High-functioning addicts — a term attributed to people who have substance use disorders yet manage to maintain a job, support a family and sustain busy social lives — often perform well in the workplace while things start progressively spinning out of control in their personal lives.
According to the National Survey on Drug Use and Health, 9.5% of full-time workers aged 18 to 64 have abused alcohol or illicit drugs in the past year. This makes it likely that, at some point, you will work with someone who has a drug or drinking problem.
Certain Professions Make Addiction More Likely
Rates of addiction among the general population are estimated at 8% to 10%, while rates of addiction among physicians and other health care workers are somewhat higher. Medical professionals in clinical environments are at greater risk for addiction than others. For example, a 2014 study revealed that 10% to 14% of emergency department physicians will develop a problem with substance use at some point in their careers.
What accounts for the higher addiction rates among medical personnel? Typically a combination of high stress, high expectations, an attitude of self-reliance and invulnerability (i.e., “I know what I’m doing, so I can use this medication without becoming addicted to it”), and ready access to substances of abuse. Yet, these same characteristics are seen among professionals in other industries as well, particularly those with high levels of stress or trauma, such as law enforcement, first responders and the military.
Thrill-Seeking or Stress Management?
Many people who abuse substances, particularly professionals who hold positions of high authority or responsibility, aren’t typically thrill-seekers looking to get high. While some may be hoping to enhance their performance in high-pressure situations like the boardroom, surgery theatre or combat zone, many are simply overworked, overwhelmed and exhausted, and looking for some relief. A 2013 study conducted by researchers at the University of Florida’s Center for Addiction Research and Education found that nearly 70% of physicians who participated in their study cited stress and physical or emotional pain as their motivation for turning to prescription drugs.
Detecting Substance Abuse Early
Early detection of substance abuse is imperative in ensuring safety of work environments, of course, but early detection is also vital in ensuring that an addicted person receives treatment as soon as possible. If substance abuse continues unchecked, the rate or volume of abuse can escalate, making it more likely that the user will become functionally impaired, thus increasing safety risks at work.
Health care workers and those in other professions may continue abusing substances for long periods without detection because many work settings do not require random drug testing as a method of early detection. A lack of early detection measures can lead to escalation of drug use.
Signs of Substance Use Disorders
How can we recognize signs of addiction or substance abuse in work environments where there are no formal processes for early detection and intervention? It can be challenging to detect substance abuse in a high-functioning addict, particularly in a physician or other professional who knows how to hide the signs. It requires a bit more vigilance, but it is possible.
Eight ways to spot a high-functioning addict in a professional setting:
- Long sleeves. A tendency to wear long sleeves at work, even during warm seasons or where this formality is not required, may indicate a co-worker is trying to hide needle marks.
- Eye drops and breath fresheners. Use of eye drops before/during work hours (perhaps a special type that makes pupils appear normal), or use of breath mints and breath sprays at work may indicate that someone is trying to cover up on-the-job drinking or smoking of illicit drugs.
- Unexplained absences. It’s not unusual for people struggling with addiction to miss work, be late for appointments or meetings, or have more sick days. They may report multiple family “emergencies,” or a spouse or family member may call in sick for them. They may disappear unexpectedly during work hours or leave early for “meetings.”
- Alcohol overuse at social gatherings. Someone who is using prescription medications to relieve stress may also misuse alcohol for the same reason. At work-related parties or social functions with colleagues, a substance abuser may consume a high volume of drinks or may continue drinking long after everyone else has had enough.
- Changes in mood, behavior and/or appearance. Addiction to substances, whether to alcohol or a drug, can lead to changes in mood, attitude and behavior, as well as to physical changes and withdrawal symptoms. Has a colleague recently lost a lot of weight? Has their personality changed? A high-functioning addict may develop a bad attitude at work when they are hungover or have gone a few hours without using. If they have become psychologically or physically dependent on a substance, withdrawal symptoms may make them grouchy, short-tempered or more difficult to work with at certain times of day. Alternately, they may display hyperactive or manic behavior at certain times, and sluggish behavior at others.
- Medication shortages in a clinical setting. Like regular civilians who become addicted to medications, doctors, nurses, dentists, veterinarians and other health care professionals may obtain legitimate prescriptions for certain drugs, such as opioid painkillers. However, if/when they are unable to refill those prescriptions, they may begin accessing the medicine supply at the clinic or hospital. Be vigilant of medication supply shortages that occur despite recent order fulfillments.
- Distancing and isolation. If you notice that a colleague has disengaged or distanced themselves from the rest of the team at work, or that interactions have become strained, these can be signs that the addicted person’s problem has grown worse and they are having a hard time keeping things together.
- Inconsistent job performance. Take note if a worker who was previously a top performer or consistent producer starts making mistakes or displaying a more erratic job performance, with some good and bad days. These can be signs of escalating addiction.
Talking to a Colleague About Their Addiction
No one wants to get a friend or colleague into trouble or permanently damage their career. However, if you suspect a colleague of having a substance use disorder that is impacting their work (or patient safety), confronting them about it can be a good first step. An honest conversation lets them know their problem has become noticeable to others, and you are giving them a chance to seek professional help before a crisis occurs or they get reported to a higher authority.
Here are four things to consider when talking to a colleague about their addiction:
- A one-on-one, discreet approach may work best to avoid negative consequences. This is especially important if your colleague is a doctor and you work in a state that doesn’t have a state-run physician’s health program — currently, there are no active state PHPs in California, Nebraska and Wisconsin. Conduct some research before your one-on-one discussion so that you can inform your colleague of private treatment programs in the area that specialize in working with doctors and other high-level professionals. Some of these programs coordinate with licensing and regulatory boards to help mitigate disciplinary actions and ease re-entry to the workplace after treatment.
- Confrontation by a colleague may be the only way a professional in a high-ranking position is going to face their addiction and get help for it. High-functioning addicts rarely ask for help. Taking action to confront a colleague about their problem one-on-one — however daunting it may be — is like throwing them a lifeline. Your private intervention may be the one thing that leads them to treatment and recovery.
- Choose your timing. It is important to approach a colleague about their addiction at the appropriate time. In addition to speaking with them alone and in private, be sure to also approach them when they are not high, hungover or agitated. You want them to be able to focus on what you are saying and to synthesize the information when they are clear-headed. They may get defensive (denial and defensiveness go hand-in-hand with addiction) but, hopefully, they will respond with remorse over their behavior and see that they need professional help.
- Be calm and compassionate, yet firm. Make it clear that although it is up to them to recognize and admit that they have a problem, you can see that their addiction is impacting their work. Convey that you respect them and assure them you will keep things confidential, but they must get professional treatment. Don’t cave in to denials of a problem, negotiations for more time or alternative “self-help” treatment methods — all of these can result in delayed treatment, continued substance abuse and a crisis.
Approaching a colleague about their addiction can be daunting, but focus on the fact that your action may help them. If you can encourage them to enter addiction treatment, they will receive therapy and psychoeducational resources that help them manage the underlying issues that initially drove their addiction, such as stress, lack of support or healthy coping mechanisms, co-occurring mental health issues, and more.
Taking Steps to Help an Addicted Colleague
If an honest conversation with your colleague doesn’t go well or isn’t feasible, you may need to take the next step. In corporate work environments, employees who suspect a co-worker is using alcohol or other substances on the job can notify a manager or human resources director. The suspected employee will typically be summoned to a private meeting with their supervisor, who will discuss the problem and give them a warning about potential consequences. They may even encourage them to take a short leave of absence to undergo addiction treatment.
Employees in many work settings feel stymied by the thought of “snitching” on a colleague, because reporting the problem may cause them professional embarrassment or humiliation, and possibly, the loss of their job and livelihood. For professionals working in medical environments, things can be even more complex and the consequences more far-reaching.
Reporting a physician suspected of substance abuse could lead to the loss of their medical license. Thankfully, many state medical boards in the U.S. run addiction rehab programs just for physicians. Doctors in those states who are reported for substance abuse are diverted into these state-run rehab programs, or physician health programs (PCP). As long as they complete the state program and abide by the rules of the aftercare plan, they can usually avoid losing their medical license and suffering other punitive damages — though this is not always guaranteed. The good news is that many alumni of these programs return to work and achieve long-term remission of their addiction, with promising recovery rates of at least 78% for those who complete 60- to 90-day treatment and submit to post-treatment drug testing and monitoring.
Whatever intervention approach you choose, the best-case scenario is that you can avert a potential crisis and prompt your colleague to get proper treatment, enter recovery, retain their job, and return to work a healthier, happier person with new skills and support in place to help prevent relapse.
High-functioning addicts: Intervening before trouble hits. W Glauser. NCBI, NIH, March 2016. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3883816/
When the addict is a doctor. The trend against punitive measures runs into resistance when the addict could cause medical errors. Steven Ross Johnson. Modern Healthcare, May 2016.
Drug Abuse Among Doctors: Easy, Tempting, and Not Uncommon. Shelly Reese. MedScape, January 2014. http://www.medscape.com/viewarticle/819223
Location, location, location! The three most important factors in choosing a property to buy can also factor into choosing a rehab center for alcohol or drug addiction treatment, especially if the location will enhance your overall recovery experience.
Thanks to several films and television shows featuring Malibu, California, this coastal community — a playground of the rich and famous — has become a popular destination for people seeking luxury rehab treatment at a premier Malibu rehab center.
Malibu Rehab: A Beautiful Destination Plus Excellent Results
When choosing an addiction treatment center for yourself or a loved one, does the destination make a difference? Of course! But location is not the most important factor. Whether you are considering a Malibu rehab or other options, the most important factor is a successful outcome — effective treatment and psychosocial training in the tools needed to sustain lasting recovery. A beautiful location just enhances and enriches the process.
You’ll want to make sure the Malibu rehab center you choose uses research-driven, evidence-based treatments, and is staffed with trained and experienced care providers who guide and support you through programs that get great results. You’ll also want to make sure the facility offers thorough clinical assessment, a range of therapies, recovery approaches and relapse-prevention strategies that can be customized to your individual needs to support your recovery. Will an addiction counselor work with you to develop an individualized aftercare plan for you to use post-treatment? Does the rehab center accept your insurance, and/or will they work with you on some different payment options (especially if your preferred location isn’t fully covered by insurance)?
Once you can confidently tick off those boxes, consider the rehab center’s location and the amenities and highlights it has to offer.
Why Malibu? Spending time in a serene hillside retreat overlooking the ocean minimizes the temptation to leave your program early and head home as soon as the going gets rough. Rehab is never easy, but you are more likely to stick it out if you’re soothed by daily views of the sun setting over the Pacific, refreshed by dips in the swimming pool or Jacuzzi and revived by the salt air in the ocean breeze.
Famous for originating the Malibu Model of treatment, which tailors treatment to match each unique individual, clients of residential programs at Promises Malibu rehab enjoy gourmet meals and therapeutic activities in a comfortable upscale home setting. Daily schedules are varied to suit a range of client needs, but typically include individual and group counseling, physical exercise, experiential therapies, and sessions on addiction-related issues like shame resilience and relapse prevention, among others. Staff also organize mountain hikes and beach walks, and plenty of breaks for clients to enjoy a game of tennis on the private court or some quiet reflection in the surrounding gardens, free from the stressors of daily life.
Clients at Promises Malibu rehab build recovery skills by meeting with alumni who have successfully completed the treatment program. These meetings are alternated with off-campus trips to community 12-step meetings for additional recovery networking and support. Weekly scheduling also includes evening social activities like game night, and family visitation weekends to facilitate healing in family relationships.
Rehab Far From Home Keeps You Committed, Provides a Fresh Outlook
Choosing an addiction rehab center in a beautiful, tranquil setting outside your local area is a great opportunity for you to escape the triggers of your home turf and get out of your natural element. Receiving addiction treatment in a scenic location can also be a great way for you to gain new perspective, focus on the recovery process, enjoy some “me time” and prepare yourself to make a fresh start into a sober lifestyle. Many alumni describe their Malibu rehab experience as transformative.
“It was a very wonderful, comfortable and luxurious treatment center,” reports one program alumna. “The food was great and the grounds were beautiful. I loved my group sessions and the recovery support meetings. I also appreciated the freedom we got. I was blown away by my whole experience. Thank You!”
For those with food-related challenges or an eating disorder, the holidays are full of events that can trigger addictive thoughts and behaviors, and Halloween is one of them.
For a loved one who struggles with food issues, Halloween conjures up images not of ghosts and goblins, but of the tempting treats that will cross their path. They will be plagued with thoughts like: Should I buy candy to give out to the kids who are trick-or-treating in my neighborhood, or will having candy in the house inspire an eating binge? Should I avoid attending Halloween parties since sweets and goodies are likely to be offered and I won’t be able to resist?
Such thoughts can be anxiety-provoking and stressful, setting a negative tone for the entire holiday season. Depending on which type of eating disorder your loved one has, giving in to temptations during October — or even just being exposed to the temptations on display — may trigger feelings of shame and guilt that set off a pattern of uncontrolled binging, purging or starving that continues through Thanksgiving and the rest of the holidays like a rolling snowball.
Helping someone with an eating disorder and ensuring the holiday season is less stressful may require using a few tips to eliminate triggers that might disrupt their recovery plan and overwhelm them with an avalanche of obsessive thoughts and difficult emotions around food.
Tips for Supporting Your Loved One Who Has an Eating Disorder
If your loved one has received eating disorder treatment or participates in a 12-step support group for people with food issues, it is very likely their recovery plan includes getting extra support in certain environments.
“Holiday challenges with family and food can be a huge trigger for those struggling with an eating disorder or disordered eating,” says Shannon McQuaid, LMFT, LISAC, CDWF, CSAT, executive director at Promises Scottsdale. “Some general coping tips for those in recovery are to attend events with a supportive friend or family member who knows their struggles, discuss a plan before the event or schedule time before or after to attend a support group.”
You can support your loved one in these ways, and here are five additional tips to assist you in helping someone with an eating disorder:
#1 Ask your loved one which triggers they must avoid.
Because recovery plans for eating disorders are highly individualized, it can be tricky to know how to help your loved one avoid their particular set of triggers. If they are open about their eating issues and you are going to be hosting them at your house over the holidays or organizing a party or outing, it is OK to call them in advance to ask them what they need for support or if there is anything they must avoid to stay strong in recovery. Let them know you want to help them stay on their program. Knowing which triggers to steer clear of is key to helping someone with an eating disorder avoid relapsing.
#2 Organize a get-together that doesn’t revolve around food.
You can break with tradition by planning a holiday gathering that does not involve food or eating. You might organize a hike in a nearby park, a trip to the local ice-skating rink, or a group visit to a museum to see the latest exhibit. The focus of a gathering like this is on making connections with loved ones and enjoying your time together during a fun activity, rather than on gathering around a table to feast on indulgent foods. Meals can be extremely anxiety-provoking for people with eating disorders, so removing a meal from the equation by hosting a non-food event is likely to be appreciated by your loved one.
#3 Advance-plan for a holiday event at a restaurant.
If a holiday event must be held at a restaurant and your loved isn’t restricted from visiting restaurants as part of their recovery, there are some measures you can take to make things easier on them. Get the restaurant’s menu in advance and share it with everyone on your guest list, asking them to choose what they will order before you make the reservation to simplify the ordering process during the event. It may help your loved one if they know in advance what they will be eating and that the event won’t undermine their recovery with unexpected triggers.
#4 Circumvent difficult people or situations that may trigger relapse.
For many people with substance use disorders and eating disorders, triggers for relapse can include being around people they find difficult, or situations that have problematic dynamics for them — negative emotions can be triggers. Helping your loved one avoid the triggers for their eating disorder may involve not inviting the person who triggers them to visit your home at the same time — stagger your invites so you are able to see both relatives, but days apart. Likewise, if you know that visiting a relative’s house triggers your loved one’s disorder, visit that relative on your own and be understanding if your loved one chooses to decline the invitation.
#5 Make meals as “normal” as possible.
While some programs for people with disordered eating encourage abstinence from certain foods that serve as triggers, (i.e., sugar and flour), others do not encourage abstinence from any foods or food groups. Instead, they teach moderation, not elimination.
“To support someone you love with disordered eating or an eating disorder, it is important to not change and adjust the menu, eliminate foods or make the person feel guilt or shame, or as if they are being singled out,” says McQuaid. “I would suggest making the celebration as ‘normal’ as possible and empowering your loved one to have a support person available to call, if needed. You can facilitate this by finding out where a local Eating Disorders Anonymous (EDA) meeting is located, and get them there. The most significant help you can provide your loved one is making sure they don’t isolate after the event and that they have someone there with them to share and support their struggles.”
Types and Symptoms of Eating Disorders. National Eating Disorders Association (NEDA).
Eating Disorders. National Institutes of Health, National Institute of Mental Health. February 2016. https://www.nimh.nih.gov/health/topics/eating-disorders/index.shtml
Eating Disorders. MedlinePlus, U.S. National Library of Medicine, September 2017.
When you have a goal in mind, understanding what will help you achieve that goal is imperative. For example, cutting down on calories is one way to lose weight. But adding exercise to the game plan can help a person reach a weight loss goal more quickly, and seeing progress is highly motivating. The more tools you have, the greater the likelihood of continued success. In terms of addiction, recovery studies show that adding any or all of the following components to regular counseling and support group meetings will improve a person’s chances of reaching and holding on to a life of sobriety.
Enjoying life when things are going smoothly is simple, but when the rough times appear it can be so much harder to be contented. Yet whatever your circumstances and more significantly whoever you are, you can discover how to be happy even when you’re not.
Anyone who enters a men’s treatment center seeking help for schizophrenia faces an uphill battle. Schizophrenia turns order into chaos and leaves victims adrift at sea with no anchor in reality. This insidious condition disorders lives in every way imaginable and men who suffer from it have no idea what’s coming from one day to the next.
Fortunately, even uphill battles can be won, and men with schizophrenia can regain what they’ve lost and restore their psychological and emotional balance. It takes time and effort to defeat schizophrenia, but recovery is always possible.
Men and women experience substance abuse and mental health conditions differently, which is why many men’s treatment centers are opening around the country. Men’s treatment centers can provide specialized care for experiences that are unique to men and boys. Here’s what you need to know about how panic disorders affect men differently than women.
In today’s society, participating in sexual gratification is widely available and accepted. But when a man is compelled to continually give in to sexual impulses and to treat sex as a method of escaping from the stress of life, he may have a problem with sex addiction. Like other forms of addiction, sex addiction can be difficult to overcome without help.
Liver failure occurs whenever your liver loses at least some of its ability to perform its normal, life-sustaining functions. One of the well-recognized potential causes of this extremely serious condition is prolonged, heavy alcohol consumption. Once liver failure from alcohol intake or any other source sets in, you can’t recover the full health of the organ. However, if you quit drinking and damage hasn’t advanced past a certain point, your doctor may be able to limit progression of the condition and help you avoid the need for a liver transplant.
Eating disorders are a group of serious, potentially life-threatening mental health conditions normally associated with women. It’s true that women represent a large majority of those affected. However, a significant percentage of men also experience symptoms of eating disorders and require assistance in some type of men’s treatment center.
Does weight loss surgery lead to alcoholism? Researchers have found that one in five people who undergoes bariatric surgery for weight loss develops problems with alcohol dependency and abuse. In some cases, patients don’t show symptoms of alcoholism until years after their weight-loss surgery, but the research indicates that alcohol use disorders may be triggered or exacerbated by these procedures, particularly in people who are at high risk for alcohol abuse.
In one of the longest-running U.S. studies of adults receiving weight-loss surgeries, including Roux-en-Y gastric bypass (RYGB) and gastric banding procedures, scientists found that among the 2,000 patients studied over a seven-year post-surgery period, a significant number developed problems with alcohol. They found that more than 20% of RYGB patients developed an alcohol use disorder within five years of surgery, and roughly 11.3% of gastric banding patients developed these problems in that time period.
Anyone exposed to a highly traumatic situation with the potential to cause injury or death can develop diagnosable symptoms of the mental health condition called post-traumatic stress disorder, or PTSD. However, for a number of reasons, men have PTSD risks that differ from those found in women. In addition, men who develop the disorder can experience symptoms that differ from those found in their female counterparts. This fact makes a men’s treatment center a possible option for effective PTSD care for men.
If you have a loved one or colleague who has addictive behaviors or is abusing alcohol or other drugs, you are probably struggling with how to address their addiction. Like many others who have walked this road, you don’t know how to help the person seek treatment, or how to communicate your concerns without angering or alienating them.