Picture an addict, and you'll probably think of someone out of The Wire, complete with droopy eyes, ruined relationships and criminal tendencies. But according to Dr. J. Wesley Boyd, a psychiatrist who teaches at Harvard Medical School, there's a whole other class of users, which he terms "almost addicted," and they might be working at your company.

This group of substance abusers is the subject of a new book called Almost Addicted that Dr. Boyd co-authored with Eric Metcalf. Who are the almost addicted? "There are people who can use drugs intermittently and not have any problems. But there is a range between that drug use and drug use that rises to the level of addiction. It's that in between range we're calling almost addicted," he explained to Inc.com in an interview.

Is My Colleague Almost Addicted?

These folks aren't at the stage of petty thievery and broken homes, and many of them are holding down jobs, even high-pressure, high-profile ones. "I've seen this in law firms, in hospitals and in high-level executives suites," says Dr. Boyd. But even though these almost addicts are only starting to slip towards full-blown addiction, there are still warning signs of trouble that colleagues or managers might notice.

"It's almost never the case that someone's walking out of a break room with a needle stuck in his or her arm. Overt signs are fairly rare," according to Dr. Boyd. Instead, he offers these more subtle warning signs but stresses they are general red flags and might also indicate depression or other personal problems:

  • Worsening personal hygiene, being disheveled
  • Slurring speech
  • Somnolence (that's drowsiness for the non-medical among us)
  • Being moody or irritable than usual
  • Unexplained weight loss or weight gain
  • Spending time behind locked doors
  • An alteration in the quality of work
  • Asking for less work or special consideration much more than usual for unexplained reasons

Unexplained absences are a particularly serious sign. "When people are functioning at a high level in business and in the professions, they have jumped through so many hoops to get where they are that if there's a change along those lines, that all by itself can be something of concern," says Dr. Boyd.

What Should I Do About It?

So if you notice an employee displaying some of these danger signs, how should you proceed? "If the person is a valued team member and you want to see them succeed, open a dialogue with the person, stick to the facts and try to refrain from jumping to any conclusions based on those facts," suggests Dr. Boyd.

"Don't say: 'Three of us are worried you have an alcohol problem.' Instead, say: 'For the first time in a decade you called out from work on four different occasions, you've left work early this many times, there's one meeting you missed and that's uncharacteristic of you, and one person wondered if they smelled alcohol on your breath,'" he elaborates.

Maybe after this conversation your employee will be jolted into action and will clean up his or her act. "Sometimes even the initial discussion is enough to shake people up and say, 'this is a lot bigger than I thought if it is presenting itself in the workplace,'" Dr Boyd says, but he also warns business owners that a positive response is far from universal: "Denial is something that is endemic in drug use, so it's the norm not the exception."

If your almost addicted team member continues to struggle, "managers have every right to insist on somebody being evaluated," says Dr. Boyd. "I would say: 'I want to make sure you visit your primary care doctor.' That's often a very good starting place. There's often a lot less stigma there than going to a psychiatrist or an addiction specialist. Insist that the boss get a report from the evaluator with a list of suggestions."

Interested in more details on how to deal with the almost addicted? Check out Dr. Boyd's new book