Patients with addictive behaviors, whether it is problem drinking, drug addiction, or any other kind of addiction, can be quite persuasive in their arguments. They might try to pin you down, often turning the conversation around to you rather than dealing with the addictive behavior. As a nurse, you need to avoid the common pitfalls.

Having pat answers to some of their statements can help. For example:

“I need alcohol (cigarettes, drugs, to shop, etc.) to block my emotional pain.”

• Say “Blocking emotional pain does not work. You are not alone. Everyone has emotional pain of some sort, and everyone needs to learn to deal with it.”

“I can’t handle frustration and pain.”

• Say “Handling frustration and pain can be learned. Developing a tolerance to frustration grows as you work with it.”

“I deserve to feel good, and get high (have sex, gamble, smoke cigarettes, etc.).”

• Say “Everyone deserves to feel good, but not at the expense of their health or another’s well-being.”

“I can’t help it.”

• Say “You are responsible for your behavior.”

“It is not my fault. I am an addict.”

• Say “You are responsible for avoiding situations that cause you to relapse.”

“I’m no good; I am a failure.”

• Say “You might feel that way now. I am not ready to accept that.”

“I am in control of my drinking (gambling, running, etc.) I can stop anytime.”

• Say “What just happened now doesn’t support that.”

Sustaining hope is also an important ingredient when working with addicts. Chronic illnesses are, by definition, illnesses of remission and relapse. However, recall that any period without the addictive substance is a period of health.

So, as nurses, we need to keep perspective, and help our patients and their family members and loved ones do the same. A little hope and a bit of encouragement may bring the addict comfort and strength to continue in recovery.

Editor’s note: This excerpt is adapted from Stressed Out About Difficult Patients, the newest addition to the Stressed Out collection. It’s due out early next month. All this week, we’ll be presenting excerpts of the book so you can get a good look at our new title.