psychiatric mental-health nurse practitioner

Why addiction treatment is a growing field for nurses

By: LaQuicha Westervelt-House, PMHNP

The U.S. Bureau of Labor Statistics estimates that between 2020 and 2030 careers for counselors in the fields of substance use, behavioral disorders, and mental health could grow by 23%. For nurses, this means many great opportunities exist for excellent, fulfilling roles in the field of addiction and mental health.

As a psychiatric mental-health nurse practitioner (PMHNP) working at an inpatient detox and rehab facility, I can tell you that my job challenges me every day, but it is also incredibly rewarding.

I had never intended to make a career in addiction treatment; however, looking back, it makes a lot of sense that I would go in this direction in my career. Addiction was a part of my family from a very early age. Then, working as a nurse in an emergency department (ED) and later as a family nurse practitioner specializing in HIV and Hepatitis C, I saw how destructive addiction is to entire communities.

I also saw how the needs of these people weren’t being met. In fact, people struggling with addiction rarely get help. In 2021, according to the National Survey of Drug Use and Health (NSDUH), 94% of Americans 12 or older with a substance use disorder did not get the care they needed. And the Substance Abuse and Mental Health Services Administration reports a “stark contrast between providers that are currently available versus what is needed to address the mental health issues faced by millions of Americans.”

But as this failure to adequately address America’s addiction crisis becomes increasingly apparent, it is my hope that more and more counselors, doctors, and nurses will enter the field to meet this demand.

Addiction stigma remains one of the greatest hurdles to closing the gap between the number of people who need help and the amount of help available. Many people who need help but don’t get it cite feelings of shame as a barrier. They might feel that others will think less of them for seeking treatment.

I believe this problem goes even deeper; the considerable stigma attached to drug use and addiction not only prevents people from seeking help but also has contributed to a lack of resources allocated to addiction treatment and fewer people entering the field.

Even as a nurse, you can become jaded to addiction or convince yourself that these people just need to stop drinking or using drugs on their own, especially considering addiction is a complicated disease with no cure. Overworked and exhausted staff in hospitals and EDs can become burned out and numb when dealing with the same problems every day.

Dangerous myths and attitudes about addiction and mental health still pervade in education, hospitals, and society at large. When I told people I was switching my focus to psychiatry, some expressed concern about patients being violent or aggressive, which is almost never the case.

My experiences early in my career made me want to focus on addiction when I returned to school to become a PMHNP. I realized that people need treatment whether it’s their heart, thyroid, or brain that is sick. Addiction is widely considered a progressive brain disease that is unlikely to improve without specialized treatment. I’ve seen personally how true this is.

Working with my patients makes it clear that addiction is an illness, not a choice or a moral failing. It also illuminates the fact that this disease affects all demographics, including all races, classes, and age groups. Misconceptions about addiction not only stigmatize those who obviously need help, it hurts the ones we don’t expect to have these problems. Many of my elderly patients went undiagnosed for a long time because they were able to fly under the radar because they didn’t fit the typical image of someone with an addiction.

Fortunately, I’ve noticed an increasing number of people who’ve made fighting this disease their passion. My professor colleagues tell me more and more grants are available for those focused on addiction treatment, and increasing numbers of students are getting their clinical hours in addiction.

To me, there’s no mystery behind why addiction treatment is becoming a popular choice for nurses. By choosing a career in addiction treatment, nurses have the opportunity to effect real change. While working as a nurse in any field involves helping people, working in addiction care provides a unique opportunity to view the positive impact of treatment on patients’ lives and those of their families.

It’s rare to find someone whose life has not been impacted by addiction—whether it’s their own problem with drugs and alcohol or a loved one’s. I share my experience with my patients and their families. At the start of the COVID pandemic, I lost my sister to a fentanyl overdose.

The loss was devastating. But working in addiction treatment afforded me the opportunity of speaking with people who truly understand my pain. I credit my patients with helping me stay sane when lockdown prevented me from visiting my family.

It’s horrifying to know that each year, hundreds of thousands of Americans die from addiction-related causes and millions more lose a beloved family member. But I’m optimistic because I also know so many are willing to fight this awful disease. We live in frightening times where the demand for nurses in this field is greater than ever, but I’m hopeful for the future.

LaQuicha Westervelt-House is a psychiatric mental-health nurse practitioner at Laguna Treatment Hospital, an American Addiction Centers facility.

The views and opinions expressed by Perspectives contributors are those of the author and do not necessarily reflect the opinions or recommendations of the American Nurses Association, the Editorial Advisory Board members, or the Publisher, Editors and staff of American Nurse Journal. These are opinion pieces and are not peer reviewed.

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