Addiction psychiatry and nursing: emerging research and the evolving roles of nurses
DOI:
https://doi.org/10.18203/2320-6012.ijrms20263119Keywords:
Addiction psychiatry, Substance use disorder, Psychiatric nursing, Addiction nursing, Mental health nursing, Harm reduction, Integrated careAbstract
Substance use disorders (SUDs) represent a major global public health challenge associated with significant morbidity, mortality, psychiatric comorbidity, social disruption, and economic burden. Addiction psychiatry has evolved considerably over the past decade through advances in neurobiology, psychopharmacology, digital health, precision medicine, and integrated behavioral healthcare models. Concurrently, the role of nurses in addiction psychiatry has expanded beyond traditional bedside care to encompass prevention, screening, harm reduction, treatment coordination, psychotherapy, medication-assisted treatment (MAT) support, recovery-oriented care, research, leadership, and policy advocacy. Emerging evidence demonstrates that nurses are central to improving outcomes among individuals with SUDs, particularly in integrated mental health settings. Contemporary addiction nursing emphasizes person-centered care, trauma-informed approaches, stigma reduction, motivational interviewing, relapse prevention, and community engagement. This review examines current developments in addiction psychiatry and explores the evolving responsibilities of nurses across clinical, educational, research, and policy domains. The review synthesizes evidence from peer-reviewed literature published between 2019 and 2026, highlighting innovations, challenges, and future directions in addiction nursing practice. Findings indicate that advanced psychiatric nurses are increasingly involved in comprehensive assessment, integrated treatment planning, harm reduction initiatives, and management of dual diagnoses. Despite substantial progress, barriers such as workforce shortages, inadequate education, stigma, fragmented services, and limited policy support continue to impede optimal care delivery. Strengthening addiction-focused nursing education, expanding advanced practice roles, promoting interprofessional collaboration, and supporting evidence-based practice are critical for addressing the growing burden of SUDs.
References
Kameg B. Harm reduction as an essential psychiatric mental health nursing skill. J Am Psychiatr Nurses Assoc. 2025;31(4):1.
Mullen AJ, Isobel S, Flanagan K, Key K, Dunbar A, Bell A, et al. Motivational interviewing: Reconciling recovery-focused care and mental health nursing practice. Issues Ment Health Nurs. 2020;41(9):807-14.
Hove E, Hazelton MJ, Santangelo P, Wilson RL. Integrated nursing care for people with combined mental health and substance use disorders. Int J Ment Health Nurs. 2023;32(2):378-401.
Sugavanaselvi K, Nattala P, Arvind BA, Murthy P. Nurses' perspectives regarding integrated nursing interventions for psychoactive substance use cessation: A mixed methods study from South India. Perspect Psychiatr Care. 2022;58(4):2183-9.
Iammarino C, Pauly B. Harm reduction as an approach to ethical nursing care of people who use illicit substances: An integrative literature review of micro and meso influences. Drugs Educ Prev Policy. 2021;28(6):533-546.
Kverno K. Harm reduction in psychiatric settings. J Psychosoc Nurs Ment Health Serv. 2024;62(7):7-10.
Finnell DS, Savage CL, Hansen BR, Sanchez M. The future of nursing: Accelerating gains made to address the continuum of substance use. Arch Psychiatr Nurs. 2020;34(5):297-303.
Theccanat SM. Integrating psychiatric nurse practitioners into psychiatric practice settings. Psychiatr Serv. 2015;66(9):935-7.
Laker CJ. How reliable is the current evidence looking at the efficacy of harm reduction and motivational interviewing interventions in the treatment of patients with a dual diagnosis? J Psychiatr Ment Health Nurs. 2007;14(8):720-6.
World Health Organization. Comprehensive mental health action plan 2013-2030. Geneva: WHO; 2023. Available at: https://www.who.int. Accessed on 15 June 2026.
World Health Organization. Global status report on alcohol and health and treatment of substance use disorders. Geneva: WHO; 2024. Available at: https://www.who.int. Accessed on 15 June 2026.
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ. 2021;372:n71.
Aromataris E, Munn Z, editors. JBI Manual for Evidence Synthesis. Adelaide: Joanna Briggs Institute; 2020. Available at: https://jbi-global-wiki.refined.site. Accessed on 15 June 2026.
Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses. PLoS Med. 2009;6(7):e1000097.
Miller WR, Rollnick S. Motivational Interviewing: Helping People Change and Grow. 4th ed. New York: Guilford Press. 2023.
Volkow ND, Koob GF, McLellan AT. Neurobiologic advances from the brain disease model of addiction. N Engl J Med. 2016;374(4):363-71.
National Institute on Drug Abuse. Drugs, brains and behavior: The science of addiction. Bethesda: NIDA. 2024. Available at: https://nida.nih.gov. Accessed on 15 June 2026.
Substance Abuse and Mental Health Services Administration. Treatment Improvement Protocol (TIP) 63: Medications for opioid use disorder. Rockville, MD: SAMHSA. 2024. Available at: https://www.samhsa.gov. Accessed on 15 June 2026.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR). Washington, DC: APA. 2022.
United Nations Office on Drugs and Crime. World Drug Report 2024. Vienna: UNODC. 2024. Available at: https://www.unodc.org. Accessed on 15 June 2026.
McHugh RK, Weiss RD. Alcohol use disorder and depressive disorders. Alcohol Res. 2019;40(1):arcr.v40.1.01.
Kelly JF, Bergman BG. Recovery from substance use disorder. Psychiatr Clin North Am. 2018;41(4):519-30.
Hawk M, Coulter RWS, Egan JE, Fisk S, Friedman MR, Tula M, et al. Harm reduction principles for healthcare settings. Harm Reduct J. 2017;14:70.
Livingston JD, Milne T, Fang ML, Amari E. The effectiveness of interventions for reducing stigma related to substance use disorders. Addiction. 2012;107(1):39-50.
Wakeman SE, Rich JD. Barriers to medications for addiction treatment. N Engl J Med. 2018;379(1):1-3.
Saitz R. Screening and brief intervention for unhealthy drug use. N Engl J Med. 2020;382(4):389-90.
McLellan AT, Lewis DC, O'Brien CP, Kleber HD. Drug dependence, a chronic medical illness. JAMA. 2000;284(13):1689-95.
Kelly JF, Humphreys K, Ferri M. Alcoholics Anonymous and other 12-step programs for alcohol use disorder. Cochrane Database Syst Rev. 2020;3:CD012880.
American Nurses Association. Psychiatric-Mental Health Nursing: Scope and Standards of Practice. 3rd ed. Silver Spring, MD: ANA. 2022.
International Nurses Society on Addictions. Scope and standards of addiction nursing practice. Available at: https://www.intnsa.org. Accessed on 15 June 2026.
Koob GF, Volkow ND. Neurobiology of addiction: A neurocircuitry analysis. Lancet Psychiat. 2016;3(8):760-73.
Volkow ND, Blanco C. The changing opioid crisis: Development, challenges and opportunities. Mol Psychiat. 2021;26(1):218-33.
Strang J, Volkow ND, Degenhardt L, Hickman M, Johnson K, Koob GF, et al. Opioid use disorder. Nat Rev Dis Primers. 2020;6(1):3.
Degenhardt L, Charlson F, Ferrari A, Santomauro D, Erskine H, Mantilla-Herrara A, et al. The global burden of disease attributable to alcohol and drug use. Lancet Psychiat. 2018;5(12):987-1012.
NIDA. Principles of Drug Addiction Treatment: A Research-Based Guide. Bethesda (MD): National Institute on Drug Abuse. 2024. Available at: https://nida.nih.gov. Accessed on 15 June 2026.
Wakeman SE, Barnett ML. Primary care and the opioid-overdose crisis. N Engl J Med. 2018;379(1):1-4.
Kelly JF, Greene MC, Bergman BG. Recovery benefits of the twelve-step model. Alcohol Res. 2018;39(1):109-17.
McGovern MP, Lambert-Harris C, Gotham HJ, Claus RE, Xie H. Dual diagnosis capability in addiction treatment. J Dual Diagn. 2014;10(2):84-95.
Mumba MN, Krause AJ, Phiri J. Substance use disorders and mental health comorbidities among adults. BMC Psychiat. 2021;21:524.
SAMHSA. Screening, Brief Intervention, and Referral to Treatment (SBIRT). Rockville, MD: Substance Abuse and Mental Health Services Administration. 2023. Available at: https://www.samhsa.gov. Accessed on 15 June 2026.
Corrigan PW, Nieweglowski K. Stigma and the public health agenda for substance use disorders. Addict Behav. 2019;92:168-72.
van Boekel LC, Brouwers EP, van Weeghel J, Garretsen HF. Stigma among health professionals toward patients with substance use disorders. Drug Alcohol Depend. 2013;131(1-2):23-35.
Brener L, Hippel WV, von Hippel C, Resnick I, Treloar C. Perceptions of discriminatory treatment by health care staff. Drug Alcohol Rev. 2010;29(2):131-7.
Magill M, Gaume J, Apodaca TR, Walthers J, Mastroleo NR, Borsari B, et al. Motivational interviewing for substance use disorders: A meta-analysis. J Consult Clin Psychol. 2018;86(2):140-57.
Miller WR, Rose GS. Toward a theory of motivational interviewing. Am Psychol. 2009;64(6):527-37.
Oesterle TS, Kolla B, Risma CJ, Breitinger SA, Rakocevic DB, Loukianova LL, et al. Substance use disorders and telemedicine. Mayo Clin Proc. 2020;95(11):2489-99.
Lin LA, Casteel D, Shigekawa E, Weyrich MS, Roby DH, McMenamin SB. Telemedicine-delivered treatment interventions for substance use disorders. J Subst Abuse Treat. 2019;101:38-49.
Hawk KF, D’Onofrio G. Emergency department screening and interventions for substance use disorders. Addict Sci Clin Pract. 2018;13(1):18.
Krawczyk N, Buresh M, Gordon MS, Blue TR, Fingerhood MI, Agus D. Expanding low-threshold buprenorphine treatment. J Addict Med. 2021;15(2):95-8.
Larochelle MR, Bernson D, Land T, Stopka TJ, Wang N, Xuan Z, et al. Medication for opioid use disorder after nonfatal overdose. Ann Intern Med. 2018;169(3):137-45.
Sordo L, Barrio G, Bravo MJ, Indave BI, Degenhardt L, Wiessing L, et al. Mortality risk during and after opioid substitution treatment. BMJ. 2017;357:j1550.
Mattick RP, Breen C, Kimber J, Davoli M. Methadone maintenance therapy versus no opioid replacement therapy. Cochrane Database Syst Rev. 2009;(3):CD002209.
Mattick RP, Breen C, Kimber J, Davoli M. Buprenorphine maintenance versus placebo. Cochrane Database Syst Rev. 2014;(2):CD002207.
Krawczyk N, Rivera BD, Jent V, Keyes KM, Jones CM, Cerdá M. Has the treatment gap for opioid use disorder narrowed? Int J Drug Policy. 2022;104:103658.
Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, et al. Relationship of childhood abuse and household dysfunction to leading causes of death. Am J Prev Med. 1998;14(4):245-58.
Hughes K, Bellis MA, Hardcastle KA, Sethi D, Butchart A, Mikton C, et al. The effect of adverse childhood experiences on health. Lancet Public Health. 2017;2(8):e356-66.
Substance Abuse and Mental Health Services Administration. Trauma-Informed Care in Behavioral Health Services. TIP 57. Rockville, MD: SAMHSA. 2023. Available at: https://store.samhsa.gov. Accessed on 15 June 2026.
Pauly B, Wallace B, Barber K. Turning a blind eye: Harm reduction in nursing practice. Nurs Inq. 2018;25(2):e12238.
Bardwell G, Kerr T, Boyd J, McNeil R. Characterizing peer roles in overdose response. Drug Alcohol Depend. 2018;191:267-72.
International Council of Nurses. Nurses: A Voice to Lead-Investing in Nursing and Respecting Rights. Geneva: ICN. 2022. Available at: https://www.icn.ch. Accessed on 15 June 2026.
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