Signs and Symptoms of Drug Abuse among Nurses

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Drug abuse among nurses is a growing problem in the medical field. According to the National Institutes of Health, in 2025, roughly 9%-10% of nurses in the United States had a substance use disorder, with another 18% reporting risky substance use behaviors.

A recent survey of nurses found that 29% used opioids, 25.5% used alcohol and 36% reported the use of more than one substance.  Although each nurse has their own reasons for substance use, the high-stakes nature of the job, emotional exhaustion and high-stress environment contribute to many of these nurses turning to self-medicating as a way to cope.

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How to Recognize the Signs of Drug Abuse Among Nurses

Nurses are a population that is at risk for substance abuse just as much as any other, or possibly more.

According to an article published by the US National Library of Medicine, exposure to a variety of drugs, easy access, high stress levels, unusual hours and a fast-paced working environment make nurses a vulnerable population when it comes to substance abuse.

Fortunately, recognizing the common warning signs of substance misuse in nurses can make all the difference in preventing a serious or even life-threatening situation. Being aware of these behaviors allows colleagues and supervisors to step in early and offer support. Some of the key signs and symptoms of drug abuse in nurses include:

• Preference for working alone- while not a constant indication, working alone provides safety from getting caught when taking drugs or alcohol.
• Frequent use of medicinal mouthwash – the smell of mouthwash, alcohol or other masking substances such as perfumes.
• Arriving early or agreeing to work after a scheduled shift – this behavior is sometimes used to obtain drugs.
• Picking up extra shifts or volunteering for isolated shifts-  overtime increases access to drugs.
• Frequent trips to the bathroom or other isolated areas.
• Evidence such as syringes, needles or bloody tissues in lab coats, lockers, bathrooms, changing rooms or call rooms.
• Unexplained small cuts or bruising on hands, feet and arms, usually with elaborate explanations.
• Unusual memory lapses in conversations or shift change report.
• Lapses in charting, record keeping, orders and timekeeping activities.
• Mood swings with patients, irritable and complaining about a patient one minute and happy the next or drastic changes in mood after a break or period of isolation.
• Preferring long sleeves or long lab coats, not removing coats or rolling up sleeves in warm conditions.
• Choosing to work with little or no supervision and becoming angry or upset when help or supervision is present.
• Volunteering to lock, unlock or take charge of the med closet or storage area.
• Frequent mistakes in reporting, administering or requesting medications, patients who have had pain medication administered may complain of excessive amounts of pain or of narcotics not working after receiving them.

Although many of these signs are not specific to just medical professionals, these signs occur more frequently in a health care setting.

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Classic Signs and Symptoms of Drug Abuse

These signs of substance abuse are grouped into physical, psychological and social symptoms.

The classic signs of drug abuse include, but are not limited to:

• Physical Symptoms:
  • Multiple health issues, neglected appearance, decreased coordination, increased heart rate and blood pressure, dry mouth, red eyes, insomnia or hypersomnolence, chronic nasal drip, increased or decreased appetite, hallucinations, memory loss, shaking, sweating, nausea and vomiting.
• Psychological Symptoms:
  • Abandoning previously enjoyed activities, restlessness, insomnia, neglecting responsibilities, isolationism, impaired judgment, hallucinations, rapid mood changes and panic attacks, especially when the drug of choice is not available.
• Social Symptoms:
  • Tardiness and absences from work, suspicious behavior such as sneaking around and frequent whispered conversations, excessive partying, disintegration of friendships and relationships, neglecting responsibilities, risk-taking behaviors like high-risk sex, driving while intoxicated and legal issues.

Personal Symptoms of Drug Abuse

When an individual is using drugs, he or she might notice changes in themselves. These changes are good indicators that substance use is becoming a problem.

• Life becomes about the drugs, how to acquire them, when to use them and how to hide them.
• Drug use becomes about avoiding the negative symptoms of withdrawal.
• Drug use continues despite negative consequences such as legal troubles, job loss, workplace impairment and loss of relationships or family ties.
• Abandoning the once enjoyable things, such as hobbies and sports.
• Loss of control and feelings of powerlessness when it comes to using the drugs.
• Drug tolerance and increased usage.

If you experience these symptoms, it may be time to seek treatment for drug addiction.

Nurses are not immune to Drug Addiction

The signs and symptoms of drug abuse among nurses can be easy to miss, often blending into the demands and stress of a fast-paced medical environment. Long hours, high-pressure situations and constant access to medications make nurses especially vulnerable, while also masking behaviors that might otherwise raise concern. What looks like fatigue, distraction or routine stress could be something more serious.

That’s why it’s critical to stay alert and informed. Recognizing the warning signs early can protect not only the health and well-being of the nurse but also the safety of their patients.  If you notice patterns that don’t feel right, don’t ignore them. Speak up, reach out and take action. Early intervention can save careers, and more importantly, lives.

If you recognize drug abuse in yourself or a friend call 800-934-1582(Sponsored) toll free to find help today.

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