30 April 2020

Providing the best care for people living with alcohol & substance addiction issues

Caring for an individual with alcohol or substance addiction issues presents a complex situation for healthcare staff, especially when they are co-occurring with other illnesses or health issues. It’s important for all carers to understand how to provide the best care possible to support service users through these situations, so knowing the warning signs, associated conditions and concurrent disorders can be of huge help even if you’re not specialised in this area of care.

Warnings signs of addiction issues

Substance abuse

An umbrella term for the use of illegal drugs or misuse of prescription medicine, warnings signs of substance abuse differ greatly depending on the substance. In general, however, the person may exhibit some or all of the following symptoms:

  • Increasing dosages without medical advice to achieve the same effects
  • Taking prescription medicine when it’s no longer needed
  • Withdrawal symptoms, including shakiness, depression, nausea or headaches
  • Hiding use of drugs
  • Combining prescription medicine with alcohol or other drugs

Alcohol addiction

Many people drink, but alcohol becomes a problem when it affects a person’s health, wellbeing and relationships. Alcohol misuse can look like the following:

  • Drinking to the point of unconsciousness
  • Craving alcohol, and needing more to achieve the same effect
  • Regularly exceeding the recommended 14 units of alcohol a week
  • Alcohol poisoning, which can induce vomiting, seizures and unconsciousness
  • Persistent misuse can lead to liver problems

Underlying and associated conditions

People living with alcohol or substance addiction are sometimes seen for other medical concerns before these issues are recognised. As a nurse or carer, recognising when a person’s physical or mental wellbeing may be at risk from these issues can lead to ensuring that they receive the right care from the right professional and will help you to support them through this time.

Physical health

Misuse of drugs or alcohol can have serious impact on the brain or the liver, and can increase the chances of having certain illnesses such as cancers, heart disease or a stroke. This may present itself in symptoms such as ascites or a vitamin deficiency caused by alcohol (especially low vitamin B1), or if the person doesn’t recover well from wounds, infections or other minor injuries. They may also experience peripheral neuropathy, where nerves in the hands, feet and arms become damaged.

Mental health

People living with alcohol or substance addiction issues can also experience poor mental health, especially low mood and depression associated with their misuse. As substances are often used to self-medicate mental health issues, it’s important that nurses and carers try to understand where a person’s depression, anxiety or other mood comes from in order to recognise whether substance abuse is playing a part in these illnesses.

Co-occurring conditions

The best care is holistic care that integrates treatment for all issues an individual may have at the same time. Mental health issues and addiction abuse can exist side by side (called a concurrent disorder) and though no one symptom is common to all cases, it’s crucial that you’re aware of both at once. At Newcross, we aren’t specialists in addiction care, but we believe that awareness of concurrent disorders can help professionals support this alongside complex conditions such as dementia, stroke recovery or in-home care.

This is important as when treating a person for an unrelated condition, underlying substance abuse issues can affect the treatment required, the recovery necessary and even which kind of medication is used throughout the process.

Best practice for healthcare professionals

Nurses and carers should aim to build a supportive relationship with service users. Especially relevant for those with addiction issues, a good relationship can encourage:

  1. Completion of treatment, with deeper exploration of problems
  2. A reduction in distress, resulting in a better mood (thus improving overall mental health)
  3. Abstinence from alcohol and drugs during treatment
  4. Better long term substance abuse outcomes.

Staff should above all have resilience and tolerance to help with any crises or relapses a person may experience during treatment. Through this, it’s also important to display therapeutic optimism and compassion: if you believe or are perceived to believe a person can make a full recovery, that can allow them to take ownership of their own condition. In addition to this, personalised care is required, aiming to reflect the motivations, views and needs of the person realistically progress to recovery. Often taking place over years due to the episodic nature of a ‘relapse’, recognising that recovery needs long term support will ensure that healthcare professionals know what support is needed and at which stage of the process the person will need it.

This long term delivery of care allows for the entire support network of service users to be collaborative; family members, loved ones and carers can work together with specialists, taking a holistic approach to addiction issues and other complex conditions and working to each professional’s strengths.

Where to find help

If you, or a person in your care, require support with substance abuse issues, we recommend that you visit the following resources: