Nicki Murff

    Addiction is defined by the American Psychiatric Association as, “a brain disease that is manifested by compulsive substance use despite harmful consequence.” Often an addicted person experiences greater tolerance to the effects of a drug, and withdrawal symptoms of ranging severity in the absence of the drug.

    The most commonly abused drugs include nicotine/tobacco, alcohol, prescription painkillers, opioids, heroin, marijuana, and cocaine. Substance abuse not only affects the individual with addiction, but it also impacts their families, communities, and society at large. Nurses and other healthcare providers can help counter the epidemic of substance abuse by treating patients suffering from addiction ethically, effectively, and holistically. Whether a nurse has the tools and training to do this all comes down to nursing education.

    Removing the Stigma

    Historically, shame and stigma have surrounded substance abuse. As is noted in the article “Harm Reduction: Compassionate Care of Persons with Addictions”:

    “Even popular media sometimes portray addicted individuals negatively. Persons who struggle with addiction often are depicted as criminals or prostitutes, weak, lazy, and morally corrupt.”

    Nurses and healthcare providers are not exempt from this influence, and if nurses aren’t careful to ward against it, negative perceptions and bias can impact how they treat their patients with addiction. There has been a push in recent years to approach addiction not as a moral failing, but as a disease of the brain.

    Dr. Nora Volkow, an American psychiatrist and director of the National Institute on Drug Abuse, takes it a step further. Dr. Volkow maintains that the effects of substance abuse render a person’s brain unable to employ free will. As she says in this quote from an article on the NIH website:

    “We can do much to reduce the shame and the stigma of drug addiction, once medical professionals, and we as a society, understand that addiction is not just ‘a disease of the brain,’ but one in which the circuits that enable us to exert free will no longer function as they should.”

    Continuing to reduce the shame and stigma around addiction and substance abuse can help nurses approach their patients with the professionalism, compassion, and knowledge necessary to successfully treat them.

    Increasing Preparedness

    The need for nurses who are educated on the issues and science surrounding substance abuse is increasing, so much so that Duquesne University School of Nursing created an infographic identifying Substance Abuse Nursing as an emerging field that will be in high demand.

    While nurses have reported attitudes of intolerance, anger, anxiety, and distrust toward patients with substance use disorders, a white paper from American Nurse Today notes that recent surveys have shown that nurses attitudes have consistently improved and become more positive. ANT goes on to say:

    “Nurses must become more knowledgeable about substance use disorders to care for patients effectively. Few have had adequate, if any, educational preparation in substance use disorders. Yet education can lead not just to more effective care but also to improved attitudes.”

    Consider bringing these educational initiatives into the classroom and curriculum:

    • Standardized patient with addiction simulation
    • Simulations specifically focused on substance abuse disorders and outcomes
    • Theory and epidemiology of substance abuse
    • Patient education and counseling simulations

    Increased knowledge can lead to more positive attitudes when treating patients with addiction. If undergraduate nursing students can have increased instruction and training in the areas of substance abuse and related disorders, they could be poised with the knowledge they need to more effectively identify and treat patients with addiction.

    Caring Compassionately

    Mary Foley, PhD, RN, FAAN, director of the Center for Nursing Research and Innovation at the University of California, San Francisco School of Nursing, said in an article on Travel Nursing, “Although there is a tremendous amount of science to our practice, there is still necessity to have the art, the communication and empathy.”

    Learning the fundamentals of compassion, patient education, and patient-centered care begin in the classroom. As one study found, there is a tangible relationship between compassionate care and patient outcomes. In the case of the substance abuse epidemic, positive patient outcomes can make a world of difference.


    Addiction Center

    American Nurse Today

    American Psychiatric Association

    Bartlett R, Brown L, Shattell M, Wright T, Lewallen L. Harm reduction: compassionate care of persons with addictions. Medsurg Nurs. 2013;22(6):349-53, 358.

    Duquesne University School of Nursing

    NIDA. (2015, June 12). Addiction Is a Disease of Free Will. Retrieved from on 2019, January 24

    Travel Nursing