Chapter 63: Addictions

Nursing interventions emphasize behavioral modification, supervised nutrition therapy, laboratory monitoring, and therapeutic communication to address underlying emotional factors. The chapter then explores substance-related disorders, establishing foundational concepts of tolerance, physical and psychological dependence, and withdrawal syndromes. Alcohol use disorder receives detailed coverage, from early withdrawal manifestations including tremors and anxiety through severe complications like alcohol withdrawal delirium with disorientation and autonomic hyperactivity. Thiamine deficiency consequences, specifically Wernicke's encephalopathy and Korsakoff's syndrome, are discussed as critical complications requiring immediate nutritional supplementation. Pharmacological management includes disulfiram as an aversion agent, naltrexone for craving reduction, and acamprosate for post-acute withdrawal syndrome management. The chapter systematically addresses withdrawal symptoms, overdose presentations, and nursing interventions for central nervous system depressants, stimulants, opioids, hallucinogens, inhalants, cannabis, and club drugs. Each substance category includes specific emergency protocols and antidote considerations such as naloxone for opioid overdose. Additional content covers codependency patterns and family dynamics, the role of support groups including Alcoholics Anonymous and Al-Anon, and professional responsibilities when caring for impaired healthcare workers. Throughout, the chapter emphasizes safe withdrawal management, crisis intervention, seizure precautions, and therapeutic communication strategies essential for clinical practice and licensing examination success.