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Substance Abuse

MEDICAL INTERVENTIONS

Medical treatment for substance use disorders includes assessment, treatment planning, and
counseling. Counseling focuses on reducing or stopping substance use, skill building,
adherence to a recovery plan. Furthermore group counseling is often used in addition to
individual counseling to provide social reinforcement for pursuit of recovery. Provide variety
of therapies. Some common therapies include:

Cognitive-behavioral therapy teaches individuals in treatment to recognize and stop


negative patterns of thinking and behavior. This therapy helps client to be aware of the
stressors, situations, and feelings that lead to substance use so that they avoid them or act
differently when they occur.

Contingency management is designed to provide incentives to reinforce positive


behaviors, such as remaining abstinent from substance use.

Motivational enhancement therapy helps client with substance use disorders to build
motivation and commit to specific plans to engage in treatment and seek recovery. It is
often used early in the process to engage client in treatment.

Medication-assisted treatment (MAT) is the use of medications with counseling and


behavioral therapies to treat substance use disorders and prevent opioid overdose.

PHARMACOLOGICAL INTERVENTIONS

Pharmacologic treatment in substance abuse has two main purposes:


(1) to permit safe withdrawal from alcohol,sedative-hyotics, and benzodiazepines; and
(2) to prevent relapse

Drugs used for substance abuse treatment:

Maintains abstinance from heroin:

Methadone (Dolophine)

Nursing Considerations:
May cause from nausea and vomiting

Maintains abstinence from opiates:


Levomethadyl (Orlaam)- is a narcotic analgesic use only to treatment of
opiate dependence. It is also use in the same manner as methadone.

Nursing Considerations:
Do not take drug on consecutive days; take home doses are not permitted

Maintains abstinence from opiates and decreases opiate cravings:


Buprenorphine/naloxone (Suboxone)- is combination drug usedfor opiate
maintenance and used to decrease opiate cravings. Buprenorphine is a
semisynthetic opiod and naloxone is an opiod inverse agonist.

Nursing Considerations:
May cause orthostatic hypotention, sedation, avoid CNS depression

Blocks the effects of opiates; reduces alcohol cravings:


Naltrexone (ReVia, Trexan)- is an opiod receptor antagonist used to treatt
overdose. It blocks the effects of any opiods. It also has been found to
reduce the cravings for alcohol in abstinent clients.

Nursing Considerations:
Client maynot respond to narcotics, used to treat cough,diarrhea, or pain; take with food or
milk; may cause headache, restlesness and irritability.

NURSING MANAGEMENT

1. Educate client and family that prescribed medication can be an abused substance.
2. Teach client about the dangers of substance abuse and possible treatment options.
3. Include patient in planning process and provide choices when possible.
4. Provide physical and emotional support for clients and their families.
5. Encourage family to participation in aftercare programs.
6. Dispel myths and misconceptions about substance abuse like:
I can learn to use drugs socially
People don't need treatment. They can stop using drugs if they really want to.
People who continue to abuse drugs after treatment are hopeless.
7. Administer medication and regulate client treatment

SUPPORT GROUPS

Narcotics Anonymous (NA)

is the most well-known and widely available self-help group for alcoholics in treatment and
recovery. NA uses fellowship and a set of guided principlesthe 12 stepsto help members
achieve and maintain sobriety. The goal is total abstinence from drinking.

A key part of a 12-step program is choosing a sponsor, a former alcoholic who has time and
experience remaining sober. A good sponsor helps you understand and work the steps to. NA
members attend group meetings facilitated by other membersall recovering participants.
Meetings take place on a regular basis, at various times, and in many different locations
around the world. Members are free to attend any of the many meetings held each week.

The 12 step program involves

admitting that you are powerless to control your addiction or compulsion

recognizing a higher power as you understand it that can give strength

reviewing the mistakes youve made in the past, with the help of your sponsor
making amends for past mistakes and wrongs

learning how to live a new life, free from old unhealthy habits and ways of behaving

helping fellow alcoholics

Secular Organizations for Sobriety (SOS)

is an international organization that takes a science-based, self-empowerment approach to


abstinence and recovery from drug and alcohol addiction.

A network of independent meetings with an alternative recovery method

Promotes abstinence and provides support from others struggling with the same
issues

Encourages self-empowerment approaches to recovery for those who are


uncomfortable with the spiritual content of

Takes the approach that sobriety is a separate issue from religion or spirituality

Credits the individual for achieving and maintaining his or her own sobriety, without
reliance on any higher power

SMART Recovery (Self-Management and Recovery Training)

is a program that aims for abstinence from alcohol or drugs through self-empowerment and
self-directed change.

Emphasizes self-empowerment, self-reliance, and self-directed change

Based on principles of cognitive-behavioral therapy (CBT)

Teaches specific tools and techniques within a 4-point program:

1. Enhancing and maintaining motivation to abstain

2. Coping with urges

3. Problem solving (managing thoughts, feelings, and behaviors)


4. Lifestyle balance (balancing momentary and enduring satisfactions)

Cognitive strategies (positive thinking)

Letting the body help (relaxation techniques, meditation, diet, and physical exercise)

Self Enhancement for Life Foundation, Inc. (SELF)

SELF is a non-stock, non-government organization dedicated to the treatment and


rehabilitation of individuals suffering from substance abuse and other Attitude
Disorders. Through its Therapeutic Community(TC) approach, SELF not only rehabilitates
its clients but works towards developing their talents and potentials so that they
become empowered members of society.

The hallmark of SELFs Therapeutic Community approach is its insistence that the
entire family participate in the healing process. Toward this end, it runs a Family
Empowerment Program, the hallmark of which is the monthly Family Association
Meeting(FAM), where seminars on the TC, recovery from dependency and co-
dependency are discussed. Family Therapy sessions are also conducted regularly to
heighten awareness and initiate the healing process.

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