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Managing Nepal’s Drug and Substance Menace

The recent shift from regulated use of cannabis and alcohol for religious and cultural purposes to synthetic opioids, heroin, amphetamines, and benzodiazepines by the Nepal youths has exposed the health sector to significant challenges. This pattern has contributed to Nepal’s soaring number of drug users, from 43,309 in 2008 to 130,424 people in 2020 (Pant et al., 2023). Unfortunately, the Nepal society’s treatment of users based on moral standards instead of health disorders obstructs nursing interventions. As a result, new strategies could eradicate these obstructions and stimulate nurse interventions toward treating drug-related ailments.

Nepal’s three-layer federal system contributed to the essential health services and national mental health training, including managing alcohol-related ailments, counseling therapy, and motivational enhancement. However, there was a need for a dedicated national treatment institution or center for the rehabilitation and recovery of alcohol and substance-related ailments (Bhandari et al., 2021). The healthcare sector needed reliable community mental health and drug-related services for proper follow-up and re-integration. More so, there was a need for the clinical definition of drug and substance-related disorders to ensure patient’s sobriety, health recovery, and social integration. This new perception requires broader understanding and could help end the stigma, prejudice, and discrimination towards drug and substance users for quality rehabilitation and recovery. In this regard, Nepal’s cultural-driven situation requires an evidence-based policy and reformed procedures. As a result, a nurse practitioner should identify the needs of drug and substance users and use them to formulate customized approaches for effective treatment and prevention of drug and substance-related ailments.

Professional View Point

From the expert’s point of view, Nepal’s situation requires a formal and universal treatment program that brings different sectors together. This consultative and collaborative program should focus on social justice and health rights when formulating interventions (Pant et al., 2023). The discussion should have representatives from specific departments, academic fields, law enforcement groups, relevant private organizations, former drug and substance abuse victims, and self-help groups. This program should highlight the evidence from guidelines emphasizing various care components (Pant et al., 2023). These should include evaluation, treatment planning, and interventions from different services that prevent relapse while enhancing social integration, learning, training, stable housing, and employment.

Tackling Client Values

Values are universal perceptions of what is essential in life: loyalty, kindness, compassion, or decadence and dishonesty. The Nepal youths consider alcohol and substance use a value because it symbolizes loyalty to their culture. While dealing with such clients, a therapist should advise them on recovery instead of specifying goals they should pursue. Interestingly, this approach could obstruct the nurse’s impact on the therapeutic process (Bhandari et al., 2021). However, this strategy enables nurse practitioners to identify the client’s values to help avoid them for change. Secondly, this approach increases the chances of the client to customize goals.


Based on the above literature, the nurse should be involved in formulating the program and internalizing its critical components: valuation, treatment planning, and intervention. These components could help manage the client’s relapse and promote sound social integration. Finally, a nurse should advise clients on how collaborating with her could stimulate quick recovery. This strategy could motivate the client to align his goals and values to recovery.


Bhandari R. T., Khatiwads B., Rajbhandari B. et al. (2021). A qualitative study to understand drivers of psychoactive substance use among Nepalese youths. PLOS ONE, November 5.

Pant B. S., Gurung B. & Howard, J. (2023). Recovery and rehabilitation from alcohol substance use and related disorders in Nepal: Call for a paradigm shift. Journal of Psychological Rehabilitation and Mental Health, pp. 10, 131–134.


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