Substance Abuse

Chemical Dependence

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American Society

for the

Prevention of Suicide:


Anesthetists in Recovery



Recovering Health Care Professional Support Forum

Signs and Symptoms of Substance Misuse Disorder In the Anesthesia Provider

The only ACTUAL pathological sign is witnessed self-administration of unprescribed or illicit drugs. There is NO explanation for that activity other than one requiring treatment as soon as possiblel

Denial is considered the primary sign and symptom of this disease, and is universal to the addict, friends, colleagues, family and faculty. Symptoms generally appear first in the community, then the family and finally at work. Addicted physicians as well as other health care professionals, feel that as long as they can do their job, they do not have a problem.

Symptoms of opioid addiction in the hospital (anesthesiologists, nurse anesthetists, and anesthesia assistants)

1. Unusual changes in behavior -- wide mood swings, periods of depression, anger and irritability alternating with periods of euphoria

2. Sign-out increasing quantities of narcotics and frequent breakage of narcotic vials

3. Inappropriately high doses for procedure being performed

4. Increasingly sloppy and unreadable charting

5. Desire to work alone

6. refuse lunch relief or breaks

7. frequently relieve others

8. volunteer for extra cases (especially cardiac, where narcotics are being used in  large quantities)

9. volunteer for extra call, come in early and leave late

10. at the hospital when off duty to stay near supply

11. frequent bathroom breaks

12. difficult to find between cases, often napping after using or unexplained absences

13. desire to administer narcotics personally in postanesthesia care unit

14. patients’ pain out of proportion to narcotic record

15. wear long-sleeved gowns to hide needle marks and stay warm

16. pinpoint pupils

17. signs and symptoms of withdrawal, especially diaphoresis, tremors, mydriasis,  rhinorrhea, myalgias, nausea and vomiting

18. weight loss and pale skin

19. undetected addicts found comatose

20. untreated addicts are found dead

21. quality of care issues -- malpractice, behind on charts

Signs found outside the hospital (all health care professionals)

1. Unusual changes in behavior (wide mood swings with depression, anger and irritability, alternating with euphoria)

2. Loneliness and isolation; addicts quickly withdraw from family, friends and leisure activity

3. Denial is the primary symptom of addiction. When confronted by a spouse, the addict may become defensive and vehemently reject accusations. They usually are very successful at being manipulative when confronted one-on-one.

4. Increase in domestic problems, fights, and arguments

5. Those addicted to hospital drugs spend increasing amount of time at hospital. Alcoholics exhibit frequent absenteeism

6. Unexplained overspending, extramarital affairs, legal or work problems (especially  DUI)

7. Decreased sexual drive

8. Pills, syringes and alcohol bottles found around the house

9. Bloody swabs or tissues

10. Locking self in bathroom

11. Frequent smell of alcohol on breath (Alcohol alleviates withdrawal symptoms in narcotic addiction as well as most other anesthetic drugs)

12. Pinpoint pupils

13. Withdrawal signs and symptoms (especially sweating and tremors)

14. Deterioration in personal appearance and physical health, especially weight loss

15. Frequent accidents

16. Numerous health complaints, with tendency for self-medication

17. Undetected addicts are found comatose or dead.

The more potent the drug being misused, the more rapid will be the clinician's deterioration!

Ignoring these signs and symptoms is unethical, unprofessional, and inhuman! (Not to mention, unacceptable!)