An Intervention On Substance Use Disorder

According to the Diagnostic Statistic Manual 5 (DSM-5) substance use disorder is when the individual has a dependency on alcohol or drug, followed by penetrating craving and antisocial behavior to acquire the substance. The terms substance abuse and substance dependence refer to substance use disorder, which has been separated into three classifications as follows

Treatment guidelines from the Substance Abuse and Mental Health Services Administration indicate that treatment should include age-appropriate group therapy, and teach skills to rebuild social support networks (Trevisan, 2008). Staff need to be experienced in working with the elderly and use a slower pace and age-appropriate content. Respect with an atmosphere of support and change rather than confrontation should be created in the therapeutic setting. Three medications have been approved for treatment of alcohol problems; however, there are few pharmacological treatment studies of alcohol dependence in older adults and no know studies of other drugs of abuse (Trevisan, 2008). These three medications include Disulfiram, Naltrexone, and Acamprosate (Trevisan, 2008).

As clinicians, there is a duty to provide as clear of a diagnostic assessment as possible, particularly in relation to substance use, in order to provide the best care. In Substance Abuse Counseling: Theory and Practice, the authors state “as with other diseases and disorders, the earlier a therapist diagnoses a substance abuse problem, the better the prognosis for the client.” (Stevens & Smith, 2013) This makes assessment crucial to the diagnostic process. In “Screening, brief intervention, referral to treatment (SBIRT) for illicit drug and alcohol use at multiple heathcare sites,” written by Madras, Compton, Avula, Stegbauer, Stein, & Clark (2009), the reported 2006 NSDUH survey statistics estimated that “22.6 million people harbor a diagnosable alcohol or illicit drug use disorder.” (Madras et.al, 2009) Over the years, researchers have developed

Drug addiction and alcoholism have a devastating effect on not only the addicts who suffers from these illnesses, but also on friends, family and workmates who interact with these addicts on a regular basis. When the addict finally succumbs to their addiction, the only way out is usually through the help of a professional and reputable inpatient addiction treatment center.

* Trained and designated care workers give controlled drugs, another trained, and designated staff should witness. (Standard 9.7 and 20.9)

The meaning of a word portrays what it encompasses and if the phrase itself is misunderstood then defining what it’s trying to explain can be a studious task. Addiction has been defined by many and holds different meanings based on the context it’s used in. Addiction can be defined as a condition in which a person undertakes the use of substance, or engages in activities, which in turn brings pleasure, and tends to divert oneself from their day-to-day duties and responsibilities. Addiction is mostly related to drug use but it is also used to describe non-drug entities, such as gambling, and Internet addictions (Avena et al, 2008). Researchers (Herbert, J. D., Forman, E. M., 2010) have been keen on identifying the factors that lead to

Substance abuse continues to be a serious health care concern with millions of American 18 and older using illegal drugs. Substance abuse occurs across all generations, cultures, and occupations, including nursing. “About 1 in 10, or 10-15% of all nurses, may be impaired or in recovery from alcohol or drug addiction” (Thomas & Siela, 2011). When a nurse is impaired they will not be able to function at their normal capacity, and are not able to provide quality patient care. They may not be able to think as quickly, and have a delayed reaction time.

There are many assessment processes that are used to identify substance abuse as well as many other disorders that are addictive. These processes include the SBIRT, AUDIT (Alcohol Use Disorders Identification Test), NIDAMED, CAGE AID (which is used frequently within the counseling foundation), AUDIT-C, and also the DAST-10 which is an assessment process used to evaluate drug abuse within the patients. These are many different processes that are currently used to identify these addictions in clients. The activity of identifying these processes can be over a period of time or can be evaluated in that same day or after the evaluation is completed.

Many people have turned to substance abuse or experience chemical dependency for a variety of reasons. Nurses experience chemical dependency as well. According to Kunyk (2013), “healthcare professionals, including nurses, are also potentially vulnerable to substance use disorders regardless of any special knowledge, skills or insights they might have owing to their education and professional experiences” (p. 54). This paper will define what chemical dependency is, report causes of chemical dependency in nurses, describe behaviors associated with chemical dependency, and explain what needs to be done upon reentry into the work place.

Government research indicates that at least 100,000 doctors have an addiction to drugs or alcohol. There have been enough documented cases of doctors performing surgeries while under the influence that it has drawn national attention and the country is now asking "Should we mandatory drug test our practitioners?". Although the exact numbers are unknown, studies indicate that the percentage of physicians who use controlled substances is said to mirror that of the general population at about ten percent; however the numbers are estimated to be higher for surgeons and doctors who prescribe narcotics because of the ease of access to these controlled substances. Exactly how many surgeons perform while under the influence of mind-altering substance remains unknown; however even a one percent population poses critical issues for the profession. The most obvious is patient safety; the chances of loss of limb, loss of function and death are increased when critical thinking and surgical skills are clouded by the effects of controlled substances. Next, trust in medicine and healthcare as a whole is diminished when such activities occur.

Addiction treatment is a complex and paradoxical issue. Despite the fact that most of the medical and academic institutions define addiction as a chronic brain disease, it is too often treated on an acute basis. Chronic conditions are defined by the World Health Organization (WHO) as requiring ongoing management over a period of years or decades and cover a wide range of health problems. The goals of chronic care are not to cure, but to enhance functional status, minimize distressing symptoms, prolong life through secondary prevention and enhance quality of life.

Another challenge of working with substance users occurs when clients arrive intoxicated for a session. This may at times be a way of testing the counsellor, and although from the outside the client may seem impaired, being intoxicated may be their more familiar, functioning state. If the client is still able to engage, it is possible and often beneficial to continue with the session, if only in a limited way, Helen says.

According to the Merriam-Webster dictionary; “Substance abuse is the excessive use of a substance without medical justification”. Addiction is not a lack of will power or moral weakness, but is a progressive, chronic, and fatal brain disease that not only destroys a person mentally, physically, emotionally, and spiritually, but also disrupts families, businesses, and society at large. Substance abuse is reported to be the most severe occupational safety issue associated with the practice of anesthesiology, with an incidence as high as 1% per year of training (Tetzlaff , Collins , Brown, Leak, Pollock & Popa, 2008). Anesthesiologists are reported to be more susceptible to substance abuse than other medical professionals (Garcia-Guasch. Roige, & Padro, 2012).´ Since it is not plausible to identify them before they become addicted, it is necessary to learn to recognize the signs and symptoms of addiction when they eventually become manifest so as to preserve the safety of not only co-workers or colleagues, but the patients they care for. Early identification of substance-abusing anesthesia providers is very crucial. Depending on the half-life of the abused agent, tolerance and dependence can develop and can rapidly escalate out of control to the point of discovery (Bryson & Silverstein, 2008). According to the AANA 2012 Peer Assistance and Wellness Committee, the typical time frame for discovery is 1

For any professional working in the substance abuse treatment field, they will very likely come across situations and be presented with dilemmas relating to personal beliefs, judgments, and values. Drug or substance use and abuse have been a controversial and heated topic around the world for centuries. Drug abuse, in a way, is a facet of human culture that has been present for a great deal of human history in general. Every culture handles the issue of drug abuse differently. The history of how a society views persons with addictions is intermeshed with emotion, misperceptions, and prejudice that directly affects the care of drug abusers. This is a kind of awareness that drug users and those who provide drug treatment or rehabilitation should have. They may be susceptible to treating patients different because of their own personal views or because of the culturally normative views of that particular society. Just like teenagers may be automatically considered dangerous or irresponsible, it is fairly normative in a health care setting for a patient to be perceived negatively just because that person is a known drug user. Because of the highly charged emotional nature of the substance abuse treatment field, providers should possess the tools to explore ethical dilemmas objectively. By doing so, and by examining their own reactions to the situation, providers can proceed with the most ethical course of action. Ethical practice is

In Counseling for Alcohol and Drug Abuse, the need to use different techniques is an integral part of the process. Working with an individual that is either entering into recovery or actively in recovery, the clinician must take their time with introducing the 12 Steps. The individual may not be open to the 12 Step philosophies at the onset. Addiction is very complex and actively affects the person on a daily basis; therefore, it is so important to start from the beginning of counseling to create a structured program.