Strategies for promotion of avoiding harmful substances.

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.