Introduction
Substance use disorder (SUD) is a key issue of public health worldwide Canada is not exceptional. Rising cases of substance abuse underscores the need for effective interventions. Nursing, therefore, is a major intervention approach in Canada, which demonstrates how to manage the multiple challenges associated with SUD. However, the ever-evolving nature of substance-related problems requires nursing interventions aimed at creating patient-centered systems of care. As such, nurses are the first touch for different approaches ranging from screening, pharmacological intervention, psychotherapeutic approaches, harm reduction, and methods that collaborative care programs address the multifaceted nature in SUD. When substance abuse brings such an immeasurable load of infinity, nursing interventions remain an essential part of the well-being and rehabilitation of individuals in Canada struggling with SUD. This literature review aims to explore and compare various nursing interventions for substance abuse disorders in the Canadian context, drawing insights from seven key research studies.
Screening and Assessment:
In the Canadian setting, screening and assessment of SUD have served as the basis of the weight of nursing intervention for people with SUD. Trinkoff et al. (2022) argue that the essence of universal screening tools is in recognizing pre-SUD individuals and people using SUD. This fact is also supported by the work by Jenkins et al. (2022) which supports the concept of culturally sensitive and reliable tools. This explains why cultural practices associated with substance use need to be understood to provide interventions that address the drug use requirements among such populations. However, Colizzi et al. (2020,) go for a completely different approach and argue that PCC or primary care clinics should establish daily clinical screening to provide a better method. They claim that the application of screening within the context of primary care practices among patients can help achieve early detection and intervention and consequent prevention of further development of substance-related issues. This difference of opinion shows that there is continuous debating amongst Canadian nursing practitioners between substance use screening assessment and best possible perceived method in this process.
Pharmacological Interventions:
Drug treatment intervention is an integral part of recovery from substance use disorder including OUD due to its treatment of withdrawal symptoms that are present in this disorder. According to Kakko et al. (2019) medication-based therapies, such as methadone and buprenorphine are antidepressants and antipsychotics, serving mood-stabilizing effects to alleviate withdrawal signs and cravings On the contrary, Anderson et al. (2021) suggest the complex way by saying that pharmacological savoir-faire requires additional personalization. Rather, they advocate for the adoption of the approach that includes comorbidities and patients’ preferences to give the most desired treatment results. This difference in perception, however, helps to understand the enduring argument regarding the potential uses of pharmacological treatments for substance use disorders, as seen from the Canadian standpoint. The conflict between the drawbacks of standardized medications and the aspiration to give personalized treatment stimulates a theoretical reflection of the current practices. It leads to further investigations to modify and create patient-tailored medication plans in the future drug therapy of SUD.
Psychotherapeutic Approaches:
One of the paradigms of Substance Use Disorder (SUD) that applies to Canada’s practice is nursing care and includes different interventions psychotherapeutic with cognitive behavioral therapy and motivational interviewing as the core elements. According to Brown et al. (2018), there is evidence that CBT assists in minimizing substance use and lowering the recurrence rate of individuals with SUD. But as Fatani (n. d.) suggests, the best alternative is to use Motivational Encounters together with contingency management. This variance draws attention to the discrete character of the treatment of SUD. It underlines the significance of personalized approaches to managing patients, as this type of treatment originates from the individual. However, it is critical to find the intervened individual’s special requirements and goals to obtain the right results. Therefore, nurses in Canada should apply a flexible approach that implies adjusting the psychotherapeutic intervention according to the specific individual situation, which means developing a strong patient-nurse alliance. This flexibility allows the SUD treatment differentiation and increases its effectiveness. In retrospect, this therapeutic movement may be viewed as a broader reaction from the Canadian SUD field to the challenges confronting it in the above-discussed ways.
Harm Reduction Strategies:
In the Canadian clinical setting, a large number of efforts that have been directed at dealing with SUDs have become centered on harm reduction strategies, a common form of pragmatism aimed at minimizing the negative consequences that most drug users carry. As per Fadus et al. (2019), supervised consumption sites are shown to have led to a steep reduction in overdose deaths by drugs in safe places where patient consumes substances. On the other hand, Thakarar et al. (2020) take a wider scope as they would like to see a full-scale harm reduction program that concentrates on supervised consumption sites, needle exchange programs, and information drives. This compilation of empirical results highlights the need for a comprehensive harm reduction strategy in nursing interventions for substance abuse disorders. With the realization of diverse features such as supervised consumption sites, needle exchange, and education, nursing professionals can target various populations of victims of abuse who benefit from adopting a broader plan for the reduction of drug-related problems.
Collaborative Care Models:
Farhoudian et al. (2022), in their paper on the treatment of Substance Use Disorders (SUDS) in Canada, recommended clear clinical guidelines and a change from the medical model and support for collaborative care through multidisciplinary practice as an alternative model of health care. Taking the multidimensional approach and treating SUDs, this model promotes knowledge from various disciplines, such as the nursing, medicine, and social services fields. This collaborative partnership, therefore, facilitates the accomplishment of individual-oriented goals besides enabling an effective response to the different needs of those who indulge in substance use. However, Kabisa et al. (2021) give a rival opinion because of a problem that had the lack of standard for cooperation. They point out that the lack of a coherent set of rules may impair the performance of group care models by adopting various approaches to patient management classification. This debate shows a fundamental issue in the field: The issue of effectiveness-risk due to the collaborative care mode and the inconsistencies from the non-standardization. It shows the priority of universal collaboration procedures that need to be undertaken in order to implement and integrate, leading to coordination, and, as the result, the guaranteed good outcome in the form of quality nursing intervention for an SUD management option in Canadian society. It is fair to note that standardization plays an integral role in achieving consistency between the systems, optimum utilization of resources, and eventually fostering better results for people consuming substances excessively over a long period.
Conclusion:
In conclusion, the diversity of nursing practices related to substance use disorders in Canada calls for a specific and tailored approach. Combining screening and assessment tools with pharmacological interventions, psychotherapeutic strategies, harm reduction methods, and collaborative care plans forms an extensive nurse toolbox. In synthesizing results from seven research studies, it is clear that a common solution needs to be attainable. Therefore, the complexity of substance use disorders requires an open and agile perspective that proclaims the significance of continuous research and the implementation of standards based on the findings to enhance nursing interventions. With time, the field keeps evolving, and nurses must move with time, change mindsets, be innovative, and remain loyal to the notion of providing high-quality care. This mandate is especially important in a Canadian context because of the high rates of meaning that healthcare practitioners must keep adjusting their approaches and remaining aware of new best practices and vices.
References
Colizzi, M., Lasalvia, A., & Ruggeri, M. (2020). Prevention and early intervention in youth mental health: Is it time for a multidisciplinary and trans-diagnostic model for care? International Journal of Mental Health Systems, 14(1), 1–14. https://doi.org/10.1186/s13033-020-00356-9
Fadus, M. C., Squeglia, L. M., Valadez, E. A., Tomko, R. L., Bryant, B. E., & Gray, K. M. (2019). Adolescent Substance Use Disorder Treatment: An Update on Evidence-Based Strategies. Current Psychiatry Reports, 21(10), 96. https://doi.org/10.1007/s11920-019-1086-0
Farhoudian, A., Razaghi, E., Hooshyari, Z., Noroozi, A., Pilevari, A., Mokri, A., Mohammadi, M. R., & Malekinejad, M. (2022). Barriers and Facilitators to Substance Use Disorder Treatment: An Overview of Systematic Reviews. Substance Abuse: Research and Treatment, 16, 117822182211184. https://doi.org/10.1177/11782218221118462
Fatani, S. (n.d.). Substance Use Disorders Management Educational Intervention: Development and Evaluating a Tailored Substance Use Disorder Intervention for Community Pharmacists in Saskatoon. Retrieved January 20, 2024, from https://harvest.usask.ca/server/api/core/bitstreams/5d46dff7-06d9-45e0-a717-8ea682662448/content
Jenkins, E., Currie, L. M., Hirani, S., Garrod, E., Goodyear, T., McGuinness, L., David, A., & Bonnie, K. (2022). Enhancing nurses’ capacity to provide concurrent mental health and substance use disorder care: A quasi-experimental intervention study. Nurse Education Today, 117, 105483. https://doi.org/10.1016/j.nedt.2022.105483
Kabisa, E., Biracyaza, E., Habagusenga, J. d’Amour, & Umubyeyi, A. (2021). Determinants and prevalence of relapse among patients with substance use disorders: the case of Icyizere Psychotherapeutic Centre. Substance Abuse Treatment, Prevention, and Policy, 16(1). https://doi.org/10.1186/s13011-021-00347-0
Kakko, J., Alho, H., Baldacchino, A., Molina, R., Nava, F. A., & Shaya, G. (2019). Craving in Opioid Use Disorder: From Neurobiology to Clinical Practice. Frontiers in Psychiatry, 10. https://doi.org/10.3389/fpsyt.2019.00592
Thakarar, K., Nenninger, K., & Agmas, W. (2020). Harm Reduction Services to Prevent and Treat Infectious Diseases in People Who Use Drugs. Infectious Disease Clinics of North America, 34(3), 605–620. https://doi.org/10.1016/j.idc.2020.06.013
Trinkoff, A. M., Selby, V. L., Han, K., Baek, H., Steele, J., Edwin, H. S., Yoon, J. M., & Storr, C. L. (2022). The Prevalence of Substance Use and Substance Use Problems in Registered Nurses: Estimates From the Nurse Worklife and Wellness Study. Journal of Nursing Regulation, 12(4), 35–46. https://doi.org/10.1016/S2155-8256(22)00014-X
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