How do you recognize a drug-impaired co-worker?

Depending upon the situation, the person, and the duration of the addiction, there are many signs and symptoms used to recognize a drug-impaired co-worker. In general, here are some common signs and symptoms:

Background Indicators:
· Family History of Drug Abuse/Misuse
· Past Medical History Requiring Pain Control
· Reputation as a Responsible Employee

Changes in Behavior:
· Increasing Isolation from co-workers, friends, family
· Social Avoidance at Work
· Frequent Reports of Illness, Minor Accidents, and Emergencies
· Complaints from Others about Poor Work Performance
· Mood swings, Irritability, Depression, or Suicide Threats
· Frequent trips to the bathroom or other Unexplained brief absences
· Difficulty meeting schedules and deadlines
· Illogical or Sloppy Charting
· Strong interest in Patient’s Pain Control and use of pain control medications
· Elaborate or Inadequate Excuses for Tardiness or Absence, which includes taking long lunch hours or using sick leave immediately after days off

Physical Signs and Symptoms:
· Shakiness
· Tremors of Hands
· Slurred Speech
· Diaphoresis/Sweating
· Unsteady Gait/Unsteady Balance
· Increasing Carelessness about Personal Appearance

Although the signs and symptoms noted above are related to recognizing a drug impaired co-worker in general, there are also more specific signs and symptoms to use to detect drug impairment related to a certain type of drug. For example, the signs and symptoms related to a Narcotic issue include:

· Frequently incorrect Narcotics counts
· Apparent alteration to Narcotics vials
· Large amounts of Narcotics wasted
· Issues between the patient reports and hospital records of pain medication
· Significant changes in the amount of drugs required on the hospital unit
· Use of long sleeved clothing for a long period of time, even during warm weather

In some cases, recognizing a co-worker who has a problem with substance abuse may be difficult because the co-worker may conceal the addiction really well. For instance, the chemically dependent co-worker may use excuses such as fatigue or the use of cough syrup or antihistamines to justify the reason for his or her drunken appearance. Even though these excuses may work once or twice, a continual pattern of excuses should raise awareness to the possibility of an impairment related to substance abuse. Surprisingly, job performance is usually the last thing to be affected by chemical dependency (Haack, & Hughes, 1989).

Even though it may be difficult to accept, as a friend and a co-worker it is important to seek help for the person if there is reason to believe that the person is misusing substances.

To take a look at Dr. Audrey Snyder's and Dr. Daniel Becker’s answers related to recognizing a drug impaired co-worker, see the VIDEO: http://www.youtube.com/watch?v=2FgmeE0M2j8

Resources:
Haack, M R, & Hughes, T L. (1989). Addiction in the nursing profession. New York: Springer Publishing Company.

Sullivan, E, Bissell, L, & Williams, E. (1988). Chemical dependency in nursing. Menlo Park, California: Addison-Wesley Publishing Company.


*For more information on Recognizing a Drug Impaired Co-Worker:
http://www.deadiversion.usdoj.gov/pubs/brochures/drug_hc.htm#how
http://www.georgianurses.org/nurse_advocate.htm#chem