The Feynman Guide to Substance Use and Therapeutic Communication (NCLEX-PN)

Think about the human brain as a magnificent, finely tuned orchestra. Every neurotransmitter, every receptor, and every synapse plays a precise note to keep us in a state of balance—what we call homeostasis. But when a person introduces massive amounts of external chemicals into this system, the conductor gets thrown off the podium. The brain is forced to adapt to this new, artificial normal. When that substance is suddenly removed, the orchestra descends into absolute chaos.

As a practical nurse, you are stepping into that chaos. You are there to keep the patient safe and, through the sheer physics of human connection, guide them back to reality.

When a client with a substance use disorder first arrives on your unit, we have two immediate jobs. First, we deal with the reality of addiction: Nurses should assess for hidden illicit substances or drug paraphernalia upon admission of a client with a substance use disorder. People hide things out of fear and compulsion; our job is to ensure a safe environment, not to pass judgment. Second, we must look at the physical toll. The pursuit of the substance often replaces the pursuit of food. Therefore, nutritional status must be assessed and managed in clients with substance use disorders due to common dietary neglect.

Once the baseline is established, we have to manage the chemical storm. Let’s break down exactly how these substances hijack the body, and how we take the control back.