Substance abuse nurses, or addiction nurses, are nurses who specialize in the care of patients with several types of addictions to include drugs or alcohol abuse. They can work in a few different settings.

Inpatient Care

Patients who are acutely ill with the effects of drugs or alcohol may require inpatient detox. In this setting, nurses must first focus on the physical effects of drugs or alcohol as well as withdrawal symptoms. Because of the nature of an acute setting, duties are more centered around physical symptoms and may include:

  • Recognizing symptoms and identifying the type of substance abuse
  • Managing symptoms such as DTs, seizures, rapid heart rates, etc.
  • Utilizing standards for assessing withdrawal symptoms, such as the CIWA protocol
  • Administering medications to assist in managing withdrawal symptoms, such as Diazepam, Valium, or "banana bag" IV fluids
  • Monitor for behavioral changes
  • Assess for, and manage the use of restraints when appropriate

Ambulatory Care

Some addiction nurses work in ambulatory care treatment settings. Patients may come in to perform drug screens, receive medications (i.e., methadone), meet with counselors, or attend support groups. Some of the duties an addiction nurse may perform in outpatient treatment facilities may include:

  • Administer medications
  • Administer drug screens
  • Draw blood/phlebotomy
  • Document a patient's progress
  • Develop a plan of care for treatment
  • Assess for relapse

Psychiatric Care

Once the physical symptoms of alcohol or drug abuse and withdrawal are managed, mental health nursing comes into play. Addressing the mental health issues that may have led to drug or alcohol abuse is critical to the long-term success of patients. Psychiatric nursing may occur concurrently with inpatient or ambulatory treatment. Duties may include:

  • Assessing for mental health diagnoses that may have contributed to the addiction
  • Assessing for events (i.e., abuse or neglect) that may have led to substance abuse
  • Utilizing active listening and a calm, quiet environment to help build trust
  • Developing a plan of care in collaboration with a psychiatrist
  • Administering and monitoring the use of psychiatric medications
  • Ensuring the patient is engaged with the treatment plan and is compliant with the treatment regimen

Substance abuse nursing is challenging, and it takes a special type of nurse to work in this role. However, it can be gratifying to witness patients on the road to success and live long and healthy lives.

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