In 2008/09 11,955 individuals were reported to the Scottish Drugs Misuse database (ISD Scotland). This figure shows that substance misuse is still an increasing problem and affects community health and social care.
Substances are used to alter perception of reality. Individuals may misuse substances for various reasons such as stress, anxiety, fear or that the do not fit into society.
This essay will focus on how substance misuse influences health across the lifespan.
It will discuss relevant local and national policies and guidelines on this issue.
Agencies and services that are available to address health needs and the relevance to nursing practice will also be discussed in the essay.
The lifespan consists of five stages. These are infancy, childhood, adolescence, adulthood and old age.
Social, personal, lifestyle and biological factors are important at each stage when discussing the influence of substance misuse on health.
The lifespan is a transition from birth to death. Roper et al (1996, p.23) state that :
"As a person moves along the lifespan there is a continuous change and every aspect of living is influenced by the biological, psychological, socio-cultural, environmental and politico-economic circumstances encountered throughout life."
Infancy is a vulnerable stage and what happens in this stage can affect an individual all through their life.
Biological factors are factors such as low birth weight due to the women misusing substances while pregnant. There is also a risk of physical and neurological damage (Scottish Government 2003).
If the child is born into an environment with parental substance misuse the child could suffer from neglect due to poor child-rearing practice and delayed development.
Environmental and heredity factors such as housing, social class, cultural norms and family attitudes and beliefs can affect an individual in many ways.
In childhood substance misuse can affect an individual for reasons like the parents being absent, unable to provide the child with emotional and practical care. The child's emotional well being and parental encouragement and affection is important at this stage. The child may experience social stigma and may become anxious due to this. As the child will probably be responsible for their own well-being, their childhood will be shortened.
If parental substance misuse is taking place the child will have a higher risk of misusing substances and social problems as an adult as this was their socialisation and the norm in their childhood.
In adolescence the individual may start to misuse substances due to poor relationships with family and family history of substance misuse.
In adolescence individuals are developing peer relationships and are more prone to experiment with risk taking behaviour. If they live in a society were it is the norm to misuse substances then they will be more inclined to do this if their peers have done it and also due to family history of drug misuse.
They may feel like they do not fit in and start missing school so their education is then affected which will then make it more difficult for them to attain employment in the future.
This could mean that it may lead to social and cultural problems and could also affect their physical and mental health.
In adulthood if an individual continues to misuse substances they could become addicted which then leads to other problems such as neglecting social roles and responsibilities.
An individual may continue with what has been normal to them or they may misuse drugs due to stress of relationships, loneliness or because of their physical and or mental health. They may see the substance misuse as an escape from their problems.
It could become difficult to hold down a job and this could lead to financial and housing problems. The individual may then resort to crime to fund their addiction.
Individuals may have medical, criminal, educational, social problems; the substance misuse contributes to or makes their problems worse and this could cause major physical and psychological problems. (NHS Choices 2009).
In old age substance misuse could occur due to social and economic problems such as feeling socially isolated or in pain due to physical illness. They may also misuse because it is the behaviour they have lived with and learned throughout their life. (Scottish Executive 2003).
In relation to substance misuse there are various local, national policies and guidelines.
They are in place to enable communities and individuals to deal with this issue and become safer, to reduce inequalities in health care and education.
'The Scottish Office Tackling Drugs in Scotland : Action in Partnership (1999)' is a policy to help Scotland's communities be safer and drug free. It is also to educate and enable people to choose lifestyles free from drugs. Also to tackle social exclusion in deprived areas and to work in partnership against drug misuse with communities and local projects.
'Good Practice Guidance for Working with Children and Families affected by substance misuse (2003)' gives guidance on dealing with the problems that children and families have in relation to drug misuse.
Another government policy that underpins children's safety is 'Getting it Right for Every Child : Proposals for Action' and also 'Getting it Right for Scotland's Children (Hall 4 Report - Hall and Elliman, 2003)'.
To enable individuals in deprived areas were substance misuse is common to gain more knowledge of the effects of these lifestyle choices is the 'Better Health, Better Care, 2007' government strategy.
'A Plan for Action, A Plan for Change, 2000' is a policy which focuses on improving ill health and ensures that each council area has a health plan in place.
'Drug Strategy, 2008 - 2018' is a ten year strategy to limit the supply of drugs and to make communities safer. It is also to prevent harm to individuals and families affected by substance misuse. The policy offers new ways for drug treatments and to carry out campaigns to raise public awareness of drug misuse.
Substance misuse is a problem which individuals or groups in society may have but there are many services and agencies available to address the health needs of these individuals and groups.
'Turning Point Scotland' offer residential, crisis units and community services. They support individuals who are misusing substances and those who may have been involved in crime and due to this are in the criminal justice system.
A voluntary community based charity 'Circle (Lanarkshire)' provides community support to children and families that are affected by parental substance misuse and social exclusion.
'Drug Treatment and Testing Order' is a statutory services which is based in the community. They take referrals from the court or social work. They offer rehabilitation, drop in sessions and group work for substance misuse.
Statutory services 'Harm Reduction Team' accept referrals from G.Ps, health professionals, social work, self-referrals and family by client agreement. They do home visits and street work. They have access to supported accomdation, drop in sessions, education on substance misuse, drug testing and needle exchange.
'Integrated Addiction Service' is another statutory service that offers conselling, detoxification, support for mental health problems. They also provide education and training relating to drug misuse. Also provided is advocacy, aftercare and drug testing.
'Aberlour Scotland's Chlidren's Charity' offer support to children who are affected by substance misuse due to their parents. The charity is for women and children only. They provide accommodation to ensure that the children and women are safe from harm.
'Rainbow House' offer residential accomdation and provide in house detox. They also offer counselling, social learning and cognitive therapy.
There are many services and agencies in Scotland and throughout the UK that provide support to vulnerable children affected by substance misuse. There are various services and agencies that provide support for the individuals who are misusing substances.
Individuals who misuse substances need care to be provided from a multidisciplinary approach to ensure that any care they receive meets their health needs.
It could be a problem to promote health depending on the individuals physical and mental health and whether or not they want guidance on health promotion.
However as a nurse you will have to deliver care to what meets the individuals needs and listen to the individuals' concerns and preferences.
To provide a good standard of care as a nurse you have to be able to challenge your own values and beliefs about drug misuse.
Awareness of your own and others attitude towards individuals who misuse substances will also help to ensure that you are not promoting your own personal attitudes and that they are not reflected in the care of the individual..
In nursing practice it may be difficult to work with the individual with substance misuse issues due to a lack of knowledge on the problems associated with substance misuse.
It also may be difficult due to society's perceived ideas that the individual will be demanding and that they are not motivated to change their lifestyle choices.
However people in your care deserve not to be discriminated against, to receive care in a non-judgemental manner and provide care at a high standard (NMC 2008).
As a nurse you should be aware of the problems the individual may go through. You should support the individual with assisting them with treatment, if they consent and accessing services that are available to them (NMC 2008).
You should also provide support and understand that the individual may or may not relapse but this should not mean that the standard of care should not be of a high standard.
All nurses should be aware of the FRAMES model of intervention and be able to offer this to the individual with substance misuse problems (Alexander, M, F. et al, 2006).
The FRAMES model consists of six parts. These six parts are feedback, responsibility, advice, menu, empathic interviewing and self-efficiency.
This allows assessment and evaluation to be carried out. It allows individual choices about goals and offers ways in which these goals can be achieved.
As a nurse providing care for an individual with problems misusing substances you treat people as individuals, respect their dignity and ensure that you help the person access the information and support that is relevant to their health needs (NMC 2008).
In conclusion substance misuse is still an increasing problem in relation to community health and social care.
Individuals who are affected by substance misuse are often stigmatised and socially excluded from society. There are many preconceived ideas and opinions about individuals or groups who have problems with substance misuse.
However these opinions and preconceived ideas must not be reflected in any of the care provided as a nurse. It is mandatory that nurses should provide to a high standard.
As demonstrated in the essay there are various government policies that are highlighting the problems with substance misuse and the surrounding issues. These policies are trying to make communities safer.
If individuals with a drug misuse problem want help then there are services and agencies available to support them.
In nursing practice there should not be any differences in the quality of care and the individual with a problem with substance misuse have a right to receive care like any other individual in society.