Action Plan:
- Offer counseling for substance abuse.
- Offer medical therapies for substance abuse when available.
- Attempt to replace drug-seeking and use behaviors with non-substance-associated behaviors.
- Behavioral contract:
- Outline specific risks as much as possible — risks with medication interactions, falls, being hit by a vehicle crossing the street, ETOH toxicity, seizures, cirrhosis, dementia, cognitive decline, weight loss, malnutrition, etc.
- Ensure the patient understands the risks and your concerns, and ask the patient to sign the contract outlining that you have discussed the risks.
- The contract can help the person formally assume responsibility for the risky behavior.
- Investigate outpatient and inpatient programs for substance abuse.
- Investigate required, involuntary treatment: court-ordered or involuntary commitment (Substance use commitment | Behavioral Health Administration).
- Ensure close communication with the resident for safety monitoring:
- Attempt to call the patient to check in when they are out of the building.
- Create a plan for this communication and provide avenues for the patient to ask for help and communicate other information to ensure patient safety.
- Monitor the patient’s condition upon return to the facility to ensure safety after substance use.
- Monitor for others enabling unhealthy behaviors and provide the patient with intervention options to avoid acquaintances that enable the patient.
- Offer supervision of the patient’s substance use if possible.
- Document ALL of it!