14.1 Introduction
Learning Objectives
- Identify assessment cues of substance use behaviors
- Identify nursing priorities for clients with substance use disorders
- Plan outcomes for clients with substance use disorders
- Differentiate safety/protective interventions for clients with substance use disorders
- Apply evidence-based practice when planning care and interventions for clients with substance use disorders
- Analyze treatments for clients with substance use disorders
- Apply the nursing process to clients with substance use disorders at risk for suicide
- Assess clients for signs of intoxication, dependency, and withdrawal symptoms and intervene appropriately
- Apply the nursing process to clients experiencing withdrawal or toxicity from substances
- Describe care for clients with nonsubstance-related dependencies (e.g., gambling, sexual addiction)
- Describe the neurobiology and risk factors for substance use disorders
- Describe protective factors and prevention programs for substance use disorders
Misuse of alcohol, drugs, and prescribed medications is estimated to cost the United States more than $400 billion in health care expenses, law enforcement and criminal justice costs (due to drug-related crimes), lost workplace productivity, and losses from motor vehicle crashes.[1] The Centers for Disease Control and Prevention (CDC) National Center for Health Statistics estimates 107,622 drug overdose deaths and 52,000 alcohol-induced deaths occurred in the United States in 2021.[2]
View a visualization of recent drug overdose death rates nationally and by state at the CDC National Center for Health Statistics’ Vital Statistics Rapid Release web page: Provisional Drug Overdose Death Counts.
Substance use disorders significantly impact individuals, families, communities, and our society. According to the 2020 National Survey on Drug Use and Health (NSDUH), 40.3 million people in the United States aged 12 or older (14.5 percent) have a substance use disorder (SUD).[3]
This chapter will provide an overview of many topics related to substance use. It begins by reviewing signs of intoxication of various psychoactive substances and treatment for overdose and withdrawal symptoms. The neurobiology of substance use disorders and risk factors are explored, and then evidence-based treatment and prevention interventions are discussed based on the Surgeon General’s Report on Alcohol, Drugs, and Health. Finally, the nursing process is applied to a hospitalized client receiving treatment for alcohol withdrawal.
- Substance Abuse and Mental Health Services Administration, & Office of the Surgeon General. (2016). Facing addiction in America: The surgeon general's report on alcohol, drugs, and health. United States Department of Health and Human Services. https://www.ncbi.nlm.nih.gov/books/NBK424857/ ↵
- National Center for Health Statistics. (2022, May 11). U.S. overdose deaths in 2021 increased half as much in 2020 - but are still up 15% [Press release]. https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2022/202205.htm ↵
- National Survey on Drug Use and Health. (n.d.). https://nsduhweb.rti.org/respweb/homepage.cfm ↵
