Diagnostic and statistical manual of mental disorders, 5th edn. : American Psychiatric Publishing; 2013

Barnett AI, Hall W, Fry CL, Dilkes-Frayne E, Carter A Drug and alcohol treatment providers' views about the disease model of addiction and its impact on clinical practice: A systematic review. Drug Alcohol Rev. 2018; 37:(6)697-720

Barnett BS, Morris NP, Suzuki J Addressing in-hospital illicit substance use. Lancet Psychiatry. 2021; 8:(1)17-18

Bartlett R, Brown L, Shattell M, Wright T, Lewallen L Harm reduction: compassionate care of persons with addictions. Medsurg Nursing. 2013; 22:(6)349-358

Braun V, Clarke V Using thematic analysis in psychology. Qual Res Psychol. 2006; 3:(2)77-101

Comiskey C, Galligan K, Flanagan J, Deegan J, Farnann J, Hall A Clients' views on the importance of a nurse-led approach and nurse prescribing in the development of the Healthy Addiction Treatment Recovery Model. J Addict Nurs. 2019; 30:(3)169-176

Comiskey C, Galligan K, Flanagan J, Deegan J, Farnann J, Hall A The Healthy Addiction Treatment recovery model. J Addict Nurs. 2021; 32:(1)E11-E20

Eaton EF, Westfall AO, McClesky B In-hospital illicit drug use and patient-directed discharge: barriers to care for patients with injection-related infections. Open Forum Infect Dis. 2020; 7:(3)

Edwards G, Gross MM Alcohol dependence: provisional description of a clinical syndrome. BMJ. 1976; 1:(6017)1058-1061

el-Guebaly N The meanings of recovery from addiction: evolution and promises. J Addict Med. 2012; 6:(1)1-9

Frank LE, Nagel SK Addiction and moralization: the role of the underlying model of addiction. Neuroethics. 2017; 10:(1)129-139

Galanter M Spirituality and recovery in 12-step programs: an empirical model. J Subst Abuse Treat. 2007; 33:(3)265-272

Gerrish K, Lacey A The research process in nursing, 6th edn. : Wiley-Blackwell; 2010

Glackin SN Philosophical issues in the addictions. Chapter 4. In: Sussman S (ed). : Cambridge University Press; 2020

Grewal HK, Ti L, Hayashi K, Dobrer S, Wood E, Kerr T Illicit drug use in acute care settings. Drug Alcohol Rev. 2015; 34:(5)499-502

Hawk M, Coulter RWS, Egan JE Harm reduction principles for healthcare settings. Harm Reduct J. 2017; 14:(1)

Johansson L, Wiklund-Gustin L The multifaceted vigilance – nurses' experiences of caring encounters with patients suffering from substance use disorder. Scand J Caring Sci. 2016; 30:(2)303-311

Kelly JF, Saitz R, Wakeman S Language, substance use disorders, and policy: the need to reach consensus on an “addiction-ary”. Alcohol Treat Q. 2016; 34:(1)116-123

Kelly JF, Wakeman SE, Saitz R Stop talking ‘dirty’: clinicians, language, and quality of care for the leading cause of preventable death in the United States. Am J Med. 2015; 128:(1)8-9

Kim H, Sefcik JS, Bradway C Characteristics of qualitative descriptive studies: a systematic review. Res Nurs Health. 2017; 40:(1)23-42

Laudet AB What does recovery mean to you? Lessons from the recovery experience for research and practice. J Subst Abuse Treat. 2007; 33:(3)243-256

McKay JR Impact of continuing care on recovery from substance use disorder. Alcohol Res. 2021; 41:(1)

Not-fatal drug-related hospital admissions in Ireland 2020. 2022. https// (accessed 5 February 2024)

Monks R, Topping A, Newell R The dissonant care management of illicit drug users in medical wards, the views of nurses and patients: a grounded theory study. J Adv Nurs. 2013; 69:(4)935-946

National Institute on Drug Abuse. Words matter - terms to use and avoid when talking about addiction. 2021. https// (accessed 5 February 2024)

Neale J, Finch E, Marsden J How should we measure addiction recovery? Analysis of service provider perspectives using online Delphi groups. Drugs Educ Prev Policy. 2014; 21:(4)310-323

Pickard H Responsibility without blame for addiction. Neuroethics. 2017; 10:(1)169-180

Rassool GH Addiction for nurses.: Wiley; 2011

Saunders JB, Degenhardt L, Reed GM, Poznyak V Alcohol use disorders in ICD-11: past, present, and future. Alcohol Clin Exp Res. 2019; 43:(8)1617-1631

Sterling R, Slusher C, Weinstein S Measuring recovery capital and determining its relationship to outcome in an alcohol dependent sample. Am J Drug Alcohol Abuse. 2008; 34:(5)603-610

Valdez A Words matter: labelling, bias and stigma in nursing. J Adv Nurs. 2021; 77:(11)e33-e35

Wakeman SE Language and addiction: choosing words wisely. Am J Public Health. 2013; 103:(4)e1-e2

West R, Brown J Theory of addiction.: Wiley; 2013

White W, Kurtz E The varieties of recovery experience: a primer for addiction treatment professionals and recovery advocates. Int J Self Help Self Care. 2005; 3:(1-2)21-61

World Health Organization. International classification of diseases, Eleventh Revision (ICD-11). 2019. https// (accessed 8 February 2024)

World Health Organization. Alcohol. Fact sheet. 2022a. https// (accessed 8 February 2024)

World Health Organization. Fact sheets: Nursing and midwifery. 2022b. https// (accessed 5 February 2024)

World Health Organization. Health topics: drugs (psychoactive) – impact. 2024. https// (accessed 5 February 2024)

Zgierska AE, Miller MM, Rabago DP Language matters: it is time we change how we talk about addiction and its treatment. J Addict Med. 2021; 15:(1)10-12

‘Selling their souls?’ Nurses' understanding of addiction and recovery in acute hospital settings

22 February 2024
Volume 33 · Issue 4



Nursing disciplines do not currently have a shared understanding of addiction or recovery to address their contribution to their patients' needs. Recent developments of addiction nursing models, alongside an international move to standardise language, is slow to be reflected in nurses' perceptions in acute hospital settings.


To explore nurses' understanding of addiction and recovery in acute general hospitals.


A qualitative study with semi-structured open-ended questions informed by a prior literature review was undertaken with nurses working in an acute general hospital in Dublin, Ireland.


The identified themes were the knowledge of addiction, including physical and psychological needs, and the understanding of recovery, patient-centred services and the impact of the individual's environment.


Standardising language for addiction and recovery and improving addiction education will give nurses a better understanding of the chronic nature of substance use and the importance of this in providing high-quality health care.

The latest estimates from the World Health Organization (WHO) are that nearly 35 million of the world's population are affected by harmful substance use and dependence, and harmful use of alcohol accounts for nearly 5.3% of deaths worldwide (WHO, 2022a; 2024). Despite the evident burden of substance misuse on the world's population, healthcare workers (HCWs) may not associate this with hospital admissions. This may be because of insufficient research into this area, despite some studies highlighting this occurrence (Barnett et al, 2021). A recent study from the USA indicated that between 33% and 41% of hospitalised individuals have used illicit substances during their admission (Eaton et al, 2020). Similarly, a Canadian study noted that of the 1028 participants who were admitted to hospital, 43.9% reported using substances during their hospital stay (Grewal et al, 2015). From an Irish perspective, recent data shows that figures for drug-related admissions are increasing, with 5457 individuals being admitted to hospital in 2020 (of whom 55 died in hospital, leaving 5402 non-fatal overdose admissions) (Millar, 2022). These three studies highlight the inevitability of nurses encountering individuals who use substances in a general hospital setting.

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