Effective Strategies for Working With Patients With Substance Use Disorders

Mental Health Nurses' Attitudes on Consumers with Dual Diagnosis: A Thematic Analysis

BACKGROUND

The issue of dual diagnosis continues to be a global health concern. There is a lack of empirical research on mental health nurses' attitudes toward consumers with dual diagnosis.

OBJECTIVE

This study aimed to answer the following research question: How do mental health nurses describe their attitude toward consumers with co-existing mental health and drug and alcohol problems?

DESIGN

This qualitative study employed purposive sampling to recruit participants. Semi-structured interviews were conducted to explore mental health nurses' attitudes toward consumers with dual diagnosis.

SETTING

This study focused on mental health nurses employed in mental health settings. It placed a particular emphasis on mental health nurses who had experience in caring for consumers with dual diagnosis. Seventeen mental health nurses participated in the interview.

METHODS

Interviews were transcribed verbatim and coded using NVivo™ 12 Plus software. Thematic analysis was used to generate codes and themes inductively.

RESULTS

Three major themes with a total of eight sub-themes were identified: (1) satisfaction and connection, with three subthemes; (2) combating negativity in others, with two subthemes; and (3) working to improve outcomes, with three subthemes.

CONCLUSIONS

Participants were concerned about their peers' sense of fear and frustration, stigmatized language, and lack of consistency in providing dual diagnosis training for mental health nurses. There is a need to investigate effective strategies to address mental health nurses' stigmatized attitudes, fear, and frustration toward consumers with dual diagnosis.

Review of Evidence-Based Strategies to Treat Alcohol Use Disorder

Alcohol use disorder (AUD) is a serious, prevalent disorder that affects millions of people. There are numerous evidence-based treatments and strategies to treat AUD, but they are under-utilized for a variety of reasons, including provider stigma, lack of knowledge, lack of professional support, shortage of willing providers, and patient barriers. Disulfiram, naltrexone, and acamprosate are approved but underused medications for the treatment of AUD. Nonpharmacological strategies and treatments include the use of motivational interviewing when talking to patients about their alcohol use, peer support or mutual help groups, and individualized therapy. Nurses are in a prime position to educate themselves and patients on evidence-based treatments for AUD and to help patients access those treatments. [Journal of Psychosocial Nursing and Mental Health Services, 59(12), 7-11.].

Substance Use Withdrawal and Detox Strategies That Work

Substance use disorders are considered chronic but treatable. The first step in recovery is going through withdrawal or detox from the substance used, which typically involves unpleasant physical and psychological symptoms. Some individuals are able and willing to enter inpatient facilities for withdrawal and detox. In some cases, outpatient withdrawal and detox programs are not available. Several barriers to treatment exist, including inability to pay, unavailability of programs, stigma, and co-occurring mental health disorders. During inpatient withdrawal and detox, patients are supported with medications. There is an underutilization of initiating medication that helps reduce substance use, such as naltrexone and suboxone, during inpatient withdrawal and detox. Many individuals opt or have no other choice but to go through withdrawal and detox on their own. Strategies include illicitly obtaining prescription medications for the symptoms and other measures, such as floating in the bathtub and exercise. Recovery from substance use can be facilitated by health care providers through use of harm reduction strategies, referrals to treatment, and prescribing medications when applicable. [Journal of Psychosocial Nursing and Mental Health Services, 59(9), 12-15.].