Advice for dealing with addicts? - page 4

by garnetgirl29

13,553 Unique Views | 32 Comments

I'm in a detox clinic & this is my first nursing job & first experience in addictions. We have standing PRN orders for 25mg Vistaril Q6H PRN, Phenergen (must see vomit),75-150mg Trazodone for sleep or 50mg Benadryl for sleep. My... Read More


  1. 2
    Quote from Heathermaizey
    Their doctor will decide that. I am astounded at the comments I have seen from what should be caring, compassionate nurses. If you have a problem with these people then you need to find a different line of nursing.

    Nurses deal with substance abuse disorders in every single area and while I agree that compassion and caring attitudes are essential in delivering nursing care to those with addiction I think it's unrealistic to expect that caring and compassion to never be tested or erroded.

    Like it or not, addiction is a disease that turns beautiful people into monsters and they are some of the most emotionally draining and challenging patients to work with. While the person with addiction is indeed suffering they also inflict an enormous amount of emotional damage to those around them and sometimes even for the best of nurses it can be challenging to allow that behavior to not bother you.

    Don't get me wrong I am not judging and I have an enormous amount of respect for anyone recovering or battling the disease of addiction but there is also a school of thought that the victim mentality mode of thinking merely feeds into the maelstrom of addiction. So yes I may never begin to understand how hard it is, but that's not unique addiction the same could be said about any disease or trial.

    To the OP, I don't think you're trying to do wrong by your patients and I think that you probably came here with noble intentions. I hope you continue to grow as a nurse and continue to be an advocate for your patients.
    TriciaJ and garnetgirl29 like this.
  2. 7
    I've been reading the various responses here and am appalled at some of the harsh words directed at the OP, who I feel needs to learn more about addictions overall, but whose heart is in the right place.

    Now I'm going to offer a bit of perspective from someone with a long history of ETOH abuse plus mental illness.

    First, anyone working with alcoholics/addicts should understand that most of us have co-morbid psychiatric disorders, which we may unknowingly be trying to tamp down with substances. For example, I abused alcohol off and on from the age of 17 until my early 30s, never realizing that I was masking symptoms of manic depression. I never landed in a rehab, but when I stopped drinking for the last time, I remember wondering what I was supposed to do about my anxiety, restlessness, and agitation. Food came in handy, and that's what I self-medicated with for decades until finally being put on mood-stabilizing medications in early 2012.

    This thread makes me wonder how my recovery (been sober almost 22 years now) might have gone had I not had access to my "drug" of choice. Or if someone had tried to teach me some sort of "lesson" by withholding Oreos and Cheez-Its when I desperately needed SOMETHING to calm me down during the stresses of early sobriety. Yes, I gained 30 lbs. that first year, but I was so much healthier overall because I was no longer poisoning myself with ETOH. And the compulsive eating also went away once I went on medication to control my mood fluctuations.

    I'm telling all of this because I want nurses who work in addictions to know that early recovery is NOT the time to take away everything that helps hold an addict/alcoholic together. There's a reason doctors write the PRN orders the way they do, and if the patient knows s/he can get the meds when s/he needs them, s/he is less likely to be anxious about it. Nursing staff also need to be consistent across the board---a patient shouldn't be able to get meds Q 2h from one nurse, and few or none from another.

    The other point I want to make is this: a patient is much, much more than a diagnosis or a set of symptoms. Underneath that manipulative, whiny, unpleasant exterior is a hurting human being who did NOT come into the world with the desire to be an addict/alcoholic. No, you can't "fix" these folks, and some will never recover no matter how many times they visit your facility. But some will, and you should want to make their transition to clean/sober living as welcoming as possible for the best chance at full recovery. The tough stuff will come later, and it'll keep right on coming for a long, long time.....trust me.
    mds1, melijm, sharpeimom, and 4 others like this.
  3. 5
    Quote from BamaRN2004
    This post is very very judgmental. You have no clue what those people go thru. Anxiety is mostly the reason they started using in the first place. And when detoxing the anxiety is unreal. so give them the meds who are you to say they can't have it unless they can't hold there eyes open. Keep on judging !!
    I know you are struggling with addiction yourself and I congratulate you on your sobriety....I don't think the OP was being judgmental. They are asking the advice of other addictions RN's for the med regime of their patients....what would BEST help them.
    sharpeimom, TriciaJ, Meriwhen, and 2 others like this.


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