk

🔷 Euphoria → high addiction potential

🔷 Tolerance develops rapidly

🔷 Withdrawal uncomfortable but not usually life-threatening

🔷 High overdose risk → especially with fentanyl

🔷 Includes heroin, morphine, oxycodone

🔎 Assessment Findings

🔷 Constricted pupils, drowsiness, slowed breathing

🔷 Slurred speech, decreased LOC

🔷 Track marks → IV drug use

🔷 Constipation, nausea

🔷 Withdrawal → yawning, sweating, muscle aches

🔷 History of overdose or naloxone use

💊 Management

🔷 Naloxone → opioid overdose reversal

🔷 Methadone → long-acting opioid replacement

🔷 Buprenorphine → partial agonist therapy

🔷 Clonidine → withdrawal symptoms

🔷 Naltrexone → relapse prevention

🔷 Monitor respiratory status

🩺 Nursing Priorities

🔷 Monitor RR and LOC closely

🔷 Have naloxone available

🔷 Assess overdose risk

🔷 Educate safe medication use

🔷 Support withdrawal management

🔷 Encourage treatment programs

6️⃣ Opioid Withdrawal

🧠 Withdrawal Pattern

🔷 Opioid withdrawal → uncomfortable, rarely fatal alone

🔷 Begins after short-acting opioids stop → heroin, oxycodone

🔷 Autonomic activation → sweating, tachycardia, hypertension

🔷 GI hyperactivity → cramps, nausea, vomiting, diarrhea

🔷 Craving intense → relapse risk ↑

🔷 Symptoms mimic severe flu-like illness

🔎 Assessment Findings

🔷 Yawning, lacrimation, rhinorrhea, sweating

🔷 Dilated pupils, gooseflesh, tremors

🔷 Muscle aches, bone pain, restlessness

🔷 Nausea, vomiting, abdominal cramps, diarrhea

🔷 Anxiety, insomnia, irritability

🔷 Use COWS scale → withdrawal severity monitoring

💊 Management

🔷 Buprenorphine → partial agonist, reduces withdrawal/craving

🔷 Methadone → long-acting opioid replacement therapy

🔷 Clonidine → autonomic symptoms, BP monitoring needed

🔷 Loperamide PRN diarrhea; ondansetron PRN nausea

🔷 NSAIDs/acetaminophen → muscle aches, pain

🔷 Hydration and electrolyte support PRN

🩺 Nursing Priorities

🔷 Monitor VS, hydration, withdrawal score trends

🔷 Provide calm, nonjudgmental support

🔷 Encourage medication-assisted treatment adherence

🔷 Assess suicide risk and relapse triggers

🔷 Teach overdose risk ↑ after detox tolerance ↓

🔷 Link to outpatient recovery program

7️⃣ Opioid Overdose

🧠 Overdose Mechanism

🔷 Excess opioid → CNS depression, respiratory drive ↓

🔷 Respiratory depression → hypoxia, brain injury, death risk

🔷 Fentanyl exposure → rapid severe overdose possible

🔷 Combined alcohol/benzodiazepines → respiratory depression ↑

🔷 Tolerance variability → overdose risk after abstinence

🔷 Emergency reversal saves life but withdrawal may occur

🔎 Classic Findings

🔷 Triad → respiratory depression, pinpoint pupils, decreased LOC

🔷 RR slow or absent, SpO₂ ↓, cyanosis

🔷 Snoring/gurgling respirations → airway obstruction risk

🔷 Bradycardia, hypotension possible

🔷 Unresponsive to verbal stimulation

🔷 Track marks, pill bottles, patches, powder may be present

💊 Emergency Management

🔷 Naloxone → opioid antagonist, reverses respiratory depression

🔷 Airway support → positioning, suction, bag-valve-mask

🔷 Oxygen therapy → hypoxia correction

🔷 Repeat naloxone doses PRN long-acting opioids

🔷 Monitor recurrent sedation after naloxone wears off

🔷 Treat complications → aspiration, pulmonary edema, rhabdomyolysis

🩺 Nursing Priorities

🔷 Airway and breathing first → do not delay ventilation

🔷 Monitor RR, SpO₂, LOC continuously

🔷 Prepare for agitation after naloxone reversal

🔷 Educate family on naloxone kit and emergency response

🔷 Assess polysubstance use and suicide intent

🔷 Refer addiction treatment before discharge

8️⃣ Stimulant Use Disorders

🧠 Drug Effects

🔷 Stimulants → dopamine/norepinephrine ↑, CNS activation

🔷 Examples → cocaine, methamphetamine, amphetamine

🔷 Acute effects → energy ↑, euphoria, alertness, appetite ↓

🔷 Sympathetic stimulation → HR ↑, BP ↑, temperature ↑

🔷 Chronic use → paranoia, aggression, weight loss, insomnia

🔷 Crash phase → depression, fatigue, intense craving

🔎 Assessment Findings

🔷 Dilated pupils, agitation, hypervigilance, pressured speech

🔷 Tachycardia, hypertension, chest pain, diaphoresis

🔷 Bruxism, tremor, insomnia, decreased appetite

🔷 Paranoia, hallucinations, violent behavior possible

🔷 Nasal septum damage with cocaine insufflation

🔷 Labs/diagnostics PRN → ECG, troponin, CK, tox screen

💊 Management

🔷 Benzodiazepines → lorazepam for agitation, HTN, seizures

🔷 Cooling measures → hyperthermia management

🔷 IV fluids → dehydration, rhabdomyolysis prevention

🔷 Antipsychotics PRN severe psychosis → haloperidol, olanzapine

🔷 Treat chest pain → ECG, troponin, cardiac monitoring

🔷 No specific antidote for cocaine/meth intoxication

🩺 Nursing Priorities

🔷 Maintain low-stimulation environment

🔷 Monitor VS, temperature, cardiac rhythm

🔷 Ensure safety → violence and self-harm precautions

🔷 Assess chest pain urgently

🔷 Monitor hydration, urine output, CK if severe agitation

🔷 Provide nonjudgmental relapse prevention teaching

9️⃣ Cannabis Use Disorder

🧠 Cannabis Effects

🔷 Cannabis → THC affects mood, perception, memory, coordination

🔷 Acute use → relaxation, altered time perception, appetite ↑

🔷 High-potency THC → anxiety, panic, paranoia risk ↑

🔷 Chronic heavy use → motivation ↓, cognition ↓, dependence possible

🔷 Withdrawal → irritability, insomnia, appetite ↓

🔷 Cannabis hyperemesis → cyclic vomiting relieved by hot showers

🔎 Assessment Findings

🔷 Red eyes, dry mouth, slowed reaction time

🔷 Impaired memory, attention, coordination

🔷 Anxiety, panic, paranoia with high dose

🔷 Increased appetite or nausea/vomiting pattern

🔷 Withdrawal → irritability, sleep disturbance, cravings

🔷 Screen driving/work safety risks

💊 Management

🔷 Supportive care for intoxication → calm environment, reassurance

🔷 Antiemetics PRN vomiting → ondansetron

🔷 IV fluids PRN dehydration

🔷 Behavioral therapy → CBT, motivational interviewing

🔷 Sleep support PRN → melatonin, sleep hygiene

🔷 Treat comorbid anxiety/depression if present

🩺 Nursing Priorities

🔷 Assess safety → driving, school/work impairment

🔷 Educate on dependence and withdrawal possibility

🔷 Monitor anxiety or psychotic-like symptoms

🔷 Encourage reduction plan and coping alternatives

🔷 Screen for polysubstance use

🔷 Refer counseling or substance program PRN

🔟 Sedative, Hypnotic, and Anxiolytic Use Disorders

🧠 CNS Depression

🔷 Includes benzodiazepines, barbiturates, sleep medications

🔷 CNS depressants → sedation, impaired coordination, memory problems

🔷 Tolerance develops → escalating dose risk

🔷 Withdrawal can be life-threatening → seizures, delirium

🔷 Combination with alcohol/opioids → respiratory depression ↑

🔷 Abrupt discontinuation after long use dangerous

🔎 Assessment Findings

🔷 Slurred speech, ataxia, drowsiness, confusion

🔷 Poor coordination → falls, injuries

🔷 Memory impairment, blackouts

🔷 Withdrawal → anxiety, tremor, insomnia, seizures

🔷 VS changes → tachycardia, hypertension during withdrawal

🔷 Review prescriptions, refills, dose escalation pattern

💊 Management

🔷 Gradual taper → safest discontinuation approach

🔷 Benzodiazepine taper → diazepam or clonazepam protocols

🔷 Seizure precautions during withdrawal

🔷 Flumazenil rarely used → seizure risk in chronic users

🔷 Support sleep hygiene and nonpharm anxiety management

🔷 Treat comorbid anxiety with safer long-term options

🩺 Nursing Priorities

🔷 Monitor sedation, RR, falls risk

🔷 Do not abruptly stop chronic benzodiazepines

🔷 Assess withdrawal symptoms and seizure history

🔷 Educate avoid alcohol/opioids with sedatives

🔷 Secure medications and prevent overuse

🔷 Collaborate provider, pharmacy, addiction team

1️⃣1️⃣ Hallucinogen and PCP Use Disorders

🧠 Drug Effects

🔷 Hallucinogens → LSD, psilocybin → sensory distortion, hallucinations

🔷 PCP (phencyclidine) → dissociation, analgesia, aggression

🔷 Altered perception → visual, auditory, time distortion

🔷 PCP → high risk for violent behavior, psychosis

🔷 Flashbacks → recurrence of perceptual disturbance

🔷 No true physical withdrawal syndrome

🔎 Assessment Findings

🔷 Visual hallucinations, altered reality perception

🔷 Anxiety, panic, paranoia, confusion

🔷 PCP → nystagmus, muscle rigidity, hyperthermia

🔷 Aggression, unpredictable behavior

🔷 Increased strength perception → safety risk

🔷 VS changes → tachycardia, hypertension

💊 Management

🔷 Benzodiazepines → lorazepam for agitation

🔷 Low-stimulation environment → calm, quiet room

🔷 Antipsychotics PRN severe psychosis → haloperidol

🔷 Cooling measures PRN hyperthermia

🔷 IV fluids → hydration support

🔷 Avoid confrontation during hallucinations

🩺 Nursing Priorities

🔷 Ensure safety → risk for violence or injury

🔷 Stay calm, avoid overstimulation

🔷 Do not argue hallucinations

🔷 Monitor VS and temperature

🔷 Protect staff and patient

🔷 Reorient gently when possible

1️⃣2️⃣ Nicotine Use Disorder

🧠 Dependence Pattern

🔷 Nicotine → highly addictive stimulant

🔷 Dopamine release → reinforcement and craving

🔷 Tolerance develops → increased use

🔷 Withdrawal → irritability, anxiety, cravings

🔷 Long-term effects → CVD, COPD, cancer

🔷 Smoking cessation reduces morbidity significantly

🔎 Assessment Findings

🔷 Smoking history → pack-years

🔷 Withdrawal → irritability, restlessness, insomnia

🔷 Chronic cough, dyspnea, wheezing

🔷 Stained teeth, fingers, odor

🔷 Failed quit attempts

🔷 Motivation to quit varies

💊 Management

🔷 Nicotine replacement → patch, gum, lozenge

🔷 Bupropion → reduces cravings

🔷 Varenicline → partial agonist, reduces reward

🔷 Behavioral therapy → quit strategies

🔷 Support groups

🔷 Avoid triggers → stress, social cues

🩺 Nursing Priorities

🔷 Assess readiness to quit

🔷 Educate on nicotine replacement use

🔷 Monitor mood changes with cessation meds

🔷 Encourage gradual or planned quit approach

🔷 Provide support and follow-up

🔷 Reinforce relapse as part of recovery process

1️⃣3️⃣ Polysubstance Use

🧠 Combined Use

🔷 Use of multiple substances simultaneously or sequentially

🔷 Increased toxicity → unpredictable effects

🔷 Common combinations → alcohol + benzos/opioids

🔷 Masking symptoms → difficult diagnosis

🔷 Higher overdose and mortality risk

🔷 Complicated withdrawal syndromes

🔎 Assessment Findings

🔷 Mixed symptoms → stimulant + depressant signs

🔷 Inconsistent history or unreliable reporting

🔷 Altered LOC, agitation, or sedation alternating

🔷 Toxicology screen → multiple substances

🔷 Unexplained VS instability

🔷 Increased risk for medical complications

💊 Management

🔷 Prioritize airway, breathing, circulation

🔷 Treat most life-threatening symptoms first

🔷 Naloxone if opioid suspected

🔷 Benzodiazepines for agitation/seizures

🔷 Supportive care → fluids, monitoring

🔷 ICU care PRN severe toxicity

🩺 Nursing Priorities

🔷 Continuous monitoring → VS, LOC

🔷 Prepare for rapid deterioration

🔷 Avoid assumptions → confirm substances used

🔷 Maintain safety precautions

🔷 Collaborate interdisciplinary team

🔷 Document findings clearly

1️⃣4️⃣ Substance Intoxication vs Withdrawal

🧠 Key Differences

🔷 Intoxication → effects while substance active

🔷 Withdrawal → symptoms after stopping substance

🔷 CNS depressants → sedation intoxication, agitation withdrawal

🔷 Stimulants → agitation intoxication, depression withdrawal

🔷 Opioids → sedation intoxication, flu-like withdrawal

🔷 Timing and symptoms help identify condition

🔎 Assessment Findings

🔷 Intoxication → slurred speech, ataxia, euphoria

🔷 Withdrawal → tremor, anxiety, sweating, GI symptoms

🔷 VS → variable based on substance type

🔷 LOC changes → sedation vs agitation

🔷 History of last use critical

🔷 Monitor pattern progression

💊 Management

🔷 Intoxication → supportive care, airway, antidote PRN

🔷 Withdrawal → symptom management, tapering meds

🔷 Benzodiazepines → alcohol withdrawal

🔷 Methadone/buprenorphine → opioid withdrawal

🔷 IV fluids → hydration

🔷 Monitor complications

🩺 Nursing Priorities

🔷 Differentiate intoxication vs withdrawal quickly

🔷 Monitor for complications → seizures, delirium

🔷 Maintain safety environment

🔷 Assess frequently → VS, LOC

🔷 Document progression

🔷 Communicate findings to provider

1️⃣5️⃣ Relapse and Recovery

🧠 Relapse Cycle

🔷 Relapse → return to substance use after abstinence

🔷 Triggered by stress, cues, emotions

🔷 High-risk situations → social, environmental triggers

🔷 Craving → key factor in relapse

🔷 Relapse ≠ failure → part of recovery process

🔷 Recovery requires long-term management

🔎 Assessment Findings

🔷 Identify triggers → people, places, emotions

🔷 Cravings intensity and frequency

🔷 Coping strategies available

🔷 Support system presence

🔷 History of relapse patterns

🔷 Readiness for change

💊 Management

🔷 Naltrexone → alcohol/opioid relapse prevention

🔷 Acamprosate → alcohol abstinence support

🔷 Behavioral therapy → CBT, motivational interviewing

🔷 Support groups → AA, NA

🔷 Lifestyle modification → stress management

🔷 Ongoing follow-up care

🩺 Nursing Priorities

🔷 Teach relapse warning signs

🔷 Encourage coping strategies

🔷 Reinforce support system use

🔷 Avoid judgment after relapse

🔷 Promote adherence to treatment plan

🔷 Provide continuous encouragement

1️⃣6️⃣ Therapeutic Communication in Addiction

🧠 Communication Approach

🔷 Nonjudgmental, supportive, empathetic tone

🔷 Avoid confrontation or blame

🔷 Encourage honesty and openness

🔷 Build trust → essential for treatment

🔷 Use motivational interviewing techniques

🔷 Focus on patient strengths

🔎 Techniques

🔷 Open-ended questions → “What concerns you about your use?”

🔷 Reflective listening → restate patient feelings

🔷 Affirmations → reinforce positive change

🔷 Avoid labeling → “addict”, “abuser”

🔷 Explore ambivalence → pros and cons of use

🔷 Set collaborative goals

💊 Support

🔷 Counseling referral

🔷 Support groups

🔷 Education on substance effects

🔷 Family involvement PRN

🔷 Follow-up planning

🔷 Crisis intervention PRN

🩺 Nursing Priorities

🔷 Maintain therapeutic alliance

🔷 Encourage participation in treatment

🔷 Respect patient autonomy

🔷 Reinforce progress

🔷 Document communication clearly

🔷 Collaborate care team

1️⃣7️⃣ Legal and Ethical Issues

🧠 Considerations

🔷 Substance use → legal consequences possible

🔷 Confidentiality → protected unless harm risk

🔷 Mandatory reporting → impaired driving, abuse cases

🔷 Consent → must be informed and voluntary

🔷 Involuntary treatment PRN danger to self/others

🔷 Stigma affects care access

🔎 Assessment Findings

🔷 Legal history → DUI, arrests

🔷 Risk behaviors → driving under influence

🔷 Insight into consequences

🔷 Family/social impact

🔷 Occupational impairment

🔷 Compliance with treatment

💊 Management

🔷 Referral to legal resources PRN

🔷 Substance treatment programs

🔷 Counseling for behavior change

🔷 Support groups

🔷 Education on legal risks

🔷 Coordination with social services

🩺 Nursing Priorities

🔷 Maintain confidentiality

🔷 Educate patient on risks

🔷 Advocate for patient rights

🔷 Follow legal reporting requirements

🔷 Document accurately

🔷 Promote safe behaviors

1️⃣8️⃣ Dual Diagnosis (Co-occurring Disorders)

🧠 Comorbidity

🔷 Substance use + psychiatric disorder coexist

🔷 Depression, anxiety, PTSD common

🔷 Substance may worsen psychiatric symptoms

🔷 Psychiatric disorder may trigger substance use

🔷 Complicates treatment and recovery

🔷 Requires integrated care

🔎 Assessment Findings

🔷 Mood changes, anxiety, psychosis symptoms

🔷 Substance use pattern linked to symptoms

🔷 Medication adherence issues

🔷 History of psychiatric diagnosis

🔷 Suicide risk ↑

🔷 Functional impairment

💊 Management

🔷 Treat both disorders simultaneously

🔷 SSRIs → depression/anxiety

🔷 Antipsychotics → psychosis

🔷 MAT → methadone, buprenorphine

🔷 Therapy → CBT, trauma-focused therapy

🔷 Close follow-up

🩺 Nursing Priorities

🔷 Assess both psychiatric and substance symptoms

🔷 Monitor medication adherence

🔷 Support integrated treatment plan

🔷 Educate patient on interaction of conditions

🔷 Encourage follow-up care

🔷 Document response

1️⃣9️⃣ Patient and Family Education

🧠 Teaching Focus

🔷 Substance effects on body and mind

🔷 Withdrawal risks and management

🔷 Importance of treatment adherence

🔷 Relapse prevention strategies

🔷 Family support role

🔷 Long-term recovery process

🔎 Key Topics

🔷 Recognize overdose signs

🔷 Safe medication use

🔷 Avoid triggers

🔷 Stress management techniques

🔷 Support resources → AA, NA

🔷 Emergency contacts

💊 Home Support

🔷 Naloxone kit availability

🔷 Medication schedule

🔷 Follow-up appointments

🔷 Safe environment

🔷 Counseling services

🔷 Community resources

🩺 Nursing Priorities

🔷 Use teach-back method

🔷 Include family when appropriate

🔷 Reinforce education repeatedly

🔷 Provide written materials

🔷 Encourage questions

🔷 Document understanding

2️⃣0️⃣ Nursing Priorities in Substance-Related Disorders

🧠 Core Focus

🔷 Ensure safety → overdose, withdrawal, self-harm

🔷 Monitor VS, LOC, mental status

🔷 Manage withdrawal and complications

🔷 Promote recovery and relapse prevention

🔷 Support therapeutic communication

🔷 Collaborate interdisciplinary care

🔎 High-Yield Monitoring

🔷 Withdrawal signs → tremor, seizures, agitation

🔷 Overdose signs → respiratory depression, LOC ↓

🔷 Mental status → confusion, hallucinations

🔷 VS → HR, BP, RR, temperature

🔷 Hydration and nutrition

🔷 Medication adherence

💊 Clinical Support

🔷 Benzodiazepines → alcohol withdrawal

🔷 Naloxone → opioid overdose

🔷 Methadone, buprenorphine → opioid use disorder

🔷 Naltrexone, acamprosate → alcohol relapse prevention

🔷 SSRIs → comorbid conditions

🔷 IV fluids, electrolytes

🩺 Nursing Actions

🔷 Perform thorough assessment

🔷 Provide safe environment

🔷 Administer medications correctly

🔷 Educate patient and family

🔷 Encourage treatment participation

🔷 Document all findings and care

🏁 Conclusion

Substance-related disorders require vigilant, nonjudgmental, and safety-focused nursing care due to high risks of withdrawal complications, overdose, relapse, and co-occurring psychiatric conditions. Nurses play a vital role in early identification, stabilization, medication management, patient education, and long-term recovery support, emphasizing therapeutic communication, relapse prevention, and interdisciplinary collaboration to improve patient outcomes and quality of life.