You Suspect Your Colleague Is Addicted—Do You Report or Support?

It starts subtly.

You notice your colleague — once confident, meticulous, and reliable — now seems distracted and inconsistent. They forget routine steps, arrive late, fumble through tasks, and sometimes appear dazed or overly alert. Their prescriptions start to raise questions. You chalk it up to exhaustion or stress.

But over time, your instincts begin to stir.
Something’s not right. You start to suspect addiction.

And suddenly, you’re faced with a brutal question:
Do you report them and potentially destroy their career? Or support them and risk patient safety?

This isn’t a theoretical exercise. It’s a real and painful dilemma many doctors and medical students may face.
In medicine, perfection is expected — and the notion that a peer could be silently battling substance use feels almost unthinkable. But it happens. More often than we care to admit.

This article dives into the medical, ethical, and emotional implications of suspecting addiction in a fellow healthcare professional — and why the path forward isn’t always a binary choice.

The Reality: Addiction Among Doctors Is More Common Than You Think

Substance use disorders (SUDs) among physicians are not rare — they are simply better hidden. Statistics consistently reveal sobering truths:

• Up to 15% of physicians will experience substance misuse during their career.
  
  
• Certain specialties — including anesthesiology, emergency medicine, and surgery — have higher risk due to access to controlled substances and high-stress environments.
  
  
• Shame, fear of disciplinary action, and the culture of invulnerability in medicine make doctors less likely to seek help.
  
  
• Many continue practicing undetected, often for years.

Beneath the layers of competence and professionalism, many doctors are quietly suffering. Addiction is not a moral failure. It is a disease — one that can affect even the most skilled clinicians.

Signs Your Colleague May Be Struggling

You don’t need definitive proof to take responsible action. But awareness of patterns can guide your judgment. Look for subtle and consistent indicators:

• Repeated lateness, cancellations, or unexplained absences
  
  
• Rapid mood changes, irritability, or withdrawal from colleagues
  
  
• Slurred speech, unsteady movements, or disoriented behavior
  
  
• Periods of unusual energy followed by fatigue
  
  
• Discrepancies in narcotic counts or frequent time in medication areas
  
  
• Increased secrecy or paranoia about being watched
  
  
• A decline in personal appearance or hygiene

One incident might be excusable. But when concerning behaviors cluster and persist, it’s time to act.

Why Most Doctors Stay Silent — And Why It’s Dangerous

Even with red flags waving, many professionals choose silence. The reasons are understandable:

• “I might be wrong and ruin a life.”
  
  
• “We’re friends — I don’t want to betray them.”
  
  
• “Maybe they’re just overworked, like all of us.”
  
  
• “Reporting could destroy their career or reputation.”
  
  
• “Nothing will happen anyway — the system will protect them.”

However, the consequences of inaction can be catastrophic:

• Patients may suffer avoidable harm.
  
  
• The impaired physician might overdose, crash, or deteriorate further.
  
  
• Legal liabilities can extend to bystanders who failed to intervene.
  
  
• You may carry guilt for years to come if something goes wrong.

Remaining silent is a decision — one with ethical weight and moral cost. Sometimes, doing the uncomfortable thing is the right thing.

Support vs. Report: It’s Not an Either/Or

This is where the complexity lies. Supporting and reporting are not opposites — they can, and should, coexist.

Reporting, when done ethically, is a powerful form of support.

Supporting doesn’t mean covering up. It means advocating for your colleague’s right to treatment, dignity, and recovery. Reporting, on the other hand, ensures that patients are protected and that appropriate systems are engaged.

Supporting involves:

• Encouraging your colleague to seek help
  
  
• Connecting them to physician health programs or counseling
  
  
• Ensuring their confidentiality and emotional safety
  
  
• Preserving professional respect, even in crisis

Reporting involves:

• Following institutional protocols
  
  
• Providing objective, fact-based observations
  
  
• Avoiding gossip or emotional accusations
  
  
• Putting patient safety and clinical standards first

Done correctly, both paths can work in tandem to help — not harm — your colleague.

What You Should NEVER Do

No matter your intentions, certain actions can cause irreparable damage:

• Don’t confront them in anger or in public spaces.
  
  
• Don’t dismiss troubling signs just because you’re close.
  
  
• Don’t falsify, ignore, or hide mistakes made under their care.
  
  
• Don’t involve others informally — this isn’t for gossip.
  
  
• Don’t try to treat or counsel them yourself.

Remember, addiction is a medical condition — not a weakness or choice. It requires professional, structured care, not impromptu interventions from well-meaning colleagues.

Steps You Can Take If You Suspect Addiction

Taking action doesn’t mean leaping into accusations. A thoughtful, clinical approach protects everyone involved.

Step 1: Document Objectively
Record what you observe — dates, times, behaviors. Avoid speculation or diagnoses. Stick to what you can see or verify.

Step 2: Review Institutional Policy
Most hospitals or medical schools have clear (and often confidential) reporting mechanisms. Learn them. Understanding the protocol is essential before making your move.

Step 3: Report Through Trusted Channels
Choose the appropriate person — such as a department head, medical director, or well-being officer. Frame your concern clinically:

“I’ve noticed some behaviors that worry me regarding a colleague’s performance and health. I want to make sure this is addressed in a way that’s safe for everyone.”

Step 4: Accept the Limitations of Confidentiality
You may not be updated on the outcome. Respect that. What matters is that the right people are now involved.

How Physician Health Programs Can Help

Physician Health Programs (PHPs) exist to offer care, not condemnation. In many countries, these confidential services specialize in helping healthcare professionals recover and return safely to work.

These programs often include:

• Thorough assessments
  
  
• Personalized treatment plans
  
  
• Supervised rehabilitation
  
  
• Structured monitoring post-treatment
  
  
• Return-to-practice strategies

Doctors who enter PHPs early often have high success and low relapse rates. Your referral could be the moment that saves a career — and a life.

What If You’re Wrong? The Fear of False Accusation

This is a legitimate fear — and one reason many stay silent. But here’s the safeguard:

You are not diagnosing. You are reporting observable behavior.

You are not punishing. You are initiating professional review.

A responsible system will assess your concern objectively:

• If the colleague is fine, nothing will happen.
  
  
• If they need help, intervention may prevent disaster.

It’s better to be mistaken with good intent than to be silently right after harm is done.

Protecting Yourself in the Process

Suspecting addiction in a colleague can be emotionally exhausting. You might feel anxious, isolated, or guilty. You may fear retaliation or backlash.

To protect your well-being:

• Reach out to trusted mentors or wellness officers.
  
  
• Keep a personal record of your steps and conversations.
  
  
• Speak to a counselor or peer support professional if needed.
  
  
• Maintain professionalism at every stage.

You’re not alone — and you’re not the villain. You’re taking responsibility for safety and care.

Final Thoughts: True Support Is Sometimes Uncomfortable

Addiction is an illness — not a scandal. And doctors are not immune.

If your colleague were bleeding, you’d stop it. If they collapsed, you’d intervene. So why not act when the emergency is hidden, but just as life-threatening?

Support means action — not avoidance.

Reporting is not betrayal — it’s a form of care.

This dilemma isn’t easy. But you’re not powerless. What you do, how you do it, and when you choose to step in can change the trajectory of your colleague’s life — and the lives of their patients.

So the question isn't just, “Do I report or support?”
It's:
“Can I live with the outcome of doing nothing?”