Substance Abuse
Special Edition of Board Notes, 2016
Signs and Symptoms of Substance Abuse in Executives and Professionals
General:
- Appears intoxicated or hung over
- Deterioration of physical appearance and grooming
- Shakiness, tremulousness
- Unpredictability, strange behavior, inappropriate behavior
- Withdrawal from responsibility
- General changes in overall attitude
- Overwhelmed easily, unable to manage emotions, emotional outbursts, overreacts
- Aggressiveness or becomes withdrawn
- Forgetfulness, poor concentration, short attention span, “blank spots” in memory
- Loses sense of humor, misinterprets situations, loses sense of perspective
- Becomes suspicious and distrustful
- Loses touch with reality at times
- Loss of intellectual sharpness, creativity, business acumen
- Becomes indecisive, confused
- Change in weight
- Frequent medical visits
- Frequent absence and inability to account for whereabouts during work day, misses deadlines, appointments
- Legal, family, social, medical problems
Alcohol:
- Needs a drink to relieve stress
- Quickly drinks or gulps down several drinks to “loosen up”
- Availability and consumption of alcohol becomes the focus of social or professional activities.
- Individual becomes erratic, temperamental, irritable, difficult to get along with
- Misses deadlines
- Chronic lateness
- Quality of work deteriorates
- Quality of presentations deteriorates
- Poor business judgment
- Trouble making decisions
- Misses work on Mondays and Fridays
- Frequent medical leaves of several days duration
- Missing during the middle of the workday
- Odor of alcohol when around individual, especially on breath
- Shakiness, trembling hands in the morning
- Frequent trips to hospitals, medical providers
- Increase or decrease in weight
- Changes in skin appearance, including flushed skin on nose and cheeks
- Repeated injuries, bruises, cuts & scrapes, limping
- Repeated complaints of fatigue, lack of energy, inability to concentrate, headache
- General “run down” appearance
- Legal difficulties
Stimulants (cocaine, methamphetamine and others):
- Dry mouth and nose, bad breath, frequent lip licking, teeth grinding, body tremors.
- Excessive activity, difficulty sitting still, lack of interest in food or sleep.
- Irritable, argumentative, nervous, extreme moodiness.
- Talkative, excited speech and incessant talking but conversation often lack continuity; changes subjects rapidly. “Grabs spotlight” during presentations, meetings
- Runny nose, cold or chronic sinus infections, nose bleeds.
- Use or possession of paraphernalia including small spoons, razor blades, mirror, little bottles of white powder and plastic, glass or metal straws.
- Euphoria, expansive mood
- Chronic financial difficulties in spite of more than adequate compensation
- Progressively aggressive or violent behavior, unusual temper tantrums
- Increased physical or sexual activity
- False sense of confidence and power
- Purposeless, repetitious behavior
- Compulsive cleaning, grooming, sorting, disassembling
Depressants (barbiturates, tranquilizers):
- Symptoms of alcohol intoxication with no alcohol odor on breath (slurred speech, stumbling gait, droopy eyes, etc).
- Lack of facial expression or animation
- Flat affect
- Flaccid appearance
- Slurred speech
Opiates (painkillers, heroin, morphine):
- Euphoria, tranquility, apathy, and impaired judgment. (Although the initial effects are generally calming or dulling, psychomotor agitation and aggressiveness can occur).
- Excessively active, frantic or lethargic, drowsy, nods off during meetings
- Slow breathing
- Very pale and sweaty or extremely thirsty
- Small, “pin prick” pupils
- Nausea
- Frequent itching and scratching
- Red and raw nostrils (sign of sniffing)
- Wears long sleeves even when inappropriate (sign of injecting)
Alcohol Self-Test
This series of questions about one’s use of alcohol and/or drugs is an informal inventory of “tell-tale signs” with many items tailored to lawyers. It is not a list of official diagnostic criteria and does not substitute for a professional evaluation.
- Do I plan my office routine around my drinking or drug use?
- Have I tried unsuccessfully to control or abstain from alcohol or drugs?
- Do my clients, associates, or support personnel contend that my alcohol/drug use interferes with my work?
- Have I avoided important professional, social, or recreational activities as a result of my alcohol/drug use?
- Do I ever use alcohol or drugs before meetings or court appearances, to calm my nerves, or to feel more confident of my performance?
- Do I frequently drink or use drugs alone?
- Have I ever neglected the running of my office or misused funds because of my alcohol or drug use?
- Have I ever had a loss of memory when I seemed to be alert and functioning but had been using alcohol or drugs?
- Have I missed or adjourned closings, court appearances, or other appointments because of my alcohol/drug use?
- Is drinking or drug use leading me to become careless of my family’s welfare or other personal responsibilities?
- Has my ambition or efficiency decreased along with an increase in my use of drugs or alcohol?
- Have I continued to drink or use drugs despite adverse consequences to my practice, health, legal status, or family relationships?
- Are strong emotions, related to my drinking or drug use (e.g., fear, guilt, depression, severe anxiety) interfering with my ability to function professionally?
- Are otherwise close friends avoiding being around me because of my alcohol or drug use?
- Have I been neglecting my hygiene, health care, or nutrition?
- Am I becoming increasingly reluctant to face my clients or colleagues in order to hide my alcohol/drug use?
A “yes” answer to any of these questions suggests that it would be wise to seek professional evaluation, but may or may not indicate that you have a diagnosable addictive disorder.
Attorneys and Substance Abuse- Stats & Research
Substance Abuse and Mental Health Problems, Growing Problem for the Legal Profession ABA Journal
Bumps in the Road ABA/GPSolo Publication
Links
- Alcoholics Anonymous (AA) Content of the “Big Book”
- Alcoholics Anonymous (AA) – Information
- Al-Anon or Al-Ateen (for Family Members of Alcoholics)
- American Society of Addiction Medicine
- Cocaine Anonymous
- Narcotics Anonymous
- National Institute on Alcohol Abuse and Alcoholism
- National Institute on Drug Abuse
- Institute for Addiction Study
- Self tests for addiction
- Women and addiction
- International Lawyers in AA
- Addiction Resources
- Trauma and Substance Abuse
- PTSD and Substance Abuse