Learning Objectives
- Assess clients for intoxication, dependency, withdrawal symptoms, and/or substance use disorders and intervene as appropriate
- Apply the nursing process to clients experiencing withdrawal or toxicity from substances
- Provide care and/or support clients with nonsubstance-related dependencies (e.g., gambling, sexual addiction)
- Describe the neurobiology and risk factors for substance use disorders
- Apply the nursing process to clients with substance use disorders
- Describe protective factors and prevention programs for substance use disorders
- Outline evidence-based treatments for clients with substance use disorders
- Discuss recovery services for clients with substance use disorders
- Evaluate client’s response to a treatment plan and revise as needed
- Provide patient education to clients and their family members
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.
Chronic 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. https://nsduhweb.rti.org/respweb/homepage.cfm ↵