Substance Abuse

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PMH specialties: substance abuse (addictions) nursing

The latest data from the Substance Abuse and Mental Health Services Administration shows that up to 75 percent of all substance abuse cases occur by age 25. While trends fluctuate with regard to the type of substance abused, the overall rate has stayed the same for the past 10 years. The U.S. government acknowledges the value of prevention and the enormous cost of these disorders.

To that end, the Affordable Care Act stipulates a number of changes, and the demand for psychiatric mental health (PMH) nurses who specialize in substance abuse treatment will no doubt soar. In coming years, services will become more widely available to substance abuse patients including increased treatment options and preventive services. Funds will be available (including Medicaid reimbursement) for clinics and group homes providing services and outreach for substance abuse treatment.

Working in addictions nursing

Substance abuse nursing is a specialty that is changing from treatment of people with drug and alcohol addictions (including nicotine) to treatment of any disorder that has an addictions component such as eating disorders, gambling, or sex disorders. Increasingly, this specialty is being called addictions nursing.

A better understanding of how to treat substance abuse has resulted in more outpatient or community-based treatment as opposed to inpatient hospitals. Many substance abuse nurses still work in inpatient facilities (general hospitals, substance abuse centers, or psychiatric facilities) but more opportunities are being created in community-based services and outreach. Some addictions nurses work strictly in prevention in settings such as at-risk communities, schools, and workplaces.

Medical experts have long agreed that substance abuse is a disease, just like bipolar disorder or diabetes, so addictions nurses must always keep in mind that addictions disorders are treatable and people can recover from them. Relapse is frequent among addicted patients, so nurses must maintain their boundaries and avoid moral judgment.

Addictions nurses assess patients, make a plan for nursing treatment, and then implement and evaluate that plan. Duties included in this process may be withdrawal treatment, medication administration and monitoring, counseling, and working with other healthcare professionals to monitor other coexisting health conditions. A large part of their job is teaching patients and groups coping strategies to deal with short-term and long-term management of their disease. This may include suicide prevention counseling. Advanced practice nurses who specialize in addiction can also diagnose and prescribe for patients, and sometimes work as researchers, educators or consultants.

Is it for you?

You don’t learn substance abuse nursing in school. You may have a clinical rotation in the specialty but you really learn it on the job. Many nurses choose this specialty because of personal experience with addictions in themselves, a family member, or a close friend. To find out if you are cut out for this work you might consider volunteering in a community outreach program or a treatment facility.