By Jessica Burgess, MSN, PMHNP-BC
Psychiatric Nurse Practitioner at the Community Health Center of Cape Cod
Anyone who has been affected by the potent force of addiction can attest to its ability to influence all aspects of
a person. The sweeping nature of substance addiction is impressive. It impinges on all aspects of an individual:
body, mind, and spirit. Because it is such a comprehensive disease, comprehensive prevention approaches are
needed, especially for those who are at increased risk for addiction.
There is not one single factor that will determine whether a person will become addicted to drugs or alcohol.
Each person has a unique combination of genetic and environmental influences that can either serve as risk
factors for substance abuse, or protective factors. Risk factors can potentially increase an individual’s chances
of developing a substance addiction, while protective factors can decrease the risk. A person’s risk factors may
include genetic predisposition (a family history of substance abuse), environmental predisposition (growing up
regularly exposed to substance abuse of others), trauma (exposure to domestic violence, physical, emotional,
sexual abuse), and mental illness (depression, bipolar disorder, anxiety, etc.). Protective factors can include
supportive and healthy relationships, academic/occupational competence, physical and mental health, and
healthy interests/hobbies. An important goal of prevention is to change the balance between risk and protective
factors so that protective factors outweigh risk factors.
People who are experiencing pain associated with these risk factors, whether it be emotional, mental or physical
may seek to alleviate the pain through substance use. This is informally referred to as “self-medicating,”
meaning that they are seeking relief from discomfort by using a substance. Individuals may feel some
temporary relief through substance effects, but the use itself then has potential to cause more problems if it
develops into abuse or an addiction.
Effective prevention efforts start with identifying a person’s risk factors and treating them with healthy
methods, before a person “self medicates” and a substance addiction develops. This approach requires a
multidisciplinary team to treat the whole individual. At the Community Health Center of Cape Cod, I am part
of a team of healthcare providers who work together to provide comprehensive treatment for each patient. Our
team includes primary care providers, psychiatric providers, behavioral health counseling providers,
nutritionists, nurse case managers, optometry, dental care, etc. We are able to ensure that all risk factors
identified are being treated appropriately. Medical providers are able to work with patients to establish optimal
physical health; encouraging protective factors through exercise and healthy eating. Psychiatric providers, such
as myself, identify risk factors of mental illness, and when appropriate, treat them with medication. Behavioral
health counselors work with patients to safely process past trauma, and to develop healthy coping mechanisms.
In aiming to prevent a disease that thrives on all types of risk factors, a multi-faceted approach is necessary. To
adequately prevent substance addiction, we need to focus on treating the whole health of a person, nurturing
protective factors and identifying and appropriately treating risk factors.
By Jessica Burgess, MSN, PMHNP-BC