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Medicine (MD/DO)
Substance Use Disorders
Substance Use Disorder Assessment (Formerly Substance Abuse Assessment)

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Substance Use Disorder Assessment (Formerly Substance Abuse Assessment)

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Substance Use Disorder Assessment (Formerly Substance Abuse Assessment)

Substance Used with Assess-man
Substance use disorder can cause many disruptions in daily life. It is important to recognize the signs and indicators of substance use disorder and then further assess for the specific substances being misused. These signs include changes in mood, poor hygiene, odd sleep patterns, anorexia, frequent injuries, financial difficulties, job and relationship issues, and poor performance. Often with substance use disorder, there will be other disorders (medical problems or psychiatric disorders) present at the same time. This is called comorbidity. Patients with mood and anxiety disorders, antisocial behavior, or oppositional disorder are more likely to have a substance use disorder (more than twice as likely).
Changes in Mood
Delta Moody-mask

The nurse should recognize that patients engaging in substance use disorder may experience mood changes. These mood changes may present as being overly talkative and open and then becoming isolated and requesting constant privacy.

Poor Hygiene
Poor High-jeans

Due to preoccupation with obtaining the substance, staving off withdrawal symptoms and/or unsafe living conditions, the patient with substance use disorder may present with poor physical hygiene and a disheveled appearance.

Odd Sleep Patterns
Bed with Odd Sleep Pattern

The patient with substance use disorder may experience unusual sleeping patterns. Assess for increased fatigue, insomnia, and sleeping at odd and unusual times.

Frequent Injuries
Injuries around the clock

Patients with suspected substance use disorder may experience frequent injuries that may be unexplained or explained by frequent falls, accidents, physical altercations or other unsafe means that may be necessary to obtain the substance.

Relationship or Job Difficulty
Relationship-loss and Job-loss

Repeated exposure to alcohol, tobacco, and or other psychoactive substances overtime may alter brain structure, chemistry, and function, leading to potential loss of control over the substance despite harm or the knowledge of risk of harm. Therefore, the patient may have difficulty maintaining relationships, as well as experiencing relationship conflicts. In addition they may experience job difficulty, i.e., constantly late or absent from work, or changing jobs frequently.

Poor Performance

If the patient with substance use disorder has a job, they may have difficulty completing tasks and being honest. It is important for the nurse to assess the patient for job difficulty and relationship issues.

Anorexia OR Weight Loss
Anorexic-rex in Baggy-pants

Due to imbalanced nutrition and deficient fluid volume, the patient with substance use disorder may present with anorexia or increased weight loss.

Social Isolation
No Social-book and Isolation

Individuals affected with addiction are often alienated and isolated from their families, workplaces, and communities, along with experiencing significant barriers, such as stigma. Therefore, in addition to having relationship and job difficulties, the patient with substance use disorder may experience social isolation causing them to be absent from work or withdraw from friends and social activities.

Financial Problems
Empty Pockets

The patient with substance use disorder may experience financial problems, which may include trying to obtain the substance illegally or in unsafe ways. This may result in theft and possible incarceration.


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