Eells M A
University of Maryland School of Nursing, Baltimore.
Nurs Clin North Am. 1991 Dec;26(4):915-27.
Obviously, avoiding harmful substances and addictions to them and intervening later once the addiction is established are complex tasks. All the aspects of primary, secondary, and tertiary interventions can be used in a given family with addiction, for there may be late-stage, chronic addiction, early addiction that can be interrupted, and youngsters who are prone to addiction. Family patterns accompanying addiction may be intense and well established, more moderate, or in a formative stage. Often addicted persons, no matter what the addiction, may never enter treatment and certainly not often of their own accord. In the select group of faithful AA members, for example, it is said that only 1 of 37 people who ever attend is successful in the program and, of course, many never enter the door. What is our responsibility to the persons who are using harmful substances and their family members? It lies in better case finding, enhanced by a greater awareness of patterns of addiction; in family intervention first, no matter what the stage of addiction or its type; and treatment for the person addicted when that is possible. This is a natural role for nurses, one for which they should take professional and, if need be, personal responsibility. Strengthening families by changing dysfunctional patterns is the ultimate strategy for avoiding the use and abuse for harmful substances.
显然，避免接触有害物质及其成瘾，以及在成瘾形成后再进行干预，都是复杂的任务。针对成瘾家庭，可以运用一级、二级和三级干预的各个方面，因为可能存在晚期慢性成瘾、可被阻断的早期成瘾，以及易成瘾的青少年。与成瘾相伴的家庭模式可能根深蒂固且强烈、较为温和，或者正处于形成阶段。通常，成瘾者无论染上何种瘾，可能都不会接受治疗，当然更不会经常主动寻求治疗。例如，在戒酒互助会（AA）的忠实成员这一特定群体中，据说每37个参加者中只有1人能成功完成该项目，当然，很多人根本连门都不进。我们对使用有害物质的人和他们的家庭成员负有什么责任呢？责任在于通过更深入了解成瘾模式来更好地发现病例；无论成瘾处于何种阶段或类型，首先进行家庭干预；在可能的情况下，对成瘾者进行治疗。这是护士的天然职责，他们应该对此承担专业责任，如有必要，还应承担个人责任。通过改变功能失调的模式来强化家庭，是避免使用和滥用有害物质的最终策略。
