Substance abuse can cause many disruptions in daily life. It is important to recognize the signs and indicators of substance abuse and then further assess for the specific substances being abused. 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).
The nurse should recognize that patients engaging in substance abuse may experience mood changes. These mood changes may present as being overly talkative and open and then becoming isolated and requesting constant privacy.
The patient with substance abuse may present with poor physical hygiene and a disheveled appearance.
The patient with substance abuse may experience unusual sleeping patterns. Assess for increased fatigue, insomnia, and odd sleeping patterns.
Patients with suspected substance abuse may experience frequent injuries that may be unexplained or explained by frequent falls, accidents, and fights.
The patient with substance abuse may experience difficulty maintaining relationships and may engage in many relationship conflicts. In addition, they may experience job difficulty, including being constantly late or absent from work, or changing jobs frequently.
If the patient with substance abuse 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.
Due to imbalanced nutrition and deficient fluid volume, the patient with substance abuse may present with anorexia or increased weight loss.
In addition to having relationship and job difficulty, the patient with substance abuse may experience social isolation causing them to be absent from work or withdraw from friends and social activities.
The patient with substance abuse may experience many financial problems, which may lead them to engage in theft and possible incarceration.
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