Saying hello..newbi

Meriwhen, ASN, BSN, MSN, RN · Aug 10, 2013

Congratulations and welcome to the dark side :)

Remember that in addictions, you are dealing with the physiological as well as the psychological, because addictions have a profound effect on the patient's body. Repeated intake of drugs or performance of behaviors can cause severe physiological damage. As far as withdrawal goes, it's not a matter of simply cutting the patient off from their drug/behavior of choice and saying, "OK, suck it up and deal!" You need to withdraw the person safely, as some withdrawals can be fatal (e.g., ETOH, benzos).

Withdrawals are usually at their worst--and most dangerous to the patient--within the first 3-4 days after the last intake of the drug. If there's going to be serious complications, this is the time that they'll happen. One exception is benzos: because they can have a longer half-life, withdrawal symptoms and subsequent dangers don't really start to kick in until day 3 or so.

Get yourself a copy of The Substance Abuse Handbook by Ruiz, et al. It covers the basics of addiction and treatment for a wide range of drugs and behaviors.

Join IntNSA, the addictions nursing society. It's open to nurses as well as non-nurses. It also comes with a handy journal: the Journal of Addictions Nursing.

Keep in mind that many CD patients are actually dual-diagnosis: they'll have at least one other Axis I or Axis II diagnosis. So brush up on psych as well.

blessedmomma247 · Aug 10, 2013

Thank you so much for the tips!!

CASTLEGATES · Aug 13, 2013

Welcome! My two cents would be to focus on the psychological signs and symptoms. I would find a pirated copy of "the brain, hijacked" by Bill Moyers. It explains addiction in the simplest sense. You might be able to get your work to buy a $500 copy, though. I would also attend at least 20 AA or NA meetings, so you understand the lingo, what it is they're facing and what you can do to help. Addicts are not bad, so don't buy into that popular attitude that it's not a diagnosis. It is a diagnosis. They don't throw diabetics into jail for eating a sugar cookie, so addicts who get arrested because of their using is just plain wrong. Our country is decades behind others (who have reduced deaths by as much as 87%)! Keep telling yourself they're sick, not stupid. It's a serious, fatal brain disorder if it's not paused at some point. It's deadly, so work on making a real difference. Don't focus on that one or two pills you can keep from them to "cure" them. It will only anger them and tell them not to return. Real countries treat addiction as a social disorder (and refer appropriately). These are not bad people. Those with the gene will drink or use. That's what they do well. We can only direct them over and over to hit community support meetings with the same fervor they used. Your hospital should have you pretty safe regarding ETOH and benzo withdrawals (stay wayyyy ahead of the CIWA score or you'll lose chasing it). You shouldn't have any DT's if you're doing your job well. Open your senses to all forms of withdrawal and read EROWID for the latest drugs and symptoms for the latest concoctions to hit the streets (in case your area is heavy on the new stuff). It's a good place to read addicts writing about their experiences, deaths of friends and determination to get high. Getting high has been happening since the dawn of man. It's nothing new. Our society doesn't support it, so we have to get them to conform best we can. It's deadly, so make it your business to know everything you can. They are depending on YOU, because the reason patients go to hospitals, is for nursing care.

Welcome! It's a dream job for many!