8.1.1.1. Risk factors


7.2.3. Implementation

64 Drug Addiction

or difficult situations.

• Community Persons with drug addiction will:

continue to express feelings.

common experiences.

he or she can make

stop using drug.

1. Assessment data include stressful life crisis, isolative behavior, low self-esteem, impulse control, superficial relationships, effective problem-solving skills, ineffective coping skills, inability to form and maintain intimate personal relationships, and avoidance of problems

• Participate in follow-up or aftercare programs and support groups

• Demonstrate effective communication with others

• Demonstrate nonchemical methods of dealing with feelings, problems, and situations

2. Encourage the PDD to explore alternative ways of dealing with stress and difficult situations. The PDD may have little experience dealing with life stress without chemicals and

3. Help the PDD develop skills in defining problems, planning problem-solving approaches, implementing solutions, and evaluating the process. You can provide knowledge and

4. Help the PDD express feelings in acceptable ways, and give positive reinforcement for doing so. You are a sounding board for the PDD. Your feedback encourages the PDD to

5. Involve the PDD in a group of his or her peers to provide confrontation, positive feedback, and sharing of feelings. Groups of peers are a primary mode of treatment in drug addiction treatment, and provide honesty, support, confrontation, and validation, based on

6. Focus attention on the "here and now": what can the PDD do now to redirect his or her behavior and life? The PDD cannot change the past. Once he or she acknowledges responsibility for past behavior, it is not helpful or healthy to ruminate or feel guilty about the past.

Sobriety, including abstinence from all substances, is associated with greater success in recovery. 1. Help the PDD view life and the quest for sobriety in feasible terms, such as "What can I do today to stay sober?" The PDD have many barriers to success in abstinence. External stimuli and internal stimuli are the big deal to challenge their self-control to say no and

7. Avoid discussing unanswerable questions, such as why the PDD uses substances.

Asking why is frustrating as well as fruitless; there is no answer.

8. Guide the PDD to the conclusion that sobriety is a choice

may be learning for the first time how to cope, solve problems, and so forth.

practice of the problem-solving process in a nonthreatening environment.


5. Restraints may be necessary to keep the PDD from harming himself or herself. If the PDD cannot be protected from injury in any other manner, restraints may become necessary.

Nursing Care for Persons with Drug Addiction http://dx.doi.org/10.5772/intechopen.73334 67

6. Do not moralize or chastise the PDD for substance use. Maintain a nonjudgmental attitude. Remember that substance use and substance abuse are illnesses and out of the PDD's

7. Talk with the PDD using simple, concrete language. Do not attempt to discuss the PDD's feelings, plans for treatment, or possible changes in the PDD's lifestyle while the PDD is influenced by the drug or in acute or severe withdrawal. The PDD's ability to process abstractions is impaired during withdrawal. You and the PDD will be frustrated if you

8. Reorient the PDD to person, time, place, and situation as indicated when the PDD is confused or disoriented. Presentation of concrete facts facilitates the PDD's reality contact.

9. Decrease environmental stimuli (bright lights, television, visitors) when the PDD is agitated. Avoid lengthy interactions; keep your voice soft; and speak clearly. Your presence and soft tones can be calming to the PDD. He or she is not able to deal with excessive stimuli. 10. Reassure the PDD that the environment is safe by briefly and simply explaining procedures, routines, and so forth. The psychotic PDD frequently acts out based on fear as a

11. Protect the PDD from harming himself or herself by removing the items that could be used in self-destructive behavior or by restraining the PDD. The PDD's physical safety is a priority. 12. Remove the PDD to a quiet area, or withdraw your attention if the PDD acts out, provided there is no potential danger to the PDD or others. Decreased attention from you and others

13. Set limits on the PDD's behavior when he or she is unable to do so if the behavior interferes with other PDDs or becomes self-destructive. Do not set limits to punish the PDD. Limit setting is the positive use of external control to promote safety and security. 14. Evaluate the PDD's response to the presence of family and significant others. If their presence helps calm the PDD, maximize their visiting time, but if the PDD becomes more

agitated, limit visits to short periods of time with one or two people at a time.

Restraints are not to be used punitively.

means of protecting himself or herself.

15. Evaluation of nursing outcomes.

• Drug addiction and dependence

8.2.1. Assessment data

• Fear

may help to extinguish unacceptable behavior.

8.2. Nursing diagnosis: ineffective health maintenance

Inability to identify, manage, and/or seek out help to maintain health.

control at this time. Moralizing belittles the PDD.

attempt to address interpersonal or complex issues at this point.
