| HPP HEALTH PROFESSIONALS PROGRAM |
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Signs and Symptoms of Addictive Disease
Chemical dependency is a diagnosis we avoid making for a variety of reasons. Diagnosing alcohol and drug dependency is fairly straightforward in severe or advanced cases. This is particularly true when there is evidence of physical dependence and withdrawal or major organ system damage. Since physicians are often consulted only late in the disease process, these cases contribute to the health care provider's stereotypical image of addiction. In its earlier stages the symptoms of addiction are primarily behavioral and psychological rather than physical. Thus diagnosis at an early stage, prior to the development of major losses and physical illness, continues to be a challenge. Timely identification, diagnosis and intervention may be career and life saving.
Symptoms of deterioration in a health professional's personal or professional life may include stress, anxiety, or depression that are often attributed to situational factors (e.g., relationships, finances and work). Chemical use frequently is not recognized as the causative or contributory agent in the development and maintenance of these life difficulties. As the disease progresses difficulties are seen in all aspects of life. Symptoms generally fall into the following categories: Compulsive Use, Personal & Cultural Destruction, Family Problems, Emotional Instability, Work Difficulties, and Health Problems as portrayed below.
Compulsive Use
Illogical, Irrational & Irresponsible Chemical Use
Lying, stealing, hiding use "Stockpiling" alcohol/drugs
Using before a social event
Using alone
Structuring life (especially social) around use
Inappropriate behaviors
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Personal & Cultural
Violation Of Own Values
Decreased involvement
Unreliability
Neglecting commitments
Socialization with other users
Unpredictable behavior
Embarrassing behavior
Leaving church affiliation
Criticizing clergy / religion
Personality Changes
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Family Structure
Marital or sexual problems
Extramarital affairs
Frequent arguments (may be violent)
Unexplained absences from home
Problems with children
Separations / divorce
Financial Problems
Withdrawal from family
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Emotional
Poor sleep, lethargy
Depression
Unexplained grief
Argumentative / edgy Explosive outbursts
Irritable
Anxiety, hyperactivity
Poor memory/ concentration
Isolation / withdrawal
Blaming -Accusing -Paranoid
Erratic behavior: shifting quickly between agitation, anxiety and paranoia to normal/pleasant behavior |
Work
Decrease in quality/efficiency
Tardiness, absences
Loss of interest in activities
Over-prescribing
Patient complaints
Conflicts with authority
Sloppy charting and dictation Rounds/ charting at odd hours
Unavailable when on call
Financial / Partnership Problems
Reduced attention to detail
Avoidance of colleagues: has few meaningful discussions and little eye contact |
Health
Frequent common infections
Self-prescribing
Uses meds for sleep, anxiety, etc...
Frequent vague illnesses
Gastrointestinal complaints
Hypertension, headaches (often migraine or cluster)
Withdrawal symptoms
Blackouts
Accidents and Injuries
Constricted pupils: opiates
Dilated pupils: stimulants, marijuana
Frequent flu-like symptoms: opiates
Seizures |
Chemical dependency among colleagues is a subject we avoid discussing/confronting. Yet, once identified and adequately treated, addiction does not impair the professional's competence and need not impact the professional's credibility or continued ability to practice medicine. Your accurate diagnosis and referral just may save a life as well as a career.
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