Signs and Symptoms

When Alcohol is the Drug of Choice (some of those listed under “When Other Drugs are Used” below may also apply to alcohol)

Tendency to isolate
Preference for working alone to avoid being caught
Irritability with peers, making mountains out of mole hills
Decrease in productivity as the disease progresses
Lateness and tardiness for work
Odor of alcohol on breath or excessively noticeable odor of mouthwash (many brands have up to 25% ETOH)
Frequent intoxication at social functions
Isolation from social functions to drink alone
Morning hangovers
Slurred speech
Illegible writing in charts, if they are usually neat

When Other Drugs are Used (some of the above will apply also)

Arrive at work early and stay late in order to obtain drugs
Volunteer for additional shifts to increase access to drugs
Often volunteer to be in charge of the "med" keys
Excessive breakage of vials or pre-filled syringes
Prefer shifts where there is less supervision
May exhibit rapid mood swings (irritable with patients one minute, then calm and jovial the next)
Make frequent trips to the bathroom
Dramatic change in mood (euphoric, mellow, agitated, “manic”, etc.) AFTER their bathroom break
Bloody tissues and/or syringes in bathrooms, call rooms, locker rooms, lockers, bags, lab coats, cars, or around the house
Experience frequent job changes in past 5 years
Have unexplained lapses between jobs
Choose positions where supervision is less likely
Exhibit dilated or constricted pupils
May have unexplained injuries on arms, hands, or body
Signs of domestic violence (male or female)
Wearing long sleeves when they rarely did in the past and/or even when it’s warm
Elaborate explanations for minor incidents
Periods of amnesia for events or conversations
Nodding off during conversations
Found unconscious or dead in bathrooms, locker rooms, call rooms, closets, etc.

Common Signs and Symptoms of Substance Abuse in Anyone

You’re neglecting your responsibilities at school, work, or home (e.g. flunking classes, skipping work, neglecting your children) because of your drug use.
You’re using drugs under dangerous conditions or taking risks while high, such as driving while on drugs, using dirty needles, or having unprotected sex.
Your drug use is getting you into legal trouble, such as arrests for disorderly conduct, driving under the influence, or stealing to support a drug habit.
Your drug use is causing problems in your relationships, such as fights with your partner or family members, an unhappy boss, or the loss of old friends.

Common Signs and Symptoms of Possible Addiction in Anyone

You’ve built up a drug tolerance. You need to use more of the drug to experience the same effects you used to with smaller amounts.
You take drugs to avoid or relieve withdrawal symptoms. If you go too long without drugs, you experience symptoms such as nausea, restlessness, insomnia, depression, sweating, shaking, and anxiety.
You’ve lost control over your drug use. You often do drugs or use more than you planned, even though you told yourself you wouldn’t. You may want to stop using, but you feel powerless.
Your life revolves around drug use. You spend a lot of time using and thinking about drugs, figuring out how to get them, and recovering from the drug’s effects.
You’ve abandoned activities you used to enjoy, such as hobbies, sports, and socializing, because of your drug use.
You continue to use drugs, despite knowing it’s hurting you. It’s causing major problems in your life—blackouts, infections, mood swings, depression, paranoia—but you use anyway.

In order to diagnose possible substance abuse or addiction, there must be a degree of suspicion and a willingness to accept it can happen in anyone we know, including family, friends and colleagues. Believing that someone can’t be an addict based on their training or level of education is a common myth.

Training does not provide immunity! Intelligence does not prevent abuse or addiction.
This isn’t about intelligence, morals or “goodness”.
It’s a disease that affects the brain, and therefore it affects emotions and behavior.

The Addicted Health Care Professional: Signs and Symptoms of Chemical Impairment

5 Myths about Drug Addiction and Substance Abuse

MYTH 1: Overcoming addiction is a simply a matter of willpower. You can stop using drugs if you really want to. Prolonged exposure to drugs alters the brain in ways that result in powerful cravings and a compulsion to use. These brain changes make it extremely difficult to quit by sheer force of will.

MYTH 2: Addiction is a disease; there’s nothing you can do about it. Most experts agree that addiction is a brain disease, but that doesn’t mean you’re a helpless victim. The brain changes associated with addiction can be treated and reversed through therapy, medication, exercise, and other treatments.

MYTH 3: Addicts have to hit rock bottom before they can get better. Recovery can begin at any point in the addiction process—and the earlier, the better. The longer drug abuse continues, the stronger the addiction becomes and the harder it is to treat. Don’t wait to intervene until the addict has lost it all.

MYTH 4: You can’t force someone into treatment; they have to want help. Treatment doesn’t have to be voluntary to be successful. People who are pressured into treatment by their family, employer, or the legal system are just as likely to benefit as those who choose to enter treatment on their own. As they sober up and their thinking clears, many formerly resistant addicts decide they want to change.

MYTH 5: Treatment didn’t work before, so there’s no point trying again; some cases are hopeless. Recovery from drug addiction is a long process that often involves setbacks. Relapse doesn’t mean that treatment has failed or that you’re a lost cause. Rather, it’s a signal to get back on track, either by going back to treatment or adjusting the treatment approach.