List common intoxicating or addictive substances.
Alcohol, cannabis, opiates, benzodiazepines, amphetamines
How might the belief ‘people who are addicted are responsible for their behaviour’ impact nursing practice?
May lead to judgemental attitudes; nurses must remain non-judgemental and understand addiction as a complex health issue.
Why might one think ‘alcohol and other substances are a form of self-harm’?
They can damage physical and mental health; however, addiction is multifactorial and not solely self-punishing behaviour.
How might the belief that intoxicated people are irresponsible and should be prosecuted impact care?
Could reduce empathy and trust; harm minimisation principles encourage support rather than punishment.
Is abstinence the only way to manage addiction?
No; harm minimisation, education, controlled use, and supportive strategies are valid approaches.
Why are people reluctant to admit substance use disorders or addictions?
Shame, stigma, fear of discrimination, fear of being judged.
What attitudes and skills are important for nurses working with addictions?
Non-judgemental, professional boundaries, respect, listening, understanding addiction and recovery principles.
What observations should a nurse make when assessing substance use?
Risk indicators, past medical history, psychosocial context, physical signs (weight, hygiene, stigmata), vital signs, mental health status.
What substance-specific information should be gathered?
Type of drug/beverage, route, frequency, dose, duration, last administration time & amount.
How should questioning about substance use be approached?
Open, non-judgemental, private environment; start with alcohol/tobacco before illicit drugs; use reflective listening and normalise use.
What is a brief intervention?
Assessment, feedback, listening/advising, defining goals, discussing strategies; suitable for low-to-moderate dependency, not severe cases.
What are the stages of motivational interviewing?
Pre-contemplation: No intention to change
Contemplation: Aware of problem but ambivalent; therapist supports choice
Preparation: Intends to change, seeks guidance; therapist inspires hope and clarifies steps
Action: Behaviour changes commence
Maintenance: Changes maintained; relapse may occur; education on relapse as normal
What is harm minimisation?
Reducing negative consequences of substance use rather than insisting on abstinence.
Examples of harm reduction strategies in NZ?
Needle exchange programmes, methadone programmes (Opioid Recovery Service), nicotine replacement therapy, AA/NA, controlled drinking programs.
Name three more examples of harm reduction strategies in NZ.
Supervised consumption sites, education on safe use of substances, provision of fentanyl test strips.
Common alcohol withdrawal symptoms?
Tremor, hypertension, restlessness, sweating, diarrhoea, headache, insomnia, decreased appetite, anxiety
Pharmacological management of alcohol withdrawal?
Benzodiazepines, thiamine
Nursing management during alcohol withdrawal?
Reduce agitation, monitor airway and vitals, assess for head injury, hydration, reduce exhaustion, remain calm
Core goals of withdrawal and detoxification (5 main areas)?
Minimise progression to severe withdrawal
Decrease risk of injury
Prevent dehydration, electrolyte, nutritional imbalance
Reduce seizure risk
Identify concurrent or differential diagnoses
