substance abuse

what is substance abuse?

Substance abuse is defined as a long-term behaviour pattern due to which a person has a chronic, debilitating, and relapsing dependence on mood-altering substances. As against common beliefs, substance abuse is not only about illegal drugs or psychoactive substances like marijuana, cocaine, etc. A dependence on legal substances like pain medications, alcohol, cough syrups, etc. that act as mood stimulants is also termed as substance abuse.

reasons why people get addicted to substances

Despite the general opinion that it’s the adolescents who are the most addicted, every age group right from young adults to the elderly have been known to abuse substances. The reasons why a person gets addicted vary for every age group and depend on factors like genetics, family history of addiction, experimentation, co-existence of mental or physical health conditions, etc. Some of the most common reasons for substance use include:

• Depression: When a person suffers from long periods of melancholy or a low state of mind, she/he may take to drugs to feel ‘good’ or in an attempt to make sense of their situation. 

• Emotional setbacks: Situations like the death of a close person, ending of a relationship, loss of a job, etc. have a devastating impact on some people. In the absence of strong emotional support, some people may resort to drugs. 

• Peer pressure: At times, the pressure to fit in with their peers is too high that propels people to try out drugs. This is especially common in teenagers and young adults. 

• External influences: The environment that a person has grown up in and is exposed to every day may trigger substance use. Factors like households where drug usage, abuse, crime are rampant, growing up in poverty, etc. are some such reasons. 

• Self-medication: Stress and pain that accompany injuries, trauma, and health conditions lead to people looking for relief from pain through these mind-altering substances. 

effects of substance abuse

Substances have short-term and long-term effects on the body and the mind. The effects depend on the severity of the addiction, the general health of the individual, age, etc. Some common effects of substance abuse include:

short-term effects:

• Sleeplessness or insomnia.
• Changes in appetite.
• Palpitations.
• Slurred speech
• Temporary feelings of ‘high’.
• Loss of coordination.
• Inability to maintain personal hygiene.
• Inability to think straight and concentrate on things. 
• Problems in relationships.
• Poor work and school performance. 
• Lack of personal hygiene.
• Sudden bouts of anger and an increase in risk-taking behaviours. 

long-term effects:

• Psychological issues like paranoia, hallucinations, bouts of excessive anger, panic disorders, aggression, etc. 
• Weakened immune system leading to illnesses and infections.
• Cardiac disorders like coronary artery disease, arrhythmia, collapsed veins, and cardiac arrests.
• Respiratory problems.
• Kidney damage and failure.
• Inflammation, scarring, and failure of the liver.
• Brain damage, seizure, strokes.
• A substance overdose may even result in death.

how is substance abuse treated?

Treatment of substance use and addiction is a complex procedure as it involves making changes to the mind functions, behaviours, and physical aspects of a person. There is no single line of treatment for everyone and depends on the affected person’s age, history of substance abuse, and her/his needs. Some of the treatment options that are used include:

• Behavioural counselling: Done individually or in groups, this includes modifying a person’s behaviour related to substance abuse and increase health-seeking behaviour. This includes:

1. Cognitive behavioural therapy where a person is trained on how to recognize, avoid, and deal with trigger situations. 
2. Family therapy to improve familial reactions and functioning. 
3. Motivational incentives and positive reinforcements that encourage abstinence. 

• Medications and devices: These are used to manage the withdrawal symptoms, relieve cravings for drugs, avoid relapse, and become more open to treatments. These include opioids, tobacco patches, sprays, gums, lozenges, etc. 
• Additional medical care: This is a very important aspect of any substance use treatment and includes a comprehensive and integrated involvement of nurses and other medical professionals. Patients and their families are offered the first line of information and treatment, emotional support, and responding to emergencies arising from substance abuse.

need for nursing care at home

Drug dependence is a complex issue that not has ramifications for the person addicted to substances but also for her/his immediate family, friends, and peers. There are important reasons why nursing care at home becomes imperative in a substance abuse situation:

• The need for dedicated at-home nursing care arises when the affected person has a severe addiction or due to co-existing conditions like health problems, disabilities, or mental illnesses is unable to care for himself. 
• The need for nursing care is especially important when the affected person is being administered a medication-assisted treatment. 

what does a substance abuse nurse do?

Nurses have always played a very important role in de-addiction and the prevention of substance abuse. From the promotion of healthy behaviours to recovery, they act as front-line information & direct care providers for the patients at all times of the day. The role of a substance abuse nurse include:

• Assisting the physician in developing the treatment plan for the patient struggling with substance abuse. 
• Counselling the family members and making the home and surrounding environment a positive place that’s conducive to treatment and recovery. 
• Educating the patient about this treatment plan, the dangers of substance use, the damage that it does, what to expect from a rehabilitation process.  
• Assessing and monitoring the condition of the patient.
• Administering therapies and medications. 
• Offering calming exercises to facilitate rest and sleep to better absorb the treatment plans. 
• Reporting withdrawal symptoms if any and reporting to the physician. 
• Helping the patient and her/his family in adjusting to a life and mood changes without any dependence on substances. 
• Developing the patient’s coping skills, interpersonal communication, and social skills to enable quicker recovery and avoiding relapse. 
• Acting as a conduit between the patient and the physician and keeping the latter updated about the condition, progress, and outlook of the patient. 
• Helping the patient’s integration back into her/his social circle and community and live a productive life without dependence on substances.