Engaging Clients Who Use Substances
Purpose and scope
The purpose of this best practice guideline is to provide nurses and the interprofessional team across all care settings with evidence-based recommendations related to assessment and interventions for individuals aged 11 years and older who use substances and may be at risk for or experiencing a substance use disorder.
The scope of this guideline includes
- effective assessment and management interventions,
- organization, and
- policy recommendations
for improving access to care for these individuals. This guideline provides evidence-based recommendations for nurses and other members of the interprofessional team across all care settings who are assessing and providing interventions to individuals who use substances and may be at risk for or experiencing a substance use disorder.
Registered Nurses’ Association of Ontario. (2015). Engaging Clients Who Use Substances. Toronto, ON: Registered Nurses’ Association of Ontario.
Do you want to learn about and implement the most- up-to-date evidence-based recommendations on this topic with your colleagues? Download and share the full best practice guideline (BPG), Engaging Clients Who Use Substances.
See below for a snapshot of the recommendations from this BPG. We strongly suggest you review the full BPG before implementing the recommendations and good practice statements. The BPG also includes further resources to support implementation and evaluation.
Recommendation 1.1: Screen all clients to determine whether they use substances.
Recommendation 1.2: For clients who use substances, use universal screening questions and/or an appropriate screening tool to determine the level of support required.
Recommendation 1.3: Conduct a comprehensive assessment with all clients who screen positive for substance use, as appropriate based on the nurses’ knowledge, skill, time, setting and resources.
Recommendation 2.1: Build collaborative relationships with clients through the use of motivational interviewing techniques to develop the plan of care.
Recommendation 3.1: Use brief intervention to collaborate with clients identified as at risk for or experiencing a substance use disorder.
Recommendation 3.2: Advocate for and support access to combined pharmacological and psychosocial interventions, as appropriate, and promote the appropriate use of combined interventions to improve well-being and health outcomes.
Recommendation 3.3: Engage youth and adolescents at risk for or experiencing a substance use disorder using family-based therapies until recovery, as appropriate.
Recommendation 4.1: Reassess the effectiveness of the plan of care until the client’s goals are met.
Recommendation 5.1: Integrate theory and clinical practice opportunities regarding care of clients at risk for or experiencing a substance use disorder into the undergraduate education of nurses and other health-care providers.
Recommendation 5.2: Health-care providers participate in continuing education to enhance their ability to assess and work with clients at risk for or experiencing a substance use disorder.
Recommendation 5.3: Nurses practice reflectively to enhance their awareness of their current and evolving attitudes, perceptions and biases, and values and beliefs when working with clients at risk for or experiencing a substance use disorder.
Recommendation 6.1: Advocate for improved health outcomes by:
- Increasing access to integrative and collaborative care for clients at risk for or experiencing a substance use disorder; and
- Reducing health inequities by dedicating resources to preventing, treating, and supporting the recovery of individuals at risk for or experiencing a substance use disorder.
Recommendation 6.2: Organizations integrate prevention, assessment, and management of substance use and substance use disorders as a strategic clinical priority across all care settings.
Recommendation 6.3: Organizations integrate components of harm reduction and the social determinants of health into comprehensive, multi-faceted approaches to addressing substance use disorders.
Recommendation 6.4: Organizations use knowledge translation processes and multi-faceted strategies to integrate best practices in the assessment and management of substance use and substance use disorders across all practice settings.
Disclaimer: These guidelines are not binding for nurses, other health providers or the organizations that employ them. The use of these guidelines should be flexible and based on individual needs and local circumstances. They constitute neither a liability nor discharge from liability. While every effort has been made to ensure the accuracy of the contents at the time of publication, neither the authors nor the Registered Nurses’ Association of Ontario (RNAO) gives any guarantee as to the accuracy of the information contained in them or accepts any liability with respect to loss, damage, injury or expense arising from any such errors or omission in the contents of this work.