Addictions Nursing

by Meriwhen Asst. Admin

Addictions nursing is a subspecialty of psychiatric nursing that addresses the nursing care of individuals suffering from one or more addictions. Nursing care is provided to patients during the detox/withdrawal from substances or behaviors, as well as during the patient’s long-term recovery.

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    Addictions Nursing

    Addictions nursing deals with the nursing care of individuals suffering from one or more addictions. Addictions nursing is considered a subspecialty of psychiatric nursing. Patients may be suffering from the addiction alone or may have one or more co-occurring psychiatric diagnoses: this is termed “dual-” or “multiple diagnosis.”

    People often think of addictions only in terms of alcohol, painkillers, or street drugs such as heroin. In addition to these substances, addictions can also include addiction to methadone, benzodiazepines such as Valium and Xanax, ADHD/amphetamine medications, non-opiate pain medications, other prescription medications, OTC medications such as cough medications, inhalants, nicotine and caffeine. Also, addictions are not limited to drugs only: patients may also be suffering from addictions to sex, gambling or shopping. In addition, eating disorders falls under addiction medicine.

    Addictions nursing is one of the more “medical” psychiatric nursing subspecialties, in that patients experience physiological as well as psychological addiction to a substance or behavior. Eating disorders have numerous physiological sequelae, many of which are severe or even fatal. Cessation of the addictive substance or behavior (“detox”) often causes physiological complications, some of which are fatal.

    Nursing Practice

    Duties of an addiction nurse include therapeutic communication, assessment, development of nursing diagnoses and plans of care plans, administration of medication, and patient education (Johnson & Johnson, n.d.). Addictions nurses care for patients during detox/withdrawal as well as during their recovery. In addition to the physiological complications of withdrawal, patients frequently have medical comorbidities that will also require nursing care.

    Practice Settings

    When it comes to where addictions nurses can work, most people probably think first of places like the Betty Ford Center. That is just one of many places an addictions nurse can practice.

    Addictions nurses are found in a variety of settings, such as freestanding psychiatric hospitals, psychiatric units in mental hospitals, intensive outpatient and partial hospitalization programs, residential (short- or long-term) treatment centers, and mental health clinics. They may also be found in private practices, schools and in community agencies (IntNSA, n.d.)

    Educational Requirements

    To become an addictions nurse in the United States, you need to graduate from a nursing program and pass the NCLEX. You can work in addictions as a RN or a LVN/LPN. Other countries may have additional requirements for practicing as an addictions nurse.

    Certification

    Certification as an addictions nurse (CARN/CARN-AP) is available through the International Nurses Society on Addictions. This certification is available for RNs or advanced-practice RNs only.

    Addictions nurses may also apply for certification by the American Nurses Credentialing Center in psychiatric-mental health nursing (RN-BC and PMHNP-BC). LVNs/LPNs are not eligible for this certification.

    Professional Organizations

    The main professional organizations for addiction nurses is the International Nurses Society on Addictions (IntNSA). Membership is open to RNs; however, LVNs/LPNs and non-nurses may join as associate or affiliate members, though they may not vote or hold office.

    Since addictions nursing is related to psychiatric nursing, addiction nurses may also be interested in joining the American Psychiatric Nurses’ Association (APNA) and the International Society of Psychiatric - Mental Health Nurses (ISPN).

    If You’re the One in Recovery…

    Psychiatric nursing tends to attract a lot of nurses recovering from their own addictions issues, and addictions nursing seems like it would be a natural fit for the recovering nurse. However, you do NOT need to be in recovery (i.e., have your own addiction problem) in order to be an addictions nurse. Nor does being a recovering addict ensure that you be good at addictions nursing. You will, however, need to self-assess to determine your own beliefs about and attitudes towards addiction, so that you can provide competent patient-centered care.

    Recovering nurses who tend to do well in addictions nursing are those who have a good handle on their own recovery. They have been clean/sober for at least a year, if not more. They are able to keep their own recovery separate from their patient’s recovery. They do not try to impose their own values, beliefs, or “this is what I would do” on the patient. They are also cognizant of boundaries: while some may choose to share their own addiction and recovery experience (keep in mind that a nurse is NEVER required to share this), they always keep the focus on the patient and the patient’s recovery. They are aware of what could trigger a relapse and work to avoid or mitigate these triggers.

    Recovering nurses that do not do well in addictions nursing are those who are newly in recovery, having been clean/sober only for a few months and are still finding their own path. They are looking to addictions nursing to take the place of therapy or to meet unfulfilled needs. They tend to see the patient in terms of their own (the nurse’s) recovery, and have a hard time understanding or even just accepting a patient’s decisions or actions. Instead, they may try to impose their own beliefs and choices onto the patient. In short, the nurse makes the patient’s recovery about themselves and not about the patient. Or they are at risk for having their own relapse triggered by their working environment.

    Only you can decide if you are able to work in addictions nursing as a recovering nurse.

    References

    International Nurses Society on Addictions (n.d.). About us. Retrieved from http://www.intnsa.org/about/index.asp

    Johnson & Johnson (n.d.). Substance abuse nurse. Retrieved from:
    http://www.discovernursing.com/speci...ce-abuse-nurse
    Last edit by Joe V on Dec 7, '13
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  4. About Meriwhen

    After graduating nursing school, Meriwhen’s first 89 days of nursing were spent as a volunteer nurse at the city free clinic. Day 90 found Meriwhen assigned to a detox/recovery unit for chemical dependency. Meriwhen hasn’t strayed far from addictions since.

    Meriwhen joined Mar '07 - from 'the Left Coast'. Meriwhen has 'never enough' year(s) of experience and specializes in 'Addictions/dual, crisis stabilization'. Posts: 7,844 Likes: 6,863; Learn more about Meriwhen by visiting their allnursesPage Website


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    3 Comments so far...

  5. 0
    Excellent Article, Meriwhen. Thank you.
  6. 0
    Thank you for sharing about this sub-specialty!
  7. 0
    how assertiveness training modules can help the substance users.....


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