substance abuse care plan

[lulu1224]

I am in need of some advice. I am doing my nusing care plan on a woman that has chronic back pain and in the process she has now become addicted to opiaites. She takes a high dose of morphine, fentanyl and hydrocodone on a daily basis to deal with the pain. She is only coming to detox because family members have threaten to CPS to take her children away because of the substance abuse. I was thinking of using the following nursing diagnosis..

Ineffective individual coping r/t inadequate level of confidence in ability to cope with chronic pain AEB abuse of substances.

Any suggestions would be great!

Thanks

[Daytonite, BSN, RN]

well, hold on a minute. is her problem chronic back pain, substance abuse, being a bad mom or not being able to cope with the back pain or the opiates? your nursing diagnosis isn't really identifying why she can't cope. an "inadequate level of confidence in the ability to cope" sounds a lot like low self-esteem to me. that's a whole other diagnosis (chronic low self-esteem). the nanda taxonomy lays out what the causes are for problems with coping. those related factors are listed on this webpage and you should look at them to see if your patient fits one of the categories: ineffective coping it is also possible that you have diagnosed her incorrectly. i worked on a detox unit. i know we all want these people to succeed, but not all of them are going to, or even want to, especially when they are there because they were forced to be there by the family. it is quite possible that she is ineffective health maintenance or ineffective denial. it is quite possible that she is happy as a clam taking her morphine, fentanyl and hydrocodone and she's only remorseful and compliant now because she's under threat of her kids (and probably their support money that feeds her drug habit) being taken away. wouldn't you? take a good look at your assessment data and refer to a nursing diagnosis book or other diagnoses on the above website before you diagnose her.