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)