Is your boss an alcoholic or an addict? I earn my living treating addicts and alcoholics who are successful business people, entrepreneurs and professionals. As the Clinical Director of the Dunes, a high-end rehab in the heart of the Hamptons with an Executive Treatment Program, I've seen my share of white collar addiction. As business leaders, my clients oftentimes employ a large number of people - in fact, they could even be your boss. And what have I learned from my experience in working with white collar addicts? And, further, what are some signs that you could look for to tell whether or not your boss might perhaps be an in-the-closet addict or alcoholic? What I've seen and heard from the front-lines of my work with white-collar addiction might shock some people. Indeed, many might find it difficult to believe that people that run hedge funds or run multi-million dollar businesses - or who perform surgery or fly airplanes, for that matter - can be full-blown drug addicts and alcoholics. Yet I've had clients from all of the above mentioned professions in my work treating addiction. That the two martini lunch from the "Mad Men" era has turned into the two and three Xanax lunch - or the two or three Vicodin lunch. Here's some of what I've discovered: That the two martini lunch from the "Mad Men" era has turned into the two and three Xanax lunch - or the two or three Vicodin lunch. Alcohol and pharmaceuticals can relieve the stress and take the edge off of an overworked person in a volatile and pressure-packed work place (think Wall Street offices); yet the pharmaceuticals of today - primarily opiates (pain pills) and benzodiazapenes (anti-anxiety meds) - can be taken much more discreetly than the lunch hour cocktails of an earlier era. Take one of my recent clients Paul (not his real name); Paul runs a successful hedge fund with 12 people working for him. By all outward appearances, he seemed to have it all: beautiful wife, plenty of money, new baby and a waterfront house in the Hamptons. But Paul is also an addict. He got hooked on pain pills five years ago while experimenting recreationally; today he has a raging pill problem, taking over 100 pills a day - that was not a typo - he would take over 100 pain pills a day! In order to understand that kind of pill usage, it's important to know that chronic pill users develop very high tolerance levels which then necessitate that they take higher and higher doses of their drug of choice in order to maintain the same effect. The average reader might understandably be asking themselves how someone who has such a raging pill problem can effectively function in the workplace - much less be in a leadership position. But we know that with people who abuse pain pills, often times it's very difficult to tell that they're under the influence; instead, the addiction is more evident when the addict is not under the influence and is instead going through withdrawal. Indeed, a pill addict will tell you that they take their drugs in order to stave off these unpleasant withdrawal symptoms that occur when the addict has stopped using their substance for several hours. These flu-like withdrawal symptoms can also lead to the more overt behavioral issues like irritability and volatility. As my hedge fund client Paul would tell me, his employees would notice a change in his appearance and behavior the days that he wasn't using (typically when his dealer was out of inventory) - and that's when he would become an office tyrant where his employees would try their best to avoid him and his wrath. What about your boss? How can you tell if he or she is an alcoholic or an addict? Let's look at Danny's boss (a composite of several of my clients). Danny's boss at his commodities office had always been very demanding, but lately he's been over the top: he had a recent angry outburst at an employee's desk where he knocked off a stack of papers in a rage; and last week, he became so angry at his assistant that his face turned beet red and he looked like he might need oxygen to compose himself. Yet at other times he seems almost sedated as he would often nod off at management meetings. He's also been disappearing for more and more vague out-of-the office "appointments," often leaving for hours at a time. And he's begun to look different as well; a beefy former college rugby player, Danny's boss was now noticeably thinner with his clothes hanging off of his much thinner frame. While many rumors swirled at work, the one question that everyone began asking is: is he a drug addict who's hiding his addiction? Many of us have had difficult bosses like Danny's - bosses who can be demeaning, belligerent or simply not very nice people. But how can you tell if your boss's "The Devil Wears Prada" behavior may, in fact, be signs of a closet addiction? Addiction is often typified by extreme mood swings, erratic behavior, unexplained disappearances and, oftentimes, deceit. In addition to those behavioral cues, there are often physical ones as well: a deteriorating physical appearance with a decreasing regard for physical hygiene; this change in physical appearance can be typified by a sudden loss of weight, puffiness or redness in the face and eyes; if opiates (i.e. Vicodin, Percocet, Oxycontin, etc.) are involved, then the eyes will be very constricted or "pinpoint" as well as the person oftentimes appearing to "nod out" while they're under the influence of the opiates. So the next time your boss acts in an erratic way, look for these tell-tale signs: Erratic Mood Swings Unexplained disappearances Change in physical appearance (i.e. weight loss; facial puffiness; red or pinpoint eyes) Deteriorating personal hygiene Deceitful behavior Falling asleep or nodding out What can you do if your boss is indeed a closet drug addict? Depending on what kind of relationship you have with them, you can suggest that they get help. If they seem receptive, you can even help them find a good clinician or treatment program. If you don't have that kind of relationship with your boss, you can alert Human Resources - while you may feel uncomfortable reporting your bosses problematic behavior, understand that addiction is a life and death issue and getting the addict help is of utmost importance. And if your addicted boss is unwilling to get help? It may not be a bad idea to start sending out your resume, because there are few things worse than working for a boss with an untreated drug problem as it will eventually adversely affect your emotional and even physical well-being as well. Dr. Nicholas Kardaras, Ph.D., LCSW is an addictions specialist and Clinical Director of the Dunes, a holistic mind-body rehab center in Easthampton, N.Y. He is also a clinical professor at Stony Brook University's Health Sciences Center where he teaches graduate level course-work on the treatment of addiction. He is a licensed NY State psychotherapist and a clinical consultant for LICADD (Long Island Council for Alcoholism and Drug Dependence) as well as being Adjunct Faculty at the Institute of Transpersonal Psychology in California. He is the author of "How Plato and Pythagoras Can Save Your Life" (Conari Press, 2011).