Common Warning Signs of a Substance Use Disorder

Attitude/Behavior Changes


  • Rapidly turns from compassionate and caring to abrupt and caustic
  • Withdraws from friends and activities
  • Becomes mistrusting, anxious, depressed, irritable

Physical Changes


  • Loss of appetite or reduced level of exercise
  • Looks tired; admits to insomnia
  • Deterioration of personal hygiene
  • Physical problems are self-treated
  • Smell of alcohol on breath while on duty
  • Euphoria or somnolence without cause
  • Red or glassy eyes

Performance Changes


  • Misses appointments
  • Makes rounds at unusual hours
  • Cannot be reached when on call
  • Sloppy charting
  • Late to work/leaves early
  • Frequent absences
  • Missing medications/frequent wasting of medications