Addictions Latest Topics

Addictions Nursing in the US

Sat, 14 Jun 2025 08:19:50 +0000

I am a nurse working in the field of addiction nursing in the Kingdom of Saudi Arabia. I would like to obtain as much information as possible about addiction and mental health nursing in the United States of America. Thank you.

Detox nursing is sucking the life out of me

Sat, 29 Mar 2014 21:46:06 +0000

Hey all, I was wondering if anyone with detox nursing experience would care to share their experience? I have been a detox RN for almost a year and I feel like it has made me jaded and is making me question why I even became a nurse. Some days are better than others, like any position, but rough shifts have me leaving feeling like I don't even want to do this anymore. Has anyone else had experience in this area, like this? Manipulative pt's aside... I don't have anymore in me to deal with being spoken down to, lied to and yelled at. I'm sure this happens in any unit but does detox carry a bit more of this sort of thing?

- frustrated

Advice for dealing with addicts?

Tue, 15 Jan 2013 19:43:36 +0000

I'm in a detox clinic & this is my first nursing job & first experience in addictions. We have standing PRN orders for 25 mg Vistaril Q6H PRN, Phenergan (must see vomit),75-150mg Trazodone for sleep or 50mg Benadryl for sleep. My clients want the vistaril like it's candy, and are lining up at the nurses station every 6 hrs (or less) to get it. It's ridiculous, but it's that addicted mentality, I know. I'm trying to be as therapeutic as I can & try to tell them that they do not need another vistaril just because the 6 hours is up. Some walk away, but others are VERY adamant. I had 4 argue with me last night because I would not give trazodone & vistaril or benadryl & vistaril at the same time at bedtime. I tried to explain that trazodone also helps with anxiety & they don't need both or that benadryl & vistaril are both antihistamines and I cannot give that much at once. Now, my standing orders do not say anything about giving meds together, but my gut and nursing judgement tell me that's just too much. Also, they beg me for phenergan all the time, and I have two whom I'm sure are making themselves vomit to get it. One (heroin addict) was begging my for phenergan IM. I offered mylanta and that really ****** her off or phenergan suppository, but she said she had diarrhea & couldn't do that.

So, can anyone give me some advice on handling these situations? I'm often the only nurse on & don't have anyone to back me up. I don't feel that handing out meds every time they ask is doing them any good. It gets exhausting when they are constantly knocking on my door and shouting out med orders while I am delivering scheduled meds to others. (I ignore the shouts because that's just rude and I am no one's servant).

These people are here to detox and learn coping skill (well, not everyone has good intentions), but I want to know that I'm doing right by not handing out a med when I don't think it's legitimately needed.

Now, some of these people who are demanding Vistaril from me are already on Buspar or other anti anxiety meds. How do you handle drug seekers?

Sometimes I wish we didn't have Vistaril or Phenergan to offer.

Also, a few weeks ago, we had a client who was soliciting others to get Vistarils for him cuz he wanted to snort them. What wold be the effects of snorting a vistaril? (this client was kicked out)

First Job as a Dispensing Nurse at an Addiction Treatment Center?

Mon, 29 Jul 2019 21:57:47 +0000

Anyone have any experience with this type of job? Should I pursue it? New grad, first job offer out of RN school at an addiction center as a dispensing nurse.

vivitrol injection

Wed, 30 May 2018 22:46:36 +0000

hello

I'm new to giving vivitrol injection. I follow the directions, but when I inject the syringe, the medication gets clogged. I take out the needle/syringe, change needles and try a second time and it usually works. has anyone had this problem?

I really don't know what i'm doing wrong. my supervisor is not a nurse, so I have no one to problem solve with.

thank you :)

Rapport with pts

Wed, 23 Jun 2021 22:31:56 +0000

Hello all -

I am sorry if this is not the right platform - but I figured this was how I could reach the most experts. I fiercely admire the patience/dedication it takes to work with patients with addiction as a disease. My friend was in rehab for alcohol addiction. Sounds like he may have established an inappropriate relationship with one rehab nurse and the other was a tech.... he had their phone numbers...they texted ...he was swinging by the rehab to pick up sober event tickets and he got one of them a coffee- like I am sorry but WHAT????

it gets better....my friend relapsed less than 5 days after discharge - he relapsed HARD... he went to a casino/bar where this staff was hanging out, they proceeded to drive him to a hotel-(he wouldnt provide them with his home address so they could take them there) so he wouldnt drink and drive. Couldnt they have called the facility to ask for his address/emergency contact--- shouldn't they have called an ambulance or IDK.... Rehab nurses please tell me what you would do if you saw your pt intoxicated/relapsing? I need your perspective.

Social worker giving meds ?

Sun, 06 Jun 2021 18:05:09 +0000

Hi. I’m new to the world of substance abuse nursing. I am working in a residential substance abuse house for adolescents. Now they seem SUPER under staffed, which isn’t alarming. What seems alarming to me is that when the nurse who’s training me (and she says it will happen during my shift too) when the nurse leaves and there’s no nurse to relieve she gives the keys to the med room to a social worker “or any other house staff” and they will administer medications as needed.
I have never heard of or seen anything like this before. Is that within their scope ? (I’m in NYC) Supposedly they are “trained” to administer meds by one of the more senior nurses who works the weekends… I just feel uncomfortable.

Observed urine setup?

Fri, 16 Sep 2022 12:58:47 +0000

I work in an outpatient opioid treatment clinic. My office is moving into a new building and we are trying to configure a bathroom setup where I can directly observe patients without actually standing in the bathroom over them, since the new bathroom is super tiny. It’s directly beside the intake office where I would be. I suggested a pass through in the wall that I could stand at and observe, with doors that could be closed if necessary if someone else needed that restroom. Someone else suggested a 2-way mirror in addition to that.

Anyone here in the same situation with any ideas that have been successful for your practice?

Personal Wellness

Tue, 16 Jan 2024 16:16:35 +0000

What is one thing that you do to maintain your personal strength, optimism, energy when working with this population?

Should mental health nursing be grouped with addictions nursing?

Thu, 04 Sep 2014 06:35:04 +0000

In our mental health facility in our hospital, the addiction/recovery/substance abuse patients are in the same milieu as those diagnosed with schizophrenia/bipolar/depression/etc. My question is, although the symptoms are the same (and often times mental illness led to substance abuse and vice versa), should the patients be treated the same, and grouped together in discussions??

I turned in my mentor because she was diverting morphine

Sat, 20 Jun 2020 14:28:06 +0000

I had to turn in a nurse who was my mentor, friend, and someone I had on a pedestal. She made my kids baby blankets, we would trade shifts and I caught her diverting morphine. Diverting from a patient who had acid burns on his face on hospice care in hospital. This happened several years ago and after I turned her in I found out she had three other occurrences reported. This was back when we wore crocs at work and she had slipped on ice and broke her leg and became addicted. Throughout the years I have caught two more, one other was a PICC line nurse who gave the patient morphine and I caught him injecting himself at the patients bedside. This is so haunting and traumatic for everyone involved. It makes you suspicious of everyone overtime and each time I discovered it was by accident.

What are your experiences with this?

Nurse new to detox and wants to learn

Sat, 13 Nov 2021 10:14:15 +0000

I just started at a detox facility after leaving a busy surgical unit. I have done psych nursing in the past working on a geriatric psych unit and had a membership for the psychiatric nurses association. I was wondering what associations would be recommended to be a member of for addictions nursing so I can learn more as I love to learn and maybe eventually get certified in? Thanks

"Addiction" Nursing is an outdated term.

Wed, 09 Oct 2019 17:39:34 +0000

I just wanted to suggest changing the name of this specialty. "Addiction" is a dated term. Currently the term Substance Use Disorder or SUD treatment nurse would be appropriate. The history of the word addiction denotes a mental/moral failure and not a disease. More and more research is bringing a better understanding of the brain and substance dependency. Changing the title of the specialty would discourage further use of the word "addiction" and the misconceptions of substance use disorder in the nursing community. Just a suggestion...

How do you destress?

Mon, 11 Jul 2022 01:42:20 +0000

Hi all,

Just wondering what you all do to destress? I have dealt with detox patients throughout my career, although this time I am actually going to be a nurse on a detox floor. I know these patients are mentally and emotionally exhausting. I already have a few things I do for my regular nursing jobs, but I am curious to know what else I can do. Thank you.

Any Nurse Considering CARN?

Fri, 31 Dec 2021 06:07:58 +0000

I've been considering testing for the CARN but have not been able to find any good study guides. I recently found Statpearls has an online study/test/ceu guide that includes over 300 questions/answers with rationals. I was absolutely pumped and signed up for 6 months. I have been working with substance abuse for over 8yrs. After doing some of these questions, I feel like I've been living in a fantasy land. Has anyone checked this out and maybe is working through these? I have to admit, it is so much more difficult than the ANCC Psych certification. I am not doing well at all and am wondering if the exam is going to be as difficult...

Systematic abuse of patient rights.

Tue, 24 Nov 2020 19:05:13 +0000

I feel terrible about the way the organisation routinely and systematically abuses patient basic human rights. I work for a private hospital that belong to one of the largest group in the country, been there about 3 years now, started working in drugs and alcohol unit 18 months ago. I feel hopeless and helpless with my situation, I’m planning to look for a new job after Christmas. I have witness countless admissions where patient are admitted while intoxicated, their blood alcohol concentration are at a dangerous level. Their insurance and financial detail are collected and they sign and agree to paid for any additional cost that their insurance won’t cover. I have seen 2 nurses who brought up the issue in the ward meeting, one of then got transfer to another unit, the other is being investigated by management over a complaints made by an unnamed patient. I got into nursing because I want to help people, not to abuse their rights or be part of a system that exploit vulnerable people financially. The Human Right Commission declined to help, Health Care Commission of Victoria wanted me to approach my employer and discuss the issue. I want to go to the media and expose them but the frontline worker are the one that get their hands dirty.

Unregistered patients

Wed, 08 Jun 2022 20:43:18 +0000

I work in a treatment center. My boss(social worker/director) has implemented a trial. Having some patients stay at the facility after their discharge date, acting as a defacto half way house.
Problem being is that these guys are “off the books”. Not officially there. Yet I’m passing meds, performing basic nursing duties. We send random drug tests to lab on these guys.
My question is: what liability am I subject to if something goes wrong with one of these guys.

CARN-AP contact hours

Fri, 24 Jun 2022 01:48:48 +0000

Just reading over the requirements for certification. I have been working in addiction services for 8 months now. How would an NP obtain supervised contact hours? Do practice hours with a collaborating count for this? Thank You

CARN/CARN-AP test advice

Wed, 13 Nov 2019 19:19:51 +0000

I just passed my CARN-AP exam and wanted to pass on some helpful info while it's still fresh. I was disappointed while studying by how few resources are out there to pass this test. I primarily used the ASAM Principles of Addiction Medicine book to study and found it very useful (though quite long and probably more in-depth than needed). Also found the webinars at https://pcssnow.org/education-training/sud-core-curriculum/ to be helpful. I bought the Scope and Standards of Addiction Nursing book, but didn't find it particularly helpful for the test. I did not buy the Core Curriculum of Addictions Nursing published by IntNSA based on the terrible reviews on Amazon, and I did fine without it.

Brief scale for benzodiazepine detox?

Thu, 15 Oct 2020 08:37:32 +0000

I am just curious if anyone is aware of a brief benzodiazepine withdrawal assessment tool, like the CIWA-A. The CIWA-B just has too many questions! Many of our nurses use the CIWA-A because our only two options are that or COWS which of course is completely unrelated. Thanks in advance!!

Medical Detox Transition Opportunity

Sun, 10 Oct 2021 18:05:25 +0000

Hi all! I'm looking for some advice and insight into a potential job opportunity within addiction nursing. First off, I'm a fairly recent (December 2020) grad, and began my career working in an adolescent inpatient pysch unit. Now, don't get me wrong, while I enjoy the core job, the politics and operation of the unit has me ready to find something new. I have always been drawn to psych for personal and general interest reasons, so staying within the realm is important to me.

Next week, I have an interview with a free-standing medical detox facility, close to home (Evoke Wellness). I have so many questions already, but I'm wondering from other's experience, how they find working in this field/job? I'm particularly interested to hear about statistics concerning patient or staff assaults, restraints, or violence of that nature, and rate of staff retention. Two BIG concerns at my current workplace. Also, with no formal medical experience, how difficult can I expect the transition to be?

Thanks in advance!

Question about drug doses from foreign nurse

Tue, 27 Apr 2021 09:40:10 +0000

Hello. I'm a french nurse with 20 years experience currently working in Norway. I work in elderly care as a night shift. But, why I'm here now is because after watching Youtube videos about the homeless in USA (Invisible people, AML, etc.) I have questions about doses these people put in themselves. They say they need 7 to 12 "bags" a day, so what's in a "bag" anyway and how much of drugs is it?

Addictions Nursing

Tue, 02 Feb 2021 07:53:00 +0000

Overview

Addictions Nursing (often referred to as substance abuse 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 the aforementioned, addictions can also include:

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
- 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 fall 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.

Duties

therapeutic communication
rapid, comprehensive assessment
pain management
development of nursing diagnoses and plans of care
administration of medication
patient education
crisis intervention
family support

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
mental health clinics
private practices
public schools
community agencies

Professional Organizations

The main professional organization for Addiction nurses is the International Nurses Society on Addictions (IntNSA). Membership is open to RNs, however, Licensed Practical/Vocational Nurses (LPN/LVN) 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).

Nurses can also join the American Society of Addiction Medicine (ASAM). It is, "a professional medical society representing over 6,000 physicians, clinicians and associated professionals in the field of addiction medicine".

The Substance Abuse and Mental Health Services Administration (SAMHSA) is an agency within the U.S. Department of Health and Human Services (HHS). This agency, "leads public health efforts to advance the behavioral health of the nation and to improve the lives of individuals living with mental and substance use disorders, and their families".

Educational Requirements

Graduate from an accredited Practical/Vocational Nursing (LPN/LVN) program or Registered Nursing (RN) program
- LPN/LVN: certificate, diploma or degree
- RN: Diploma, ADN, BSN, or MSN
Successfully pass the NCLEX-PN or NCLEX-RN
Current, unencumbered LPN/LVN or RN license in U.S. state of practice

Nurses can work in addictions as an RN or an LPN/LVN. Other countries may have additional requirements for practicing as an Addictions nurse.

Certification

International Nurses Society on Addictions (IntNSA)

The following addictions nurse certifications are available for the RN and the Advanced Practice Nurse (APN):

Certified Addiction Registered Nurse (CARN)
Certified Addiction Registered Nurse – Advanced Practice (CARN-AP)

The Addictions Nursing Certification Board (ANCB) offers the certifications supported by the IntNSA.

The certifications are available for RNs or advanced-practice RNs only and are valid for 4 years.

CARN eligibility (not all-inclusive)

Current, unencumbered RN license in U.S. state of practice
30 hours of continuing education credits
Evidence of 2000 hours with experience in addictions nursing within the last 3 years

CARN-AP eligibility (not all-inclusive)

Current, unencumbered RN license as an RN in U.S. state of practice
Master of Science in Nursing (MSN) degree or higher
45 hours of continuing education
Minimum 500 supervised hours in addictions and 1500 hours of nursing experience in addictions as an Advanced Practice Nurse (APN) within the last 3 years practice in addictions

American Nurses Credentialing Center (ANCC)

RNs and Nurse Practitioners (NP) may also apply for the following certifications by the ANCC*:

Psychiatric-Mental Health Nursing Certification (RN-BC) {for the Registered Nurse}
Psychiatric-Mental Health Nurse Practitioner (Across the Lifespan) Certification (PMHNP-BC) {for the Nurse Practitioner}

*LPNs/LVNs are not eligible for these certifications

Psychiatric-Mental Health Nursing Certification (RN-BC): eligibility (not all-inclusive)

Graduate from an accredited RN nursing program with a Diploma, ADN, or BSN degree or higher and successfully passed NCLEX-RN
Current, unencumbered RN license in U.S. state or territory or hold the legally recognized equivalent in another country
2 years full-time as an RN
Minimum 2,000 hours clinical practice in psychiatric–mental health nursing within last 3 years
Completed 30 hours of continuing education in psychiatric–mental health nursing within last 3 years

Psychiatric-Mental Health Nurse Practitioner (Across the Lifespan) Certification (PMHNP-BC): eligibility (not all-inclusive)

Current, unencumbered RN license in U.S. state or territory or the legally recognized equivalent in another country and successfully passed NCLEX-RN
Master of Science in Nursing (MSN), post-graduate, or nursing doctoral degree from an accredited psychiatric-mental health NP Program
Minimum 500 faculty-supervised clinical hours must be included in the psychiatric-mental health NP Program

Salary (2020)

According to salary.com, the average hourly wage for an Addictions Nurse in the U.S. is $34 and falls between $31 and $38.

According to ZipRecruiter, the average annual pay in the U.S. is $62,104 a year with salaries as high as $132,000 and as low as $22,000, depending on education, experience, and location.

If You Are 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 will 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 that Tend to Do Well in Addictions Nursing

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

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 on the patient.

In short, the nurse can make the patient's recovery about themselves and not about the patient. Or, they can be at risk of 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.

Brain skills in methadone clinic

Mon, 08 Jun 2020 20:01:15 +0000

I have an interview at a methadone clinic this week. I am currently employed at an FQHC and I’ve enjoyed it but am looking for something new. I have never cared about my “skills” like IVs or wound dressing, so I’m not concerned about that. I do, however, like to use my brain. I like to assess and I love to do patient education. I’m a great communicator. Those of you with methadone experience— how was your experience? Was it just, pour the med, hand it to to the patient, say goodbye? Or do you feel that you were able to use your nursing education?

Breaking the Stigma of Addiction

Sat, 02 Jan 2021 23:08:50 +0000

I have a question for those of you who currently work in ER/or admin.
Can you give suggestions for recovering people with substance use disorder (& also current active addiction) who need to come to the ER for various reasons.
Please no arguments on choice vs disease, clean vs mat treatment etc. Facts are that there are 21 million people with addiction and less than 10 % seek treatment partly due to not knowing how to take care of their medical needs when they are technically self harming with substances. But they still deserve our care without judgement as humans and medical professionals.
I'm trying to help a recovery group when they seek care so as to not further the stigma that all they want is drugs when when in legitimate pain. I haven't been to any pain conferences or medical addiction seminars in years so I need ideas.
Thank you in advance.