1. The client/caregiver can define substance abuse.
   1. Substance abuse is the abuse of tobacco, alcohol, and other drugs (legal and illegal).
   2. According to the National Institute on Drug Abuse, addiction is defined as a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use despite harmful consequences.
   3. The National Institute on Drug Abuse fact sheets from the 1999 report
   4. Drug abuse can change the structure of the brain and how it works. These changes can be permanent.
   5. Addiction is a developmental disease. It usually begins in childhood or adolescence.
   6. Substances frequently abused include (but are not limited to) the following:
      • Marijuana
      • Hallucinogens (such as LSD)
      • Cocaine (a stimulant that is snorted or injected)
      • Amphetamines (methamphetamine, a stimulant that is growing in popularity)
      • Opiates, such as heroin
      • Anabolic steroids (used to build muscle strength)
      • Prescription drugs (oxycodone is the most abused prescription drug in the United States)
      • Sedatives, hypnotics, and antianxiety medication
      • Inhalants
      • Designer or party drugs
2. The client/caregiver can list indicators of substance abuse.
   1. Behavioral changes such as
      • Secretiveness
      • Change in friends
      • Missed work or school
      • Poor performance at job or school
      • Frequent job changes
      • Legal difficulties
      • Increase in accidents and injuries
   2. Physical signs such as
      • Unsteady gait
      • Slurred speech
      • Odor of alcohol or inhalant on breath or clothes
      • Constricted or dilated pupils
      • Needle marks
      • Runny nose or constant sniffling
      • Twitchiness or tremors
      • Seizures
      • Sores from picking or scratching skin
      • Weight loss
      • Red eyes
   3. Emotional symptoms such as
      • Personality changes
      • Moodiness
      • Irritability
      • Anxiety
      • Poor attention or concentration
      • Restlessness
      • Euphoria
      • Depression
      • Agitation
      • Paranoia
   4. Environmental factors such as
      • Poor living facilities or frequent moves
      • Poor personal hygiene of self or dependent children
      • Unkempt house
      • Presence of empty bottles or drug paraphernalia
      • Cigarette burns on furniture, rugs, or clothes
3. The client/caregiver can list the results of drug abuse.
   1. Violence
   2. Car accidents
   3. Financial difficulties
   4. Addiction
   5. Crimes, including homicide, theft, and assault
   6. Mental illness
   7. Family and child abuse
   8. Birth defects
   9. AIDS
   10. Death
4. The client/caregiver can list some community settings/activities for all three levels of prevention and health promotion.
   1. School
      1. Education of the students, parents, and educators
      2. Health fairs, presentations by positive role models, and so forth
      3. Training for peer counselors
   2. Workplace
      1. Seminars, presentations, discussion groups
      2. Referrals
   3. Community in general
      1. Health fairs, and educational presentations at various centers (senior centers, neighborhood meetings, child and teen organizations such as scouts, homeless centers, etc.)
   4. Home and neighborhood
      1. Talk openly with family members.
      2. Have accountability for any prescription drugs or alcohol used in the home.
      3. Supervise children’s activities, and know the people they interact with.
      4. Form discussion and support groups.
   5. Church
      1. Offer facilities for support groups such as Narcotics Anonymous or AA to meet.
      2. Have social activities without the use of drugs and alcohol.
      3. Make health screenings for blood pressure and other things available.
      4. A parish nurse can assist in education and support.
5. The client/caregiver can list treatments available.
   1. Substance abuse treatment program
   2. Inpatient programs
   3. Residential treatment
   4. Outpatient treatment
   5. Halfway houses
   6. Community-based treatment
   7. Employee assistance programs
   8. Holistic treatments
      1. Massage
      2. Nutrition therapy
      3. Acupuncture or acupressure
      4. Hypnosis, meditation, or guided imagery
      5. Aromatherapy
      6. Energy medicine such as Reiki or Therapeutic Touch

Resources

National Institute on Drug Abuse
www.nida.nih.gov/

U.S. Department of Health/SAMSHA Clearinghouse for alcohol and drug information
http://ncadi.samhsa.gov

Narcotics Anonymous World Service
www.na.org

National Center for Complementary and Alternative Medicine/National Institutes of Health
http://nccam.nih.gov

National Center for Health Statistics
www.cdc.gov/nchs/fastats/druguse.htm

Drug testing

Counseling

Support groups

References

Ackley, B. J., & Ladwig, G. B. (2006). Nursing diagnosis handbook: A guide to planning care. St. Louis: Mosby Elsevier.
Canobbio, M. M. (2006). Mosby’s handbook of patient teaching . St. Louis: Mosby Inc.
Hitchcock, J. E., Schubert, P. E., & Thomas, S. A. (2003). Community health nursing: Caring in action. Clifton Park, NY: Thomson Delmar Learning.
Hunt, R. (2005). Introduction to community based nursing. Philadelphia: Lippincott Williams & Wilkins.
Varcarolis, E. M. (2006). Manual of psychiatric nursing care plans. St. Louis: Saunders Elsevier.