Stay in the know.

Join our free nurse community to get updates on trending questions and the topics you care about

What are the pros and cons to working on a substance abuse unit?


January 9th, 2023

After 25 years of working with patients with Substance Use Disorder (SUD) (replaces Substance Abuse diagnosis), these are my Pros & Cons.
Pros: 1) Like helping patient with any diagnosis, helping patients with SUD meet their health and life wellness goals can be very satisfying. 2) You quickly learn that you cannot 'make' anyone do any to which they are not committed. Instead, you learn to be a partner, source of information, cheerleader, guide to help patients meet their health and life wellness goals. You interact with your patients frequently, so you have an opportunity to really have an impact. 3) #2 leads to personal and professional growth which are needed to continue to work with patients who have SUDs. 4) You must remain current with common diseases/disorders like diabetes, hypertension, asthma/COPD, GERD, etc. as patients with SUDs also have comorbidities as well as depression, anxiety, PTSD as many patients also have a dual diagnosis.
Cons: 1) Many patients require more than one attempt at sobriety to be successful. This leads to a high rate of recidivism on an SUD unit which can be demoralizing to professionals that are trying to help and can lead to compassion fatigue. 2) Some patients are not able to successfully enter into recovery and succumb to their SUD through overdose or or fatal medical consequence of SUD (esophageal varices, endocarditis, HepC, etc.) 3) Patient are in such physical and emotional pain that they can lash out at the professionals who are trying to help and say some very unkind things. However, if you appreciate that this is a sign & symptom of their disease process, it will lead to Pro # 3 - personal and professional growth. 4) Learning to manage manipulative patients is complex and extremely challenging. Again, sticking with it will lead to Pro # 3 - personal and professional growth.

November 22nd, 2021

The pros are the intensity and frequency of using every bit of skill and knowledge the nurse has, assisting patients towards full and productive lives.
The cons are dependent upon the nurse's own program of personal growth and recovery - whether in substance abuse recovery, or other personal issues. If the nurse is well-grounded, attends to professional and personal boundaries, the cons would likely be limited to keeping healthy relationships with those working under the R.N.'s license, and working effectively with administrative policies and people, and being aware of possible overwork/"burn-out," and settining clear, professional limits on superiors' requests/demands when necessary for the nurse's health and work-life balance.
There are very real risks in working in such units, without such precautions and awareness. If those are present, it's a "win-win" for everyone - especially our patients.

March 11th, 2024

You will get assaulted at some point!

January 18th, 2024

PROS: For the most part, I worked with dedicated, loving, caring, professional Registered Nurses, psyche techs, social workers and providers that put a lot of effort, interest, and work in detoxing these patients and making a difference in their life while they are on the unit and after they are discharged. Thru my many years working these units, I had an opportunity to have "conversations" that I hope/pray that it made a life-changing difference once they return to their homes and ADL's. As a Christian Nurse and a firm believer that God can and will change anyone that believes and surrender their life's humbly before Him, I also had an opportunity to pray and cry with "many of my patients" .... This was an opportunity and blessing that I will treasure and appreciate forever! It is a "nice feeling" knowing that, even though I was not able to make a difference in every one of my patients, I was able to "touch a few" by His Grace and with the professional and loving care that I provided to each of them!

CONS: It is an interesting and challenging work environment in which you have to deal with the patient that "really wants" to be detox and want to be "substance free", and also have to deal with the ones that are there because of many other reasons that had nothing to do with wanting to be free of drugs and "finally detoxed to start a "new life"! Many are there because the wife/husband gave them "an ultimatum"; the Court ordered them to seek help; "hiding away from the dealer", and many other reasons .... Therefore, it is much difficult when you have to work with an individual that has little or no incentive about the program, rather he/she is "just there". Example: Have male patient A today and the "girlfriend" brought him house items such as shampoo, clothing and so for. While doing the traditional and required search, the psyque tech was curious enough to check inside the shampoo bottle, where she found the hidden dope! Another CON: I had the opportunity to work in "a few" substance abuse units in more than a "few states", and there was one "common denominator" .... Too often, patients are discharged on a Xday after getting detoxed, and you see too many of them back within days, within a short period of time, and at times, the same day. Therefore, after a while of this routine you questioned yourself if the unit and the work done is "really accomplishing its goals"!

Thank you for reading. This comments comes from a RETIRED Registered Nurse that worked 40+ years in the profession and 25+ years in Mental Health/Substance Abuse.

"really accomplishing the goals or where/what is failing!

September 9th, 2023

Well, I work on a detox unit. I've been a nurse for twelve years, all of which has been in addictions treatment. People come in with an immediate need. Detox. They may have co-occuring mental health or physiological issues, but they're generally stable to undergo detox. As such, this tends to be a narrow focus for me of keeping these people comfortable, stable, and safe. They won't be with me for long, maybe a week. Then they move on. Some nurses might be bored with this, or feel it's limiting. I enjoy it. There's always something new in addictions, and we're getting a lot of attention these days because of the opioid crisis.
Part of " keeping people safe" is being aware of diabetic patients status, untreated or undiagnosed mental health disorders, etc. These issues will appear and cause problems at times while the body undergoes the stress of detoxing. Be prepared. Hope my rambling answer has cast some insight.

February 9th, 2023

The pro is seeing someone that was beaten down by addiction rise up and take their life back.

The con is that most of those that present to drug rehabilitation centers are not there to overcome their addiction. Most are manipulative liars and are there for underlying reasons. That's what can burn healthcare workers out.

May 16th, 2022

PROS: Nice nursing specialty to have as a skill, Cons: patients can be aggressive/threatening, narcotics a nd other contraband can make unit unsafe. Patients can be very sick while going through detox process.

April 20th, 2022

Pros: learning to talk with and relate to patients on a different level, see people who do want to work on themselves and be more than their addiction

Cons: seeing people struggle/relapse, unable to do IVs/ give certain meds or do diagnostics - you just gotta ship to the hospitals

April 20th, 2022

hectic overworked exhausted Fuel food for the unit!