Nearly 75 percent of all adult illicit drug users are employed, as are most binge and heavy alcohol users, meaning that users and addicts likely are in your midst.

So how do you know if someone is just a casual drug or alcohol user or if they’re heading for self destruction, and how do you help, especially if that person is in upper management or the C-suite?

Dr. David Sack, CEO of Promises Treatment Centers, which works with CEOs and other highly successful people who have become addicts, describes three progressive signs of abuse.

1. A highly motivated employee becomes less motivated and easily distracted.  He may miss appointments, spend more days out of the office, be  less prepared for meetings, fail to return emails and just seem to have a bit less of a grasp of the details of the business.
2. As someone’s drug or alchol use increases, he may become more emotionally unpredictable. Someone may be more irritable or swing from being exuberant one day to hostile the next.
3. Lastly, an addict tends to have more medical problems, some related to withdrawal symptoms. If someone drinks heavily on the weekends, and stops on Monday, they may have chest pain, their blood pressure may go up. “Often before an addiction is known, there’s a flurry of medical issues over a short period of time that are unexplained,” says Dr. Sack.