Chemical Dependency Resources
Printer-Friendly Version

Self Test

National Council on Alcoholism and Drug Abuse (NCADA)

Ask yourself the following questions:
  1. Do you lose time from work due to drinking/drug use?
  2. Is drinking/drug use making your home life unhappy?
  3. Do you drink/use drugs because you are shy with other people?
  4. Is drinking/drug use affecting your reputation?
  5. Have you ever felt remorse after drinking/drug use?
  6. Have you gotten into financial trouble as a result of drinking/drug use?
  7. Do you turn to people you normally don't associate with when drinking/using drugs?
  8. Does your drinking/drug use make you careless of your family's welfare?
  9. Has your ambition decreased since drinking/drug use?
  10. Do you crave a drink/drug at a definite time daily?
  11. Do you want to drink/use drugs the next morning?
  12. Does your drinking/drug use cause you to have difficulty sleeping?
  13. Has your efficiency decreased since drinking/using drugs?
  14. Is drinking/drug use jeopardizing your job or business?
  15. Do you drink/use drugs to escape worries or troubles?
  16. Do you drink/use drugs alone?
  17. Have you ever had a memory loss as a result of drinking/drug use?
  18. Has a physician ever treated you for drinking/drug use?
  19. Do you drink/use drugs to build up your self-confidence?
  20. Have you ever been to a hospital or institution because of drinking/using drugs?

Scoring: If you answered "yes" to:

  • 1 of the questions, you may have an alcoholism/drug addiction problem.
  • 2 questions, chances are that you have an alcoholism/drug addiction problem.
  • 3 or more, you definitely have the disease of alcoholism/drug addiction.

If you think you may have a problem with alcohol or drugs, call National Council on Alcoholism and Drug Abuse (NCADA) at (314) 962-3456 and speak with one of their counselors. If treatment is recommended, be advised that the North Carolina Board of Nursing requires assessment and treatment through a participating treatment provider.

Warning Signs

Identifying Substance Use Disorders (National Council State Boards of Nursing)

Behavioral Signs:
  • Tends to administer more medications, always uses the maximal dose
  • Volunteers to give medications
  • Demonstrates patterns of excessive wastage and breakage
  • Increasing discrepancies in management of controlled substances
  • Complaints from patients reporting ineffectiveness of pain medication
  • Requests to work evenings, nights, week-ends when there is generally less activity and less supervision
  • Exhibits increased anxiety, sudden mood swings, inappropriate anger or crying
  • Demonstrates problems interacting with peers and supervisors
  • Exhibits forgetfulness or memory lapses
  • Makes frequent trips to the bathroom or has other unexplained absences
  • Demonstrates patterns of absenteeism, tardiness, and sick calls especially following days off
  • Sloppy or illogical documentation
Physical Signs:
  • Shakiness, tremors of the hands
  • Slurred speech
  • Falling asleep
  • Watery eyes, dilated or constricted pupils
  • Diaphoresis
  • Unsteady gait or staggering
  • Runny nose
  • Nausea, vomiting, diarrhea
  • Weight loss or gain
  • Change in dress or grooming – (i.e. Suddenly wears long sleeves/lab coats)

Suspected Impairment Checklist

Download the Suspected Impairment Evaluation Checklist to evaluate a possible impaired practitioner.

When to Refer

What to Consider

If a nurse’s performance is suggestive of a Substance Use Disorder consider the following information:

  • Review your facility’s policies and procedures before initiating action unless patients and/or staff are in imminent danger*
  • Use your facility chain of command in addressing the issue
  • If drug screening is requested, assure adherence to strict chain of custody protocols
  • Use the 5 W’s Test in organizing your thoughts
    • Who made the complaint? (i.e. Patient, Family, Peers, Colleagues)
    • What is the nature of the complaint? (Under medicating, Documentation discrepancies, Excessive wasting patterns, Impaired on duty)
    • Where is the location of the incident?
    • When did the event occur?
    • Why did the events occur? (Possible motivations, Causes)

Referrals should be made to the Board of Nursing when any one of the following situations arise:

  • Positive pre-employment drug screens
  • Positive results on a “for-cause” drug screen
  • Signs and symptoms of impairment including the smell of alcohol on the breath, regardless of whether or not the impairment is alleged to be as a result of the nurse’s own prescription meds
  • Reports of excessive use of controlled substances, increased wastage, sloppy or careless wasting, consistent failure to follow facility policies for wasting controlled substances, documentation discrepancies, manipulation of medication dispensing systems
  • Any time there is a violation of the Nursing Practice Act

When in doubt, you may call the Board at (919) 782-3211 ext. 271  for further consultation.

Last Changed 14-Sep-2021

North Carolina Board of Nursing

Protect the public by regulating the practice of nursing.

Copyright © 2022
North Carolina Board of Nursing
All rights reserved

Terms of Service Privacy Policy

Contact Information

(919) 782-3211
(919) 781-9461
8 a.m.-5 p.m., Mon-Fri
North Carolina Board of Nursing