Many drugs and volatile substances are subject to abuse (as noted in previous plans of care). This disorder is a continuum of phases incorporating a cluster of cognitive, behavioral, and physiological symptoms that include loss of control over use of the substance and a continued use of the substance despite adverse consequences. A number of factors have been implicated in the predisposition to abuse a substance (e.g., biological, biochemical, psychological [including developmental], personality, sociocultural and conditioning, and cultural and ethnic influences). However, no single theory adequately explains the etiology of this problem.
This plan of care addresses issues of dependence and is to be used in conjunction with plans of care relative to acute intoxification/withdrawal from specific substance(s).
CLIENT ASSESSMENT DATA BASE
Refer to appropriate acute plan of care regarding involved substance(s).
DIAGNOSTIC STUDIES
Drug (including-alcohol) Screen: Identifies drug(s) being used.
Addiction Severity Index (ASI) Assessment Tool: Produces a “problem severity profile” of the patient, including chemical, medical, psychological, legal, family/social and employment/support aspects, indicating areas of treatment needs.
Other Screening Studies (e.g., Hepatitis, HIV, TB): Depend on general condition, individual risk factors, and care setting.
NURSING PRIORITIES
1. Provide support for decision to stop substance use.
2. Strengthen individual coping skills.
3. Facilitate learning of new ways to reduce anxiety.
4. Promote family involvement in rehabilitation program.
5. Facilitate family growth/development.
6. Provide information about condition, prognosis, and treatment needs.
DISCHARGE GOALS
1. Responsibility for own life and behavior assumed.
2. Plan to maintain substance-free life formulated.
3. Family relationships/enabling issues being addressed.
4. Treatment program successfully begun.
5. Condition, prognosis, and therapeutic regimen understood.
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