my coworker sounds drunk on work calls

by Alison Green on March 17, 2021

A reader writes:

One of my coworkers is an older woman who lives alone. She could be a bit difficult before the pandemic because she gets very intense about her work, but during the pandemic she’s seemed markedly different.

Lately it’s become apparent that she is impaired at times during the work day. She slurs her words, confuses names, and goes on tangents about irrelevant material. It could be a medication issue of some kind, but what it sounds like is drunkenness.

This has happened on calls with our supervisors and in front of clients, which has been mortifying for us all, not to mention how mortified we feel on her behalf. These calls tend to be long so it can feel like watching a horror movie for two or three hours.

The day after one of these incidents, she doesn’t appear to notice anything was off about her behavior.

I think the clients have just been really confused, but it’s really only a matter of time before the supervisors catch on.

We’re worried that if we go to HR or to our boss, she may be fired or disciplined, when what she really seems to need is help. Work appears to be the main thing she has going in her life and it would be really destabilizing for her if our intervention, however well-intended, took that anchor away.

But if we approach her directly about our concerns for her and it turns out to be a medication issue, it would be terribly embarrassing for her to know that a number of her coworkers think she’s been drunk on the clock.

Is there some third option? Or am I overthinking the other two? I’ve been so trained to be suspicious of HR in general.

Ugh, this is tough.

It’s so odd that this has happened with managers on the calls and they haven’t said anything! Ideally one of them would have said something in the moment like,”Jane, are you doing okay? We can do this another time if you need to.” Or they could have ended the call and talked to her privately immediately afterwards.

In theory, there might be some types of calls where you or another peer could do that too.

But personally I would approach her privately and ask if everything is all right, say she sounded like she was slurring her words, etc. You don’t have to say “you sounded drunk” — just express concern. If it’s a medication issue, it’s good for her to know what’s happening because she may not realize it or may not realize that it’s noticeable to other people. And if it’s drunkenness … well, it’s good for her to know people are picking up on it. What she does with that information is up to her. Either way, I think it’s a kindness to let her know.

Don’t get too hung up on the idea that if it’s not alcohol-related, she’ll be embarrassed to know her coworkers have thought she’s been drunk this whole time. First, you don’t need to say it’s been going on for a while; it’s okay to just talk about what you’ve noticed recently. But more importantly, in the long run it’s much more embarrassing for her if no one says anything and it keeps happening. And more importantly than that, embarrassment aside, the potential consequences of no one saying anything could be really high — losing her job, yes, but also maybe a serious health issue going unidentified and untreated.

If none of that works, then you’re right that talking to a manager or HR would be the next step. But if you’re concerned that would do more harm than good, it’s also okay to decide that at that point you’ve done what you can and don’t have the power to do much more.

Read an update to this letter here. 

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{ 192 comments }

{ 192 comments… read them below }

  1. Mental Lentil*

    Impaired is the key word here. There are a lot of medical conditions that can make you appear drunk. I wouldn’t focus on the alcohol aspect unless you’ve seen here drinking on screen.

    Do reach out to her out of concern for personal well-being. It would be a kindness, especially if she is having a medical issue which is or could be life-threatening.

    1. London Lass*

      Absolutely. I can think of a couple of people I know with invisible medical conditions that can cause symptoms like this if they have an episode. I would assume nothing without further information.

      1. JJ*

        I start to slur and become flighty/forgetful when I’m overtired and overworked…general pandemic stress compounds it. I think it’s definitely possible she has some condition that’s under control in normal times and just exacerbated now.

        1. Cj*

          Yes, migraines do it for me. I can slur my words, and very often can’t think of the word I’m looking for, even it is a common one I would never forget otherwise.

      3. David*

        I was going to say… this could be anything from migraines, to insomnia, to mini-strokes.

        Don’t assume it’s something to do with substance abuse of any kind, and don’t assume she’s aware of it at all.

        It might cost her life if you don’t bring it to her attention.

    2. Abogado Avocado*

      Agree! I would add that her impairment may be such that she does not know how she’s coming across, particularly if symptoms come and go (based on medication levels), etc. You would do her a significant kindness by inquiring.

      Additionally, if you are not sure how to approach her, think of how you would want a coworker to raise this with you if you were in her shoes.

      Please let us know how this turns out.

      1. Amaranth*

        Aside from the condition of the coworker, if OP says something to the employee only, could it bite back at OP if it becomes more of a problem and it they didn’t bring it up at least to their manager? Is this a case where they should talk to the employee then if it happens again talk to management?

    3. Amber Rose*

      Yes! My parents lost friends when I was younger because they thought my dad was drunk all the time. Turned out to be MS, which can cause that kind of symptoms (slurring, confusion, etc.) Impairment can be a sign of more things than just alcohol.

      1. Anon and on an on*

        Don’t know if you remember Laverne and Shirley, but Squiggy, David Lander had MS, but his career stalled because most people thought he had a drinking problem.

    4. AKchic*

      This is what I was coming to say.
      Whether this is a medication, substance issue, or a medical condition (that she may or may not be aware of); this is something that does need to be addressed. I would bring it up privately as a kindness first, unless something happens that is so egregious that it can’t be ignored (i.e., she insults a client).

      I would also cover my bases and document the conversation and note that you had it with your manager, or at least one other coworker who knows what’s going on. Anyone, really. And cc your *personal* email so there’s an outside copy of your documentation.

      Do I think that HR/management should be aware? Yes, but no. Yes in the context that this could be a medical condition and they need to have some awareness that an employee is displaying possible symptoms that could be hurting the employee if the employee isn’t aware of the symptoms. No in the context that if this is a medical condition that HR/management is already aware of and she has asked for privacy so HR/management hasn’t said anything to the staff, then they are abiding by her request. (ugh, such a fine line there, y’know?)

        1. DinoGirl*

          As HR, I disagree. But it depends on your HR reps. Some are better than others, like every thing. HR could have a sensitive conversation to alert them to the issue, if it’s medical, then they’ll know, and HR can provide resources, like leave options, EAP, etc.
          This is a real issue particularly during the pandemic, people are struggling with the routine changes and increased solitude.

          Second the note that neuro conditions can do this. My MIL was often mistaken for drunk.

    5. SheLooksFamiliar*

      Thank you for pointing this out. Sometimes people don’t respond well to new or adjusted medications, or they have an undiagnosed health concern. One of my colleagues was suffering from undiagnosed mini-strokes; you could say she sounded ‘drunk’ but our first concern was something else going on.

      1. Loredena Frisealach*

        This! My grandmother had many mini strokes before we even realized there was a problem, and by then the impairment was extreme and permanent. It’s the first thing I thought of as a result, and it would be a kindness to her to give her the nudge to see her doctor if she hasn’t realized.

      2. Aspiring Chicken Lady*

        I once worked with a woman who had been a medical transcriptionist. She was doing simultaneous transcription for a doctor elsewhere in the building. She noted a sudden change in his speech and was able to alert others to get to him — he was was having a stroke while dictating.

        Not quite the same situation, but a pretty impressive story.

      3. M. Albertine*

        Oh yes, I had a co-worker who had displayed a change in her behavior and it turned out that she had been having strokes. She was able to bring those concerns to her doctor and get a diagnosis in time to be treated.

        1. SimonTheGreyWarden*

          My dad had this happening…he is an alcoholic so it was harder and we did think it was the drinking, but actually he had a serious kidney infection.

    6. Joan Rivers*

      It’s not unkind to record her to play back later if needed. If she denies there’s a problem, and denial is common if it’s a drinking issue, that would make it clear.
      Or if it’s a med or health issue, and she seems unaware or in denial, you can help her w/that too.

      It’s also not unkind to want clients never to see this.

      What’s unkind is to ignore someone who seems to have a problem.

      1. joss*

        Just a warning about recording her. You better be sure that recording is legal in your state or doing this could get you in big trouble even if you are doing it out of kindness

      2. NerdyKris*

        I would not advise doing that at work without the explicit permission of HR. Recording your coworkers without their consent is crossing some pretty major boundaries, even if you think it’s for the best. It’s a good suggestion when dealing with a substance abuse problem in a personal relationship, but as a coworker it might be too much of a privacy issue.

      3. Firecat*

        I would not be happy to be recorded by a coworker just to show how bad I sound. WTF? Just be kind and speak up. Don’t gather documentation for peets sake!

        1. Amaranth*

          Agreed, it feels a little creepy to find out someone was recording you when you were unaware, even if you have good intentions.

      4. Dr Rat*

        Umm….where I work, recording anyone without explicit consent of management AND the person being recorded is grounds for instant termination for cause. And they mean it and will follow through with it! In addition, 11 states in the US are two party consent states where recording someone without their consent is illegal. I’m sure you mean well, but your advice could get the OP sued and/or fired.

        1. Stays in my lane*

          Recording her would be insanely creepy and I can’t imagine her appreciating it, under any circumstances. Nor do I think the HR department would appreciate it. I guess it would prove OP’s point, if that is what is important to them.

          Frankly, if the managers have been sitting in on some of these meetings where the slurring occurred, I’m sure they’ve noticed if it is so obvious. For all OP knows, the managers have discussed this with the slurring coworker and are aware of a medical condition that the coworker wants kept private. OP needs to mind their own business.

    7. Malarkey01*

      I slur with my migraines, and with WFH I have jumped on a few critical conference calls when sick that I wouldn’t have attended in the office (because I have light sensitivity with mine I can’t sit in an office with a migraine or drive with one but at home can darken a room and attend a 30 minute meeting). I only know about the slurring because family members told me, I think I sound fine.
      (Adding that my slurring is medically okay and not the sign of a more serious condition)

      1. Miss V*

        My migraines can not only cause slurred speech but also aphasia. As well as clumsiness (because I have dark spots or auras affecting my vision as well as a lack of depth perception.) I’m fully aware of how this may look to others and I’ve had conversations with my manager so she’s aware of that it’s a possibility. But if I didn’t know I could absolutely imagine thinking that I just need to push through this meeting and then I can lie down without realizing how it looks to others.

      2. Cj*

        I was on the phone with a sales person (not related to work) and was actually slurring my words so badly that they thought I was having stroke and asked if I wanted them to call 911 for me. I probably realized I didn’t sound exactly like my usual self, but had no idea how bad it was.

        Like you, I often think I sound fine, and it I speak to my husband while at work and am having this problem, he’ll tell me to e-mail, text or message co-workers and clients instead of speaking to them as much as possible, so they don’t think I’ve been drinking. Co-workers I deal with frequently do know this happens and why, and if they notice it they will also say I shouldn’t be talking to clients until I’m feeling better.

    8. Anne*

      Even a blood surgar thing or neurological condition, which means its probably prudent to mention it.

      1. Quoth the Raven*

        That’s my sister. If her blood sugar gets too low, she sounds and looks like she’s really drunk, and she doesn’t really notice it.

      2. une autre Cassandra*

        I was going to say this could be diabetes related. Whatever it is, everyone is correct that mentioning it privately, directly and sensitively, is the best first step. I hope she’s OK.

    9. Just Here for the Free Lunch*

      Yes definitely. I had a coworker whose behavior changed over time. Most people assumed that she had a substance abuse issue or untreated depression. Turns out it was a brain tumor. It was heartbreaking.

    10. agnes*

      True. A woman in our office was slurring her words and turned out she had severe diabetes and almost had an aneurysm. Apparently slurred speech is a symptom.

      1. Chauncy Gardener*

        A friend was slurring her words quite a lot and it turned out to be that she had really severe sleep apnea and was SO tired! Once she got that machine she’s been a different person!

        1. Sacred Ground*

          I was just about to chime in that lack of sleep or poor sleeping over time can absolutely cause what OP describes.

    11. The Starsong Princess*

      Reminds of of someone in my previous department. She was making a lot of mistakes and smelt of alcohol. Her boss finally went to HR about it. Apparently, if someone is suspected of drinking on the job, HR will ask them to take a breathalyzer. They can refuse but then things become more difficult. Anyway, she took the breathalyzer and had no alcohol in her system as well she knew. They finally figured out that the alcohol smell came from wine scented hand cream and the mistakes because her eyesight was declining rapidly – she is now legally blind. The good news is accommodations were made and she’s still with the company. The lesson here is that things are not always how they appear.

        1. Blue*

          It’s true there are lots of things that can make someone seem drunk. I have POTS, a kind of dysautonomia, and what that means in practice is that if I’m upright too long, I don’t get enough blood to my brain, and I start to look (and feel) exactly as if I’m drunk. And I don’t always realise it’s happening.
          The main thing is, it doesn’t matter, because if she is in fact drunk it’s best to address it as if it was any other medical issue.
          She either isn’t aware it’s happening or isn’t aware it’s noticeable, and that’s information she should have. Gently let her know, without drawing any conclusions, and let her take it from there. If she doesn’t address it, then it’s management’s job to step in, but you don’t need to figure out what’s causing it before you talk to her.

    12. LCH*

      agree if it is medical, she might not know it’s happening. my dad was very noticeably limping during one of his visits and about 6 months later told me he’d started PT for it. i didn’t bring it up when i noticed because he’d already told me about his hip pain so i figured he knew he was limping. nope!

    13. File Herder*

      Another one here with migraine dysphasia. Often the first symptom is confusing names, followed by problems with actually getting any words out of my mouth. It’s worse speaking on the phone than face to face. It also affects my co-ordination. Sometimes I go off on rambling tangents and friends and colleagues do the “File Herder, you’re rambling, go and rest/ get some painkillers right now before it hits” thing.

      It was a source of mild amusement at work until the day it suddenly stopped being funny because I couldn’t speak at all – because my migraine had suddenly flipped from mild intermittent to severe continuous. It took a long time to find a medication regime that let me function at some vague approximation of normal.

      So yes, this could be a medical condition, exacerbated by stress, and she may not even realise it’s happening if it’s something that’s started or slowly become worse during the last year. There are quite a few medical conditions where either the condition or the medication could have these effects.

    14. DocVonMittens*

      I second this. I had brain cancer and an early symptom was slurring/forgetfulness. I also wasn’t even aware I was slurring my words.

      I would not jump to alcohol use. You can address this without even mentioning why you think this is happening but just explain what you’ve noticed and that you’re concerned.

    15. Sahara*

      I totally agree, Mental Lentil. An awful lot of both medical conditions and treatments/medications can impair someone to the extent that they will appear drunk or otherwise intoxicated. And caching the communication around concern for her and her wellbeing is definitely the best approach.

      (Having dealt with something similar myself, OP, I’d leave HR out of it, and even management in the first instance, especially if they have proven themselves to be useless and/or damaging in the past on other issues.)

    16. Lego Leia*

      Is it possible to do a “Worker, you are not coming across clearly, is your microphone ok?” workaround? Give the worker an out?

    17. TardyTardis*

      Yes. I once found it was bad to start a new job and a new medication at the same time myself.

  2. Black Horse Dancing*

    Absolutely don’t assume it’s drunkenness! Medication or other things can cause this. Do as Alison says–privately ask her if she is OK. Good luck, OP!

    1. earl grey aficionado*

      Yeah, as someone who takes several medications that can cause me to seem drunk, I might feel a little embarrassed if someone pointed it out, but it’s infinitely preferable to no one saying anything. I’ve also had a number of family members struggle with alcoholism and other substance use disorders, and while I know it was embarrassing and painful for them to discover that they were no longer able to disguise their substance use, it was also a relief for them to get some kind of outside sign that they were not okay, if that makes sense. Either way, as long as you’re speaking privately and kindly (I cannot emphasize the “privately” enough, and I’d also avoid any language that makes it sound like this has been a topic of group conversation – e.g. “We’re all worried about you…”), I think you’re in the clear to say something, OP!

      1. earl grey aficionado*

        Meant to add: If it *is* a medication issue, it’s probably an issue of dosage. She genuinely might not realize how “off” she seems (I often don’t notice my meds are wacky until months of odd behavior have gone by) and by pointing it out you would be giving her a really helpful data point to take back to her doctor. Another good reason to speak up!

        1. Grits McGee*

          And the info “Work appears to be the main thing she has going in her life” makes me wonder if OP’s coworker isn’t interacting a lot with people outside of work that could also clue her in that this is happening. No matter what the issue is, it can be difficult to self-assess how you are coming across to others, and coworker may have no idea that the effect of whatever is going on is so visible.

          1. AKchic*

            Dosage or even an interaction issue. If a doctor started her on a new medication or upped the dose of an existing prescription and it interacts with something else, it could have some weird effects. Even OTC medications/vitamins, foods, drinks, etc. can interact with prescriptions in the wildest of ways.

            A diabetic friend of mine was trying a new diet without consulting her doctor. It did not go well. It kept messing with her blood sugar levels. The amount of times she was too up or too down because she wasn’t eating properly for her body… ugh. I was so glad when one of our other friends finally looked her in the eye and asked her if she even ran the diet by her doctor to see if it was *safe* for her to do it.

            1. Cj*

              Yes to this. I take prescription pain killers, they never really did affect me mentally or physically much, so that wasn’t a problem. But when they added a muscle relaxant to this mix, I admittedly did seem *really* impaired at work the first time I took them. Slurring my words, running into things, etc.

              My supervisor/big boss insisted I had been drinking even though they didn’t smell any alcohol on me. They called my husband to pick me up (which their only good idea), and told me not to come in the next day, but they would call me in the morning, During which call they told me I was terminated.

              They were required by their own policy (and the law?) to give me an alcohol/drug test at the time it happened. And offer treatment if it was an alcohol/drug problem. They did not. Then they protested unemployment claim because they said I was drunk on the job. The UC investigator said it sounded like a simple drug interaction, they had no proof otherwise, and even mentioned my rights to me and pretty much implied I should insist on being rehired (or sue them for monetary damages). Since I hated that job anyway, and was eligible for quite a bit of unemployment, I didn’t pursue any of that.

              TLDR: please *do not* assume

        2. Seal*

          That was the issue described in my comment below. My staff member didn’t realize how off she sounded and I was genuinely concerned that something worse was going on, so I’m glad I asked.

      2. LilyP*

        I want to double-emphasize the **I** not “we” part. It’ll feel really natural to fall back on the safety of “the group” (plus it’s probably true that you’ve been discussing it as a group?) but owning this conversation as just yourself is a painless way to make this less embarrassing for her.

        1. Glitsy Gus*

          Agree on this one. Keeping it to “I noticed” makes it sound a lot less like “everyone is talking about you.”

    2. Seal*

      This. Recently one of my staff members was obviously slurring her words in a Zoom meeting. Because it was so obvious and out of character for her I immediately asked if she was OK. Turns out she had just come from the dentist and her slurring was due to the anesthesia not having worn off. If it was more subtle or happened repeatedly I would have asked privately, though.

      1. KateM*

        Ha, maybe this coworker is going to dentist a lot… I went once for months every Monday (because it was the only day of week when I did NOT have to talk at work).

    3. Sylvan*

      Yep! You can also talk about the behavior, if you need to bring it up with someone else, without mentioning drunkenness.

      I take medication for panic disorder that can have this effect on people at high doses, and I could see someone being prescribed a high dose and not realizing they’re impaired. Someone who’s having a medication problem or some other medical issue could easily deny being drunk and not understand what’s happening.

    4. I'm just here for the cats*

      YES!!! My mom once was on a medication and they had the dose way to high. She looked like she was high, couldn’t walk straight sometimes, and often fell or got dizzy. A neighbor, who she only spoke to a few times, and who worked with my aunt told my Aunt that my mom was on drugs. This caused a bunch of problems with their relationship because aunt took neighbor at their word (which is a whole other thing).

    5. Glitsy Gus*

      Agreed! I had one prescription cold medication once that made my mouth a little numb. I sounded ridiculous and really didn’t realize it at all until someone said something. Turns out it was a pretty common adverse reaction, but I would have never thought to even ask the doctor about it if my friend hadn’t said anything.

      As far as not embarrassing her, the way around that is if she writes it off, “oh, I’ve been really tired/ had dental work/etc.” or whatever, let her have that with grace and drop it. You’ll have given her the heads up at that point and that’s the important thing. If she doesn’t want to share beyond that, it’s fine.

  3. SharedB*

    This is how my uncle was diagnosed with ALS. His coworkers called 911 because he was slurring words and they were worried about a stroke. Please escalate this and note health concerns.

    1. Ana Gram*

      A similar thing happened to a friend’s father. A colleague mentioned that he didn’t sound like himself and he (friend’s dad) made a doctor’s appointment and was diagnosed.

      I think if you’re frank and kind, there is a way to bring this up to someone. Just don’t probe for info after the fact.

    2. Bee*

      Yeah, I was gonna say, this sounds like there’s a real chance it’s something neurological – especially with the fact that she doesn’t seem to remember it the next day – and if she lives alone she might not have anyone else who sees her enough to note that something’s off. Which is why I’d say something but not suggest it’s alcohol-related at all. If it IS, she’ll be able to figure that out herself.

      1. Liane*

        Yes! The mini-strokes can ruin memory permanently (multi-infarct dementia). It happened to my dad.

      2. Sandi*

        “she doesn’t seem to remember it the next day”

        It’s hard to know if she isn’t remembering the problem the next day, or if she doesn’t know that it is a problem at the time, or if she knows but isn’t saying anything. It could easily be any of those.

        I have a coworker who used to chat with me in the evenings, and it was clear that they were drinking alcohol during the call as they were drinking a lot of something and their slurring got worse during the conversation. They didn’t remember some parts of our chat the next day, which I found hard, so I stopped being available. In their case they weren’t aware that they were slurring, and they didn’t remember commitments they had made. My point being that memory isn’t a good assessment tool in the OP’s case as the situation isn’t clear.

    3. Not your average Jo(lene)*

      My mind totally went to some sort of neurological issue. I work in the disability world though so I tend to think about that instead of self induced impairments. I hope she gets whatever help she needs!

      1. PT*

        COVID can cause neurological symptoms too, especially long COVID. And we’re at 30 million cases just in the US.

    4. Ashley*

      And especially if you are doing video and notice any facial paralysis.
      This definitely feels like someone who is friendliest calling for a kind welfare check of types erring on the side of are you feeling ok, you seemed a little off and not mention drinking.

    5. AKchic*

      Urinary Tract Infections, especially long-term, untreated ones, can cause slurring words and disorientation. It’s the *only* sign/symptom my grandma ever gives of having a UTI other than the occasional fever (sometimes she won’t get a fever at all).

      1. SharedB*

        Also a good point. My elderly grandmother lost her mind during UTIs, which she seemed to have often as she aged. Medication cleared up a lot of what looked like dementia symptoms.

      2. OyHiOh*

        There’s someone in my social network who has been taken to the ER multiple times over the last year for “delirium.” Actual diagnosis: chronic UTI that’s moderately resistant to treatment.

        I’ve learned many things I didn’t know I needed to know about untreated UTI’s. They’re surprisingly multi systemic!

    6. Warm Weighty Wrists*

      Yes, my mother started slurring her speech, and she only wasn’t suspected of being drunk at work because she was known to be a lifelong tee-totaler. Doctors at her work recommended a full check-up (I did too, but for sure she listened to the doctors more), and that led to an ALS diagnosis.

  4. BeeKind*

    My dad has had several small strokes. He slurs sometimes.

    Also, coworker might need the help the company health insurance provides.

    1. Not Australian*

      Mini-strokes were my first thought, too – or potentially some medications can have a similar short-term effect. And definitely agree about the insurance.

  5. Web Crawler*

    This is excellent advice. Also, I hope that nobody thinks I’m drunk when I work with a migraine. Independent reports from friends indicate that I seem high with a migraine instead of drunk. I’m not sure if that’s worse. I’m pretty open about my chronic migraines, so hopefully that makes it a different scenario?

    1. SharedB*

      I’m in those shoes, too. So far, no one has commented on it, but I’m very open about aphasia and slurring being due to the migraine I’m experiencing at the time.

      1. 3DogNight*

        This is me. I have a hard time talking or writing with a migraine, and sometimes I even mix up words.

        1. Properlike*

          I will forget words and names (even friends’ names) in the days before and during a migraine. That’s usually one of my first clues one is coming.

    2. Migraineur*

      Agree with this – my migraine meds sometimes make it hard for me to talk coherently (though I can still think clearly). I usually just apologise and explain that I’ve taken them.

    3. Annika Hansen*

      I took Topamax (aka Dopamax) for migraines for awhile. It made me forget words. The doctor had me start at a small does and gradually increase. I didn’t realize that it was the medication at first. I thought I was losing my mind. I could see how someone could interpret that as substance abuse issue.

      1. 3DogNight*

        Topamax did the same to me. It also can cause irreversible eye sight damage. Yay, not. I was able to get lasik to correct mine, but seriously, was not good for me.
        And the losing my words, that has never gone away. Although, it is pretty entertaining when I describe the word I lost. “Hey, can you clean out the silver thing that makes bread brown?”

        1. Sled Dog Mama*

          Yep, others look at me funny when we’re at the store and I remind hubby we need a new plastic thing for the thing you stand in to get wet and clean. You’re welcome friends for the entertainment!
          I had the problem before Topomax and it just got worse while on it, perhaps it was fortunate that Topamax did nothing for my migraines.

        2. Bee*

          My mom has a real problem coming up with the right noun on the first try (no medical reason, just the way her brain is wired), so she just runs through adjacent things until she gets there! “Can you put this in the microwave – dishwasher – cabinet – fridge?” (Usually by that point we have already divined that the Tupperware of leftovers should, in fact, go in the fridge.)

        3. Annika Hansen*

          That’s terrible! I am so sorry to hear you have to deal with that. My problems were relieved when I stopped Topamax. My doctor prescribed it off-label for migraines. Years later, it got approved for migraines. I saw an article about a new migraine medicine that has weight loss as a side effect. I thought perfect! I have always struggled with my weight. Then I read that it was Topamax. I was so disappointed. It didn’t help me lose weight. Just made things taste weird. Then around age 40, my migraines disappeared. I feel so fortunate.

          1. Bear Shark*

            Topamax didn’t help me with weight either. It was supposed to help with my anxiety and mild compulsions but it just made me lose my words.

      2. Not A Girl Boss*

        Topamax is the devil (obviously if it works for you, great, but it definitely isn’t brain power friendly). They gave it to me in high school, and I went from straight-A student to failing my classes.

        1. Frideag Dachaigh*

          I had the same issue while I was taking it in middle school- came home from school, mom asked how my major end of the year paper we had been spending months working on was going, and I had no idea what she was talking about. Couldn’t tell you the topic, if I had worked on it, when it was due, anything. Looking back, I have plenty of memories from before and after the med, but the period of time I was on it is a blank void.

        2. RecoveringSWO*

          It is the devil! My insurance required that I try it for a certain number of months before approving a monthly injectable CGRP. I was in grad school and it was so bad for my studies (and didn’t help the migraines at all) that I eventually stopped taking it and just filled the prescriptions until I met the minimum required trial period.

          1. Not A Girl Boss*

            Ugh, I lied. Insurance is the real devil. They overruled sooooo many prescriptions from doctors that were really useful but prohibitively expensive. Specifically ‘no generic substitute’ and a few drugs for which there wasn’t yet a generic available.
            Their argument was that we didn’t have enough “objective evidence” of effectiveness. I kept an incredibly detailed migraine journal for years, but that didn’t count as “evidence” according to my insurance because there was no proof I actually experienced migraines. We never did figure out how to prove I had a migraine when I claimed I did, so I never did get the medicine.

      3. AKchic*

        I’m on Topamax for my migraines, but luckily for me, I already had problems with forgetting words (I’ve had a few TBIs). If the Topamax has made it worse, I haven’t noticed. Topamax *has* made everything taste faintly of tin, but after a while, you get used to it. I first started taking it back in 2006 (?).

        I hear they now prescribe it as a weight loss medication for some people.

        1. LavaLamp*

          They do. Tompamax made me loose too much weight, crash a car, and have to look at my own ID to remember how to spell my name. I STILL don’t remember everything that happened when I was on that one except how hungry I was once I was off of it, and I was on it off label for chronic pain.

      4. R*

        Hello, another Topamax person here. Besides forgetting words, when I get very tired I start to stutter… which is so awkward. It did reduce my migraines significantly, though, so I deal with the side effects.

        1. Not A Girl Boss*

          Totally unsolicited advice you can feel free to ignore: If Topamax works for you, you might be a good candidate to treat migraines with a ketogenic diet. Both Topamax and beta-hydroxybutric acid (ketones) work on a similar brain pathway, which is also why both are used to treat seizures. I was really lucky to get a neurologist who also does a lot of work with drug-resistant seizures, so he had me try keto and it made a huge difference.

    4. MissDisplaced*

      I used to get ferocious migraines and I would seem hungover-like. Plus, the Imitrex made me very tired and spaced out as it was taking effect.
      I suffered migraines every month for some 30 years. They went away after menopause. There is hope!

      1. Seal*

        Same here. I tried a number of different migraine meds and all of them had more or less the same side effects. Plus they never really worked for me, so if I was able to go to work at all during an episode I’m sure I came off as a bit drunk. I ultimately ditched the meds in favor of daily doses of riboflavin, which actually worked quite well, and finally stopped getting migraines after menopause. Quite a relief!

      2. Not A Girl Boss*

        Fellow hormonal migraine sufferer, and far from menopause. Trial and error with 30000 birth controls to find one which I take continuously (no periods ever) knocked it from 2 weeks/month to 2 days/month. Following a ketogenic diet and supplementing with magnesium glycinate and vitamin B knocked it down to about 4 per year. There’s a good kindle book about it “Keto for Migraine.”

    5. lost academic*

      Maybe but in my experience (I also have chronic migraines) most people don’t understand migraines and aren’t familiar with the associated common symptoms – they tend to simply compare it to the worst headache they have ever had, if that. You might be better off being clear about what you are experiencing in this case.

    6. WellRed*

      I wouldn’t know what “high with a migraine” looks like, but I’d be totally sympathetic to migraines.

    7. A tester, not a developer*

      I warn people I’m meeting with when I’ve taken migraine meds – they make everything feel like it’s on a few seconds delay. I don’t know if it’s super noticeable, but I don’t want people to think I’m not paying attention.

      1. Delightfully Anonymous*

        My husband suffers from migraines and balance disorder. Both of those combined can make him look to be drunk because he loses focus, is slow to process things and if there’s a very patterned carpet he cannot walk straight at all.

        OP, I definitely think reaching out privately to share your concern would be helpful. I agree with the commenter above who said just express your own rather than group concerns.

        Good luck to you and your colleague.

    8. Not A Girl Boss*

      Honestly, this is a big part of why I’m less and less willing to work through a migraine. I work in a field where full mental capacity is important, and drinking at work lunches and stuff is strictly prohibited. I figure, if the work can’t be done after a few beers, I have no business working when migraines impair my thinking much worse.

      It did take careful explaining to my bosses – that its not just whining about my head hurting, its that physically my brain doesn’t work, and after the 9000th time I found some crazy error I made while working-with-migraine, I decided its just plain counterproductive.

      Of course, this was *much* easier when I had virtually unlimited sick days. My new job, I almost didn’t accept because of pooled PTO that means most of my days off go to migraine days.

  6. Veryanon*

    HR person here. Please reach out to your co-worker privately and express your concerns that she doesn’t seem herself. Focus on what you’ve observed (slurring words, etc.) and don’t offer any conclusions, since you don’t know what is going on. If she lives alone, she may not have someone in her personal life who has noticed anything unusual and she may be experiencing a medical event, or reacting badly to medication, or who knows. I also don’t think it’s a bad idea to go to your manager with your concerns (again, focusing only on what you’ve observed, not offering any conclusions). The manager may be able to refer her to some company resources, or maybe reach out to her emergency contact for a wellness check.
    Best of luck. These situations are always tricky.

    1. Van Wilder*

      Totally agree with the first part. Excellent advice. I’d balance the advise about looping in your manager against what you know of your manager.

  7. Relosa*

    As the child of an alcoholic who can no longer work due to their drinking (literally could not keep a job, driving to work drunk, drinking all day at her desk, etc), I don’t want to doom-and-gloom you but it’s not your job to worry about her job if she’s that far gone.

    Alison is right; at first, it’s entirely possible she’s on a medication or dealing with something she may not even know like an underlying condition that is affecting her. But only do what you would do in a similar situation if you didn’t suspect drunkenness. If she’s drinking on the job, that’s not a good place for her, whether or not it’s her only anchor. There’s a point where you can only do so much, and for your own health and safety should not do any more than what you normally would.

    Alcoholism is a disease, so whether her behavior is due to drinking or another issue, it’s still a medical one and should be treated just the same.

    2. Cj*

      Since this only started after the pandemic hit, I wouldn’t say she’s necessarily “that far gone”. She may have a psychological addition to alcohol, but probably not a physical one yet. Or not even to the point of any type of actual addiction where she feels she *needs* to drink, and could quit easily if she had the motivation. No matter how much stress you are under, drink at work is absolutely not something you should/can be doing, but somebody bringing it to her attention, not an actual intervention, *may* convince her she needs to stop. At least during work.

      1. Cj*

        I should have said if it even is alcohol. As mentioned in a previous thred, many medical conditions, some that the person may not even be aware they have, can cause you to slur. For instance, my migraine.

  8. TWW*

    Does OP know that managers and HR aren’t aware of the issue? Perhaps they know exactly what’s going on, as opposed to OP who’s only speculating.

    If they know she has a medical condition, they might be more tolerant of her unclear speech and lack of focus than someone who thinks she’s drunk.

    1. WellRed*

      But if this is on calls with clients, and it’s causing calls to drag on for two or three (!) hours, managers should have intervened by now.

      1. Detective Amy Santiago*

        I didn’t get the impression that these actions are causing the calls to last longer than expected. Simply that they are long calls.

        1. Dust Bunny*

          It doesn’t matter if it’s the cause or not: Clients watching a (drunk-appearing) employee for hours might be a problem.

          And maybe there is something else entirely going on and clients have been advised that employee is fine and to disregard this, but apparently not everyone has been. Which gets weird about people’s medical history, but if the bosses can say, “It’s handled; you don’t need to worry about it,” then the LW can let it go.

          1. Captain dddd-cccc-ddWdd (ENTP)*

            OP said “I think the clients have just been really confused” — what’s confusing about this?

            On the surface they’re dealing with someone who appears drunk (or ‘impaired’ or ‘suffering effects from medication’ or whatever it is) one day but not the next.

            Putting myself in the shoes of the client in this scenario I’d either think I was dealing with someone who sometimes is under the influence on the job, or extend more understanding and think that it may be due to medication / a medical condition / etc.

        2. Malarkey01*

          If this is happening the duration of a 2-3 hour call that points even more to it being medical and not alcohol related. Unless the person is drinking during the actual call, maintaining alcohol impairment at the slurring level for that long would be really unusual. Typically you’d either sober up a little and stop slurring in an hour or you’d cross through to the sleeping stage (just some of my experience as a former bartender).

    2. meyer lemon*

      I wouldn’t be inclined to bring this up with management or HR, since they have apparently had an opportunity to witness this for themselves. As far as the OP knows, maybe there is a medical issue at play that they’re aware of. If not, it could do more harm than good.

      But I do think it would be worth saying something privately to the coworker, just in case it’s the sign of some kind of medical problem or side effect she wasn’t aware of.

      1. Captain dddd-cccc-ddWdd (ENTP)*

        I wouldn’t be inclined to bring this up with management or HR, since they have apparently had an opportunity to witness this for themselves.

        I wouldn’t assume that management or HR magically know about things just because they’ve had the opportunity to observe them!

        They can be happily (or perhaps ‘studiedly’? IKD…) immune to things that go on under their own nose, in my experience. Sometimes, and I hate to say it but it’s true, in the guise of “if I ‘don’t notice’ it, I can’t be blamed for noticing it and not taking action”.

        1. meyer lemon*

          Oh, that is definitely possible! I just don’t know that this rises to the level where I would feel the need to get involved with however management is dealing with it. Alerting the coworker about a possible medical issue, though, is potentially more urgent.

  9. Roaring Twentysomething*

    Coming from a person with a neurological disorder, assuming alcohol impairment isn’t a good idea. It may be medication, it may be alcohol or another substance, or your coworker may be experiencing health issues. Cognitive fog can be a major disruption for many with chronic illness. She may be trying to “tough it out” as many chronically ill people do. Reaching out privately out of concern for her well-being would be a good move for her safety and privacy but also for the sake of client relationships.

    1. Danielle*

      My secondary concern with this is client relationships! If her slurring words is THAT noticeable, it’s likely making an impression on clients too.

    2. AngryOwl*

      Yes! When my concussion symptoms get bad, I might look like this. Definitely not drunk.

  10. anon24*

    Alison has great advice as always. Thankfully my migraines have been lesser in severity and frequency with my current medication, but I used to get 20+ migraines a month and they were all terrible. And while I thought I was more or less functioning ok despite wanting to die, I had people tell me that if they didn’t know me better they’d assume I came to work drunk off my ass because apparently I was slurring my words and unsteady on my feet. Having someone report me for being drunk would have been devastating to me, because I was already so distraught from living with my symptoms.

    That said, I feel like if migraines were the case this co-worker would have been doing this in-office, but a new medication problem or medical issue can’t be ruled out. Either way, whether she is drunk/high, having a medical problem/medication issue, or something else entirely, you’ll never regret approaching the situation with compassion and concern rather than judgment.

  11. Janet Pinkerton*

    This could be any number of things—sleep deprivation, medication, an untreated UTI (which can manifest as dementia in the elderly population), a buildup of ammonia in the liver, migraine, etc. I definitely wouldn’t assume it’s alcohol!

    We had a situation like this. Definitely say something—it was us saying something that got the coworker to her doctor to figure out what was happening.

    1. fhqwhgads*

      I don’t think OP is assuming it’s alcohol, but rather noting that to the untrained ear and eye, the best way to describe it is “seems drunk” and because of that, the optics for all the external people encountering it are especially bad. OP did seem to be aware there are many other possibilities and wanted to tread accordingly.

  12. MsClaw*

    HOW has this happened multiple times and no one has followed up to ask if this woman is okay!?!?!

    “But if we approach her directly about our concerns for her and it turns out to be a medication issue, it would be terribly embarrassing for her to know that a number of her coworkers think she’s been drunk on the clock.”

    WHY would you jump to this conclusion? Why would you even mention ‘everyone thinks you’re drunk’??? You describe the *behavior* and say people are concerned, ask if everything is okay. I mean, there are literally dozens of things that could be going on here that are not gin-related. Good gravy.

    I’m just really baffled about people have handled (or *not* handled) this situation.

    1. Esmeralda*

      Please be kind. The OP is asking what to do. And it’s not a pattern until it’s happened a few times.

    2. PT*

      Because a lot of people at work tend to assume the worst of others. I have no idea why. I’ve seen people accused of all sorts of wild stuff not remotely in evidence, simply because they were a few minutes late or called in sick or seemed extra tired or had a doctor’s appointment two weeks in a row. They’re lazy, partying, faking, on drugs, pregnant, interviewing elsewhere! When in reality there was traffic, they were sick, they slept poorly the night before, and had some coincidentally timed doctor’s appointments.

      1. hbc*

        I have a colleague who thought *everyone* had a drinking problem if they showed any of the potential signs. Dude with blood-shot eyes–alcohol, not allergies. Person tired or drowsy–definitely hungover, not just dealing with insomnia or other sleep issues. It was really annoying because it always ended up misdirecting the conversation away from what needed to be done to a debate on how likely it was alcohol (and his claim to being very, very good at detecting it on people.) And of course, he always discussed it when it wasn’t a current issue.

        Anyway, I finally told him that if the alcohol was relevant, he needed to bring it up right when it was happening and we’d send the person for a screening. Not surprisingly, he never brought it to me anymore, except when we butted heads on something months later. He then brought up the time I “had come to work drunk”–a couple of years before, after I’d come straight to work after a transatlantic flight. (So, definitely bleary eyed, disheveled, and probably smelling of *mouthwash*, all for obvious reasons.)

        It still makes me angry, years later.

      2. Batty Twerp*

        Based just on the comments here so far the consensus is leaning towards medication, not alcohol. Maybe as a result of Alison’s reply, or maybe we’re more inclined to hope for best intentions (perhaps in self-defence against the bad boss syndrome!).

        I would reach out in private and in kindness. It could even be neither medication, not alcohol, but as a result of stress. OP describes her as intense pre-pandemic; just a check-in to see how she is may work wonders.

      3. MsClaw*

        Oof. Yeah, I suppose it just seems like a huge leap to me unless the coworker was previously known to make jokes about her day drinking or some other predicate that isn’t in the letter. It just seems bananas to me that you’d both jump to that conclusion and also think that’s the opening salvo to go with when following up with your colleague.

    3. meyer lemon*

      I agree that it would be kind to check in with the coworker, but I can understand why the OP and their coworkers hesitated to say anything. It probably wouldn’t occur to everyone that the coworker herself isn’t already aware of the slurring and confusion, so it might just feel like berating her for something she’s already struggling with.

    4. friendly neighborhood marxist*

      …because disability visibility is so horrendous that the only time we see people slur their words in pop culture is when they’re drunk. it’s good that we’re correcting that impulse but it’s not particularly surprising that’s where people’s minds go.

    5. J*

      I actually think a lot of this comes down to personal experience. We tend to extrapolate based on what we know. I have limited experience in both my personal and professional lives working with people with medical issues to the extent described, but plenty of experience in my professional life dealing with genuinely intoxicated individuals.

      Especially if we aren’t aware it’s something we *should* point out, we’re often conditioned not to ask about things that we think could cause embarrassment for the other person. I think OP is being thoughtful in seeking these outside perspectives.

      1. MsClaw*

        That’s a good point — if the OP has dealt with a lot of people with alcohol problems in her life, that could explain why she is jumping to that conclusion. Whereas for me, when someone older starts slurring, becoming forgetful, etc, my mind immediately jumps to something related to medication or early signs of Alzheimers, because that’s something I have seen happen with people over time.

        But just in general, if you think something is up with a coworker, you ask if they are okay — you don’t lead off with ‘we are all concerned about your obvious X problem’.

    6. Cassidy*

      “HOW has this happened multiple times and no one has followed up to ask if this woman is okay!?!?!”

      —————————

      Please stop the dramatics. Just because the LW hasn’t approached her c0-worker doesn’t mean “no one has followed up…”

      1. MsClaw*

        I’m not the one being dramatic. The OP in the letter represents that there are group of people who have concerns, but are hesitant to reach out. It’s certainly possible that someone outside that group of people has, and for any number of reasons has chosen not to share that info with the group.

        But gossiping with your colleagues about the possibly juicy reason your coworker has a problem instead of just saying ‘hey Barb, you sounded odd on the call today; is everything okay?’ is a very dramatic way to deal with this. They’re talking about going to HR before even sending her a slack message to ask what’s up?

  13. So Anon Today*

    We had a coworker who was alcoholic. He came to work drunk, drank during the day – you could smell it on him. He was a high level staff member, so those who noticed were loathe to say anything to him or HR at first, and there was some gossip. Eventually someone concerned heard the comments, observed for themselves, and went to his boss for advice. The boss had a few words with him, looped in HR and EAP resources, and we got an official email about so and so’s sabbatical. He got the help he needed, and it was handled very compassionately. He chose to retire soon after coming back, but leadership was clear that this was a disease, he was being treated for a medical issue, and he would be welcomed back once he felt his treatment was successful. I truly don’t know how long it would have gone on if no one had said anything, since he seemed to think he was hiding it. I’m sure he was mortified to realize people noticed, but I was very proud of how it was handled in the end.

    1. So Anon Today*

      Which is not to say that this woman is drunk – as others have pointed out, there are many reasons for her behavior on the calls. Just to say that whatever is going on, someone needs to approach her (or someone she would trust to speak with) so that she can receive the assistance she needs, in whatever form would serve her best.

    3. Cat Tree*

      I think a lot of companies have a policy that if an employee self-reports a substance abuse disorder, the company will try to help them with it. But if it’s discovered through a drug screen, it would be handled differently. This makes sense as a policy to encourage people to seek help. I’m not sure where third-party reports would land though.

      1. Captain dddd-cccc-ddWdd (ENTP)*

        I’ve encountered these types of policies (in reading through the HR material, not being exposed to the policy first-hand that is) and the corollary to the company helping them to seek help is often that after “treatment”, if they then encounter a relapse, it’s at the company’s discretion whether to accommodate them or take disciplinary action at that point.

        So it can be a bit of a double edged sword, because you come forward with alcohol (or whatever) addiction, the company supports you in time off for treatment … but everyone knows this treatment isn’t 100% successful and there are many documented cases of people relapsing. And then you’re basically out on your ass. It seems to crystallise a ‘just fix it’ approach of management, honestly.

  14. Dust Bunny*

    Agree: I would contact her privately to ask if she’s all right but would not mention alcohol.

    I injured my leg years ago. Long story, but the pain meds made me horrendously sick and I had to get an anti-nausea medication to settle my stomach before I could finish taking my antibiotics. But the anti-nausea medication made me both sleepy and kind of loopy. Fortunately, I was under doctor’s orders to stay home with my leg elevated because I would definitely have appeared drunk!

    (I basically slept the whole week. I was afraid I’d be bored sitting at home, not allowed to do anything I couldn’t do with my leg propped up, but I was out like a light most of the time because of the medication.)

  15. Detective Amy Santiago*

    In addition to everything else that’s been mentioned so far, I’ve known diabetics who exhibit these symptoms when they are having low blood sugar issues.

    Basically, don’t assume drunkenness and please do gently address it with your coworker if you feel comfortable doing so. If you don’t feel comfortable bringing it up, then please talk to your manager and say “I’m concerned about Jane’s well being based on [specific action] during the call with the Llama Groomers Association. I know there are any number of conditions that can cause those type of symptoms. ”

    It’s also possible that your manager is aware of some medical condition and that’s why nothing has been said that you’re aware of.

    1. Clisby*

      Diabetes was the first thing I thought of. My sister is a Type 1 diabetic, and has had a few episodes like this when she hadn’t eaten enough to offset the insulin.

  16. Miki*

    Had TIA episode and one of the first symptoms was me talking gibberish : I knew what I wanted to say, but when I tried to say it, it was completely wrong word.
    Do tell your coworker you’re concerned (my friend who was present was as well), it might prompt her to go see a doctor and save her life!

  17. Looking Forward*

    I am a diabetic and went the doctor when my coworkers noticed I was acting funny. Really Low Blood sugar does this to people and it mimics drunkenness very well, Please tell her so she can get to doctor untreated this can kill her if she lives alone ect then you mentioning it will get her to doctor. If she passes out from low blood sugar she may not get the help she needs, From first hand experience please approach her and you can use the diabetes as a starting point to alleviate the uncomfortableness you are trying to help her.

    1. JSPA*

      I don’t think a coworker should be going beyond, “something seems really off to the point that it’s worrying.”

      1. OP’s a coworker,
      2. OP is not a doctor,
      3. it can land as ageism (or size-ism, or some other ism) to presume a specific condition that’s associated in the public mind with one or another group of people
      4. If the problem actually is substance abuse, “aha, it’s fine, they think it’s just low blood sugar” is not a great direction to point them in.

      And of course, if the answer is, “I’ve spoken to the boss, and beyond that, it’s private,” then that’s where it ends. No digging allowed.

  18. Mid Manager*

    Also don’t forget the part about your clients! Whatever the reason, it seems this has been noticed by clients and could affect your company’s reputation. I would discuss with your manager as far as what you have noticed about the effect on business.

  19. Kimmybear*

    I just want to echo what everyone is saying about the many reasons someone might not be acting like themselves. All of them are areas for concern but your peephole into her life through Zoom isn’t enough to say anything more than “this is what I’m seeing and I want to make sure you are ok”.

  20. Tiger*

    I love the advice here and want to add some of my own.

    I have a neurological condition. I make sure my supervisors are aware of it, because when it acts up, I act really strange. I take medication, go to the doctor, and control it to the best of my ability. But sometimes, things happen and it gets out of control. I will truly act like an idiot for about 3 days, and don’t know this is happening/will happen until it hits me, and can’t pull myself out of it. It isn’t life threatening, and I am seeing a doctor. Maybe your supervisors aren’t doing anything (like ending the call), because they already know what is happening. If you ask your coworker, they might tell you, but if you don’t get a straight answer, please consider that your supervisors are already aware of what is going on, and have deemed it okay. It might be worth stating that it is concerning your clients, but my point is mostly that you might not know the full picture, while others could.

  21. Sled Dog Mama*

    LW please tell her that you notice. I take a medication that has side effects if I miss a dose, which happens every now and then and has happened more often during COVID. Apparently taking my meds was part of the going to the office morning routine and sometimes gets skipped in the WFH morning routine. I didn’t think this was noticeable to my coworkers until one day one of them asked if I was ok because I looked wobbly. I had zero idea that I looked as bad as I felt. Your co-worker may be having a medication issue but think “I feel terrible but it’s only noticeable to me” telling them could prompt the thought “I need to go see the doctor to get this worked out”.

  22. Jen*

    I had a similar experience with a colleague who was my boss. And then he was diagnosed with Lyme disease. In his case, the symptoms typically got worse later in the day as fatigue set in, and he’d slur words, go on tangents, lose his train of thought, etc. Now that I understand what’s happening, I’m able to recognize it and can address it when I start to notice symptoms, which he may not be as quick to notice because Lyme causes a brain fog when it rears its ugly head.

  23. Anonymous Poster*

    If you have the right kind of relationship with this person, you should definitely try to address is privately at some point soon. Just say what you heard – slurred speech, some wandering thoughts, whatever it was. Not that you sounded drunk. You’re just identifying symptoms of whatever might be the underlying condition, but you don’t have enough to really know whether it was one thing or the other.

    I know I’d appreciate the private heads up, and then I could try and react appropriately to the situation. I know people that have other conditions that could sound like that, and other people that were drinking during the day. Who knows, maybe this person thinks they sound fine after one glass of wine but doesn’t realize it, or has some other condition that they don’t have the regimentation of a work schedule to help them keep a handle on. For example, I knew people that would take medication at lunch – but what even is lunch nowadays? Whatever it is, the private heads up is definitely the way to go.

    And, if this person does have an alcohol problem, then this might help them get the help they need and any accommodations they need to recover and continue their job. You’re doing them a great service by chatting with them privately about it.

  24. Robin Ellacott*

    I work in an addictions-adjacent field and have had this conversation a lot. If you are kind and matter of fact and list the symptoms rather than assuming the cause, people respond better whether it is substance-use related or not.

    “Hey Jane, I wanted to check in with you…. Yesterday in our call your speech was pretty unclear and you didn’t seem as sharp as usual. It was pretty different from how I remember you from the Before Times in the office so I noticed it. I hope you’re ok?”

    Of course it may be that management is already talking to her about it but is doing so confidentially.

  25. JSPA*

    If it’s constant, and at all hours, I’d worry more about a medical condition than inebriation.

    If it comes and goes, and is higher at times of stress, a maladaptive stress response through substance use may be more likely.

    As someone in the hot flash and insomnia years, though, I can say that between lack of sleep and disrupted sleep and playing melatonin roulette (helps the insomnia, but powers up the hot flashes)…there are days on end where I can’t find my other glasses on top of my head, nor (as the saying goes) my ass, with both hands.

    And then, there’s grief. Depression. Despair. A lot of people are going through the motions at a level that leaves them barely able to move their lips.

    On a really basic level–broken dentures, a tooth problem, or some other mouth issue can leave people slurring and distracted. This is from recent experience; being high risk, and more willing to risk minor damage to a tooth than see a dentist during the first local Covid peak (in an area where too many otherwise-intelligent people were in denial) I ordered a little jewler’s file for a sharp tooth edge that kept goring the side of my tongue. I know I was slurring and probably also distracted, for the several days it took the file to arrive, and the sore to heal.

    “Are you OK, things seem a bit off” or “I know none of us are great these days, but you have not been sounding your normal self to the point that I’ve been worrying”–yes, you can do that. But if there are prickles in the relationship, or some other reason not to ask her directly (or you don’t want to do that, be rebuffed, and then go to your boss or to HR, minus the screen of plausibly not knowing her take on the matter), you can use the same sort of language in asking your boss or HR if they could check in with her.

  27. NewHerePleaseBeNice*

    One of the students I tutor suffers with really severe (but thankfully relatively infrequent) migraines, and the first sign that she’s going to get a migraine is that she starts slurring and muddling her words. She was accused of being drunk or on drugs by a teacher in her previous school, and bullied by her peers, which is why she’s now studying independently for her A-Levels.

  28. Sally*

    A couple years ago, I had a co worker who worked across the country from me. I worked very closely with her through out my work day. In order to get our jobs done, we had to be on the phone/messaging each other almost constantly throughout the day. We had only met a couple times in person, but had a lot in common. We formed a quick bond and despite our distance, became good friends. I had a frightening encounter with her one day when speaking over the phone. At first it sounded like she had to be drunk or high (or perhaps partied way too hard the night before, even though I never knew her to be one to out and get crazy), she was slurring her words, had delayed responses, and couldn’t recall basic details like the names of people we work closely with. I let it slide, thinking to myself, god forbid she went out and had a little fun last night, or perhaps stayed up way too late, we’ve all been there haven’t we? When we spoke the next day, I was surprised to see she was exhibiting the same behavior and my thoughts immediately changed to – is my friend having a stroke or something?! What is going on here?! I immediately spoke up then and said I was worried about her and to please go to the doctor. She said she had been feeling “off” and horribly tired lately, but didn’t realize that others were picking up on it.

    She went into the doctor a few days later, they found cancer in her brain, and she was gone less than 30 days after our initial phone call that got me worried about her.

    This might be a dramatic response to your scenario here, but please, please say something. There are so many different ways to kindly interject here. And you could really be helping someone by calling this out to them. Sometimes things aren’t as they seem.

  29. Zelda The Magnificent*

    I was once confronted by my (unbelievably condescending) boss about my “drinking problem”. It was 100% a shock to me–apparently, Boss was informed by a client that I reeked of alcohol and cigarette smoke, and she had to air out her office after my visit. This meeting was at 8am. I don’t smoke, and while I probably had a glass of wine with dinner the night before, I was most certainly not drinking before the meeting!

    Once people believe something, it’s hard to shake. Same boss wound up regularly informing our board chair on my “level of hangoverness” before major meetings (surprise–I wasn’t hungover. I wasn’t on medication…), and (not even joking) commented once on how it felt like I was often “sick” on Mondays, and maybe there was something I could do differently over the weekend? Since she had done an internal audit, and about 20% of my PTO days were taken on Mondays. What can you say to that kind of logic?

    Interestingly, I found most of this out when she left, after recommending and promoting me to her executive director role, meaning I had access to her internal email. So they thought I was an alcoholic, but apparently a very high functioning one? It was one of the most confusing work episodes of my career.

      1. Zelda The Magnificent*

        I never figured out if it was true or not! This was all related to my board chair by Boss via email. There was nothing from the client themselves. It was actually a potential donor (I’m in the NFP sector). I figured appointing me, if it was true what she thought, would make for an awkward convo–“sooooo…you think I’m a drunk. Huh. Wanna donate to our cause?” seemed like a bad idea, and challenging head-on, if I didn’t know for sure who said what (except what my unreliable narrator of a boss wrote), wasn’t, IMO, a convo I wanted to have. As far as I know, my reputation hasn’t suffered–I’m still the ED after 3 years so…?

        But it sucks to be at certain events and have to judge if I’ll be judged for having a glass of wine. Or wondering if ppl think my cran and soda has vodka in it or something. It’s a nagging doubt I’m not sure I’ll ever shake. Upside: I’ll never be an embarrassing holiday party story! :P

      1. Zelda The Magnificent*

        Right? To be honest, if she really wanted to audit, she should have looked at various World Cup/Euro/Champions League schedules and aligned those with my half-days/personal days. She’d have had a much strong leg to stand on!

  30. ObservantServant*

    I once had to have an uncomfortable conversation with an employee – they had started exhibiting some issues with errors in their work, appeared confused about things they once had nailed down and often misspelled the most basic of words that are used continuously in our industry. I gently pointed out the things I observed, asked if things were OK, and wanted to be sure they used spell-check for external communication since most of the things I saw were in internal docs that don’t normally have spell-check automatically enabled.
    They were very alarmed about this, especially the spelling. They lived alone and did not have anyone in their life who would have seen the issue on a regular basis. A full medical check up was done based on these concerns and they received a diagnosis of early onset Parkinson’s. They had to leave the job but thanked me for alerting them to the issues – the early intervention helped delay the progression of the disease.

  31. The Rafters*

    Years ago I worked with a lovely woman who had ALS. Outsiders would sometimes actually yell at her for being drunk on the job. No, you tools, she was terminally ill. Another colleague was being incorrectly medicated. Her behavior was so odd, we asked her supervisor to speak with her. He did and she gave him permission to speak with her doctor about what we were all seeing and her medications were adjusted. Please, express concerns, even speak to her manager — but without accusations of drunkenness.

  32. Ash*

    Honestly…I would do nothing. It doesn’t sound like you have a particularly close relationship with her, nor is her behavior affecting your work. I would just let it go. If the managers want to talk to her about it, if they even notice an issue, that’s their prerogative.

    1. New Jack Karyn*

      Whoa, I don’t know about that. First, it is affecting her work. How clients perceive her is an aspect of the job. Secondly, as a lot of people have said, it could be a health condition. Possibly an undiagnosed one. She may not realize what’s happening. A trip to the doctor–even just for a medication adjustment–could make a world of difference for the co-worker.

  33. GreenDoor*

    I would inquire from a perspective of being concerned. Don’t frame your inquiry as “you appeared drunk” or “are you on meds that mess you up?” or any other language that is accusatory or presuming. Just say, “I’m worried about you. On our last few video calls, you were mispronouncing and slurring words and that’s not like you. Are you OK?” And let her respond from there. If it’s strictly a personal issue, just give an encouraging word. If she says nothing or denies it, well, you raised your concerns and you need to leave it there.

    As for me as a manager, what I’d want to know is if she says or does anything that sounds like a violation of your workplace rules (like she admits to drinking while she’s on work time), anything that could jeopardize a client relationship (“I have to get high before I can handle a meeting with Client”) – basically anything that is preventing the work from getting done. That’s not tattling it’s reporting. You are not responsible if there are workplace consequences for her behavior. If she needs an accommodation for a medical or mental health issue, SHE needs to take responsibility and work with her management. That’s not on you!

  34. Captain dddd-cccc-ddWdd (ENTP)*

    I wondered at first if this letter was about someone I work with, as I have noticed something similar (I know it’s not though as the details are different, such as my colleague works ‘internally’ rather than with ‘clients’. I haven’t got involved as my colleague is ‘distant’ enough from me in the org that I don’t really have the standing to say anything).

    I think the ‘client’ piece is quite significant to this, though. She has done this multiple times, in front of clients, with no explanation and like it or not, I think many people’s assumption/impression, especially if they don’t know her well, is the ‘occam’s razor’ one of her being impaired through alcohol or other ‘substances’.

    For me the involvement of clients, especially since you know they have noticed, pushes this towards something that needs to be escalated, rather than handled more gently with ‘are you ok’ etc. because it becomes a “company reputation” issue. I’m aware this likely won’t be a popular opinion, because it does involve some level of risk to your colleague. (Does the company have a history/culture of treating mental health etc problems sympathetically?)

    If it is a medication adjustment issue or something like that, I’m not sure how it ought to be approached with clients actually. (I’ve told this story before) I was in a situation when I first started taking a certain medication, where one of its side effects while it’s getting into the system can be excessive yawning — which unfortunately I did suffer from quite badly! I proactively brought this up to bosses (not in detail about the medication, but just that I had started taking medication for a condition that had this side effect, etc). [I didn’t work with clients back then, but if it was noticeable I probably would have briefly mentioned it in the moment there.]

    TL;DR I think the fact that clients have already noticed ‘something’ is up changes the calculus somewhat.

  35. AstralDebris*

    It sounds like a group of people on your team are concerned, so I just want to add that the kindest way to address this is privately, one-on-one. Mention the symptoms that you, personally, have noticed, and avoid saying things like “we are all worried about you” or “Martha and I noticed you were slurring your speech,” even though those things might be true. As the person initiating the awkward conversation, it often feels like you are on stronger footing when you can demonstrate that other people agree with you, but the awkward conversationee tends to hear things like that as “you were so mortifyingly over the line that everyone within a 5 mile radius was embarrassed for you” or “all your coworkers have been talking about you behind your back,” and can end up getting defensive or shame-spiraling instead of listening.

    You can always escalate to having multiple people check in with her if the initial conversation doesn’t have an effect, or raising concerns for her with management/HR if you think they would handle it appropriately. But start with a private, coworker to coworker check-in first and see where that gets you.

  36. _ID_*

    Chiming in from the diabetic front here. Low blood sugar can look like drunkenness as well. Slurring words, dizziness, seeming “out of it”, etc. are not uncommon. When you are first diagnosed and start on medication, you can accidentally lower your sugar to a dangerous level if you’re not careful. Also the need to go to the bathroom a lot can disrupt your sleep – which doesn’t help on the memory front.

    1. Captain dddd-cccc-ddWdd (ENTP)*

      Yes! There was a high profile example of this here in the UK where the politician Diane Abbott (Shadow [i.e. the party not in power] Home Secretary at the time) was interviewed in the run up to our 2017 Election about budget and personnel numbers etc around policing and she came across as totally ‘out of it’ and incoherent in the interview, gave a bunch of egregiously wrong numbers, etc. Without getting into politics, that’s not typical of her and while I don’t necessarily agree with a lot of what she says, she is typically very competent as a politician!

      It was revealed later, after a few days, that she’d been suffering from a Type 2 diabetes-related incident which was now being medically addressed etc. In those few days though, there was a furore about her competence and what not, characterising it as her “making up figures”, “having no clue” etc. This was all over the news media. Wikipedia link to follow in a comment as links often seem to go into a rabbit hole!

    2. Waving not Drowning (not Drowning not Waving)*

      I had a work colleague who was diagnosed as a type 2 diabetic, and he could not tell when he was high/low.

      I got used to asking him to check his bloods particularly in the afternoons, he’d start slurring words, and trailing off mid conversation. It could have VERY easily been mistaken for him being under the influence of alcohol.

  37. not always right*

    I’ve not read all the comments, so I may be beating a dead horse, but it is possible she may have had or is having mini strokes. They can cause one to slur words and issues with thought processes. She may be having aphasia which can cause focus issues and difficulty coming up with words which can sound like rambling.

  38. Karate Saw*

    A relevant anecdote: one time a person I had known since I was a very small child told me, “When your mom was slurring at [their mutual friend’s] funeral I thought she has just taken something to get her through, but when she was still slurring a month later I wondered if she had had a stroke.” This person shared this with me the week I moved home after Mom was diagnosed with ALS. To which I could only say, very unkindly, “You thought your close friend of 40 years, that you saw at church every week, had had a stroke and you never asked her?” I’m ashamed of it now, but in that moment I was very angry.
    I will say that this in fact sounds like substance abuse to me, and it has not been a year to manage substance abuse issues well alone.
    Either way though: if your coworker is actually very ill and you don’t mention a symptom that is noticeable, OR if they need help with alcohol or drugs and you don’t mention a symptom that is noticeable, one day you might feel very bad that your didn’t mention it, I think. Privately saying, “I’ve noticed once or twice you’re slurring in client meetings, I hope that you are well” can cover a lot of scenarios here.

  39. Dr Rat*

    It may be beating a dead horse at this point, but I want to sum up what a lot of people are saying. First, don’t jump to conclusions. Many, many medical conditions can cause someone to sound “off” and slur their words. I heard Jeri Jewell, a comedian with cerebral palsy, do a comedy skit one time about being at an airport and two people from a rehab thinking she was the alcoholic they were supposed to pick up. (I think she literally had to show her ID to prove she wasn’t “Rebecca”.) Second, if you want to address something with a co-worker, address the BEHAVIOR, not the ASSUMPTION. Most people are going to respond much better to “I just wanted you to know that I’ve noticed you’ve been slurring your words a lot lately – is everything okay?” than to “Hey, everyone’s been hearing you slur your words lately, so we’re all decided you’re an alcoholic.”

  40. Former Employee*

    I didn’t read all the comments, but a local news person in my area was reporting on a story from the field and all of a sudden she started speaking gibberish. People thought she was having stroke. It was a migraine.

    As others have pointed out, it could be a serious and undiagnosed medical problem. She may need to see a doctor ASAP.

    Let her know.

  41. PspspspspspsKitty*

    One of the companies I worked at got sold. It was handled very poorly and a lot of people’s careers ended that day. My usually happy coworker kept getting more negative and depressive. I waited for everyone else to be gone and finally spoke up and said “Are you okay? I’ve noticed that you’ve been sounding pretty defeated lately. You don’t have to talk about it, but I just wanted to make sure you are okay.”

    She seemed to be cool with that and thanked me for asking. It’s always hard to speak up with this kind of thing, but I always believe society will be better if we simply asked if people were okay. It doesn’t have to go into personal details or “office therapy”.

  42. E*

    Whether it’s perfectly innocent or not (I personally got my epilepsy meds adjusted in November and it’s been making me sleepy during the day which I’ve been developing coping mechanisms for)

    …You and she need to take steps so that she isn’t slurring or repeating herself on client calls. Maybe she doesn’t need to be on them for the full 3 hours or however long it is? There may be a solution.

  43. North European*

    I did not read the entire chain. It seems that most of the respondents want to remind OP that many other (medical) reasons can cause slurring than drinking. But, as the daughter of an alcoholic I want to point out that some alcoholics indeed ”secretly” drink and believe no-one will notice (or because of the dependency are unable to face that issue). My parent appeared to family celebrations drunk or in a bad hungover and not apologizing at all, I think they really thought that bobody noticed (EVERYONE noticed). I am quite sure they did it at work as well.
    Which of course does not mean that you need to voice your potential suspicions to your colleague. The general, more vague wordings which the other repondents posted would be very good in this case as well.

    1. New Jack Karyn*

      Yeah, addressing the observed behaviors seems like the way to go. OP can say what she actually saw, and not speculate about the cause. If she’s genuinely concerned about the coworker’s well-being, say that too.

      As someone else noted above, if she *does* have a substance abuse problem, realizing that others notice might be a step toward addressing it.

  44. LondonLady*

    A former manager of mine, who lived with diabetes, often appeared as drunk when their insulin levels were off. If your colleague is living alone it may be harder for her to manage her diet and medication than when she is regularly interacting with others. I used to carry and offer sweets in meetings if he seemed off colour (offer to all, but with this colleague in mind) but obviously that’s harder when we are all remote. I am sure a kind enquiry after their health would be OK, but don’t assume it’s alcohol-related: it’s the impact on work that matters, not the cause.

  45. ElleKay*

    Hi LW, in addition, could the reason your managers aren’t responding be b/c they know that something’s going on already? If this is a medication/health issue it’s possible HR or management is already on it; in that case a gentle question from you gives her the opportunity to say “Yes, and I’m so sorry about it all! I’m working with HR as I find a solution.”

    From a person who’s medication was causing her to fall asleep in meetings/at work/be extremely late and who’s team was validly confused until I told them that HR, my manager and I were working on a solution.

  46. RebelwithMouseyHair*

    I remember reading a book by Oliver Sacks in which he described a woman who had lost her sense of proprioception (perception or awareness of the position and movement of the body, thanks Google). She said she might stumble as she got on the bus, and people would assume she was drunk and make remarks about it only being 3pm. This is the kind of thing that needs to be checked out if she isn’t drunk or medicated.
    (Although drunkenness and over medicating are probably far more likely, I prefer to take a generous view first).

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