Page 2301 - Saunders Comprehensive Review For NCLEX-RN

dependent.
F. Other factors to consider in a client with a substance-related
disorder
1. Rebellion and peer group pressure in adolescence may
contribute to the onset of substance use.
2. Substance use may become a coping mechanism used
to decrease physical and emotional pain.
3. Depression may precede or occur as a result of or in
association with substance use.
4. Grief and loss may be associated with substance use.
G. Dysfunctional behaviors related to substance misuse
1. Preoccupation with obtaining and using substance
2. Manipulation to avoid consequences of behavior
3. Impulsiveness
4. Anger, including physical and verbal abuse
5. Avoidance of relationships outside the family unit
6. Relationships within the family become dysfunctional
as the children take on atypical roles to protect the
family unit.
7. Sense of self-importance and requiring special
treatment
8. Denial—blaming everything but the substance use for
problems
9. Use of rationalization and projection to justify
unacceptable behavior
10. Low self-esteem
11. Depression

12. Codependency issues

a. Codependency refers to the presence of
coexisting behaviors present in a
significant other, which serves to
enable the addict or alcoholic to
continue the irresponsible patterns of
use without experiencing
consequences.
b. Examples of codependency: Paying
bills for which the addict or alcoholic is
responsible, bailing the addict or
alcoholic out of jail, and helping the
addict or alcoholic call in sick to
employment agency.
c. It is important to address codependency
issues with the family to maximize the
chance for recovery of the client with
the addiction and the person with the
codependent behaviors.
III. Alcohol Misuse

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