Unmasking the Shadows: Recognizing and Understanding the Signs of Substance Use Disorder

Are you struggling with substances?  

Or are you concerned about a healthcare partner who is struggling with substances?  

Here are some signs and symptoms to watch for.  Believe it or not, this is frequently seen in high-functioning and excellent nurses.  

Concerning signs include:

1. Increased work absences (alcohol use disorder)
2. Picking up overtime or showing up when not scheduled to work (opioid use disorder)
3. Frequent bathroom breaks or bathroom visits
4. Volunteering to administer pain medications to patients, typically narcotics
5. Suspicious drug log entries or cancellations
6. Drug discrepancies
7. Altered verbal or phone medical orders
8. Reports that patients do not have effective pain control
9. Heavy wastage of drugs
10. Underperformance
11. Wearing long sleeves when inappropriate
12. Personality changes or mood swings
13. Changes in appearance
14. Falling asleep during slower times
15. Shakiness
16. Practice errors

You are not alone. Here are some very helpful resources: 

1. Wisconsin Peer Alliance for Nurses (WisPAN): https://wipeeralliance.org/ wispan2021@gmail.com
2. National Suicide Prevention Lifeline: 988, 1-800-273-8255 https://suicidepreventionlifeline.org
3. AANA Peer Assistance: https://www.aana.com/membership/wellness-and-peer-assistance/peer-assistance/
4. International Doctors in Alcoholics Anonymous: https://www.idaa.org/
5. WI Pharmacy Recovery Network (WPRN): https://www.pswi.org/Resources/WI-Pharmacy-Recovery-Network-WPRN 
6. National Suicide Prevention Lifeline: 988, https://suicidepreventionlifeline.org
7. An Unlikely Addict: http://www.unlikelyaddict.com/ 
8. Re/entry, A Guide for Nurses dealing with Substance Use Disorder: re/entry a guide for nurses dealing with sud 
9. Impaired, A Nurse’s Story of Addiction and Recovery: Impaired, A Nurse’s Story of Addiction and Recovery 
10. American Nurses Association: http://www.nursingworld.org/ 
11. National Council of State Boards of Nursing (NCSBN) Alternative to Discipline Programs for SUD: 
    • https://www.ncsbn.org/alternative-to-discipline.htm
12. Health Professionals in Recovery Facebook Page https://www.facebook.com/groups/1461031774049631/
13. Minnesota Nursing Peer Support Network: https://www.npsnetwork-mn.org/ 
14. Women for Sobriety https://womenforsobriety.org/ 
15. Refuge Recovery https://www.refugerecovery.org/ 
16. Celebrate Recovery https://www.celebraterecovery.com/ 
17. SMART Recovery Forum for Medical & Mental Health Professionals in Recovery:
    • https://www.smartrecovery.org/community/forums/31-Medical-amp-Mental-Health-Professionals-in-Recovery
18. InTheRooms, a global recovery site offering virtual support meetings: https://www.intherooms.com/home/ 
19. Alcoholic Anonymous: https://aa.org and Narcotics Anonymous www.na.org 
20. Recovery 911 Online (all healthcare professionals welcome), Fridays at 8pm Eastern
    • Register here: https://us02web.zoom.us/meeting/register/tZckc-yvqT0qEtId0f82RPgBTn5XQHruFSgF
21. UC San Diego Healer Education Assessment and Referral (HEAR) Program
    • https://medschool.ucsd.edu/som/hear/Pages/default.aspx 
22. Organizations have compiled resources to help healthcare professionals cope with stress and improve resilience: 
    • American Medical Association: Managing Mental Health During COVID-19
    • Substance Abuse and Mental Health Services Administration (SAMHSA) Tips for Healthcare Professionals 
23. Second Victim Support: https://secondvictim.co.uk/ 
24. International Nurses Society on Addictions: https://intnsa.org/ 
25. Dr. Lorna Breen Foundation: https://drlornabreen.org