Attorneys and others seeking information on substance abuse, addiction, treatment options, treatment facilities and related information will benefit from the following active links. If a link is no longer active, please contact me so I can make appropriate updates.
I. CALIFORNIA STATE BAR & RELATED RECOVERY RESOURCES
- Lawyers Assistance Program (LAP) The LAP offers confidential help to attorneys seeking substance abuse, mental health or other career assistance. Call 877-LAP-4HELP (877-527-4435) or email at: LAP@calbar.ca.gov.
- Alternative Discipline Program (ADP) The ADP provides an alternative to attorneys in the facing discipline at the State Bar Level for substance abuse or mental health issues.
- The Other Bar The Other Bar Offers peer to peer support & information to attorneys in recovery & those still struggling. The Other Bar maintains a statewide meeting calendar & 24-Hour Toll-Free Help Line: 1-800-222-0767
II. AMERICAN BAR ASSOCIATION (ABA) SELF-HELP PROGRAM LINKS
- ABA Commission on LAPS The ABA’s Commission on LAP’s provides extensive information and links to regional resources specific to Attorneys seeking mental and behavioral health assistance.
- ABA Directory of LAPs The ABA’s state by state directory of Lawyers Assistance Programs allows practitioners and others to access assistance programs for attorneys in a specific jurisdiction.
- ABA Compilation of National Resource Links The ABA’s national resource page provides a comprehensive list of active links to information relating to chemical and process addictions, mental health, suicide prevention and related sites.
III. TREATMENT FACILITIES AND LOCATORS
- Substance Abuse Treatment Facility Locator (SAMHSA): This excellent on-line information source allows you to enter a zip code & locate substance abuse and mental health treatment centers anywhere in the United States.
- SAMHSA’s National Help Line: This helpline provides 24 hour no cost, completely confidential treatment referrals and information about mental and substance abuse disorders, prevention, treatment and recovery in Spanish and English. 1-800-662-HELP (4357) TTY: 1-800-487-4889.
- Suicide Prevention Lifeline: This 24 hour, toll free hotline provides confidential suicide prevention support to anyone in suicidal crisis or emotional distress. Your call is routed to the nearest crisis center in a national network of more than 150 crisis centers. 1-800-273-TALK (8255); TTY: 1-800-799-4889.
- Opiate Treatment Directory This site resource allows you to identify and locate medication-assisted treatment programs, family and provider support resources and other support networks in your state that treat opiate dependence and addiction.
- CRC Health Group This comprehensive network of specialized behavioral health care affiliates provides “healing and hope” to patients & families across the United States. Access their library to learn more about addiction and treatment.
- Hazelden-Betty Ford Addiction Treatment Center A household name in the treatment of alcohol and drug addiction disorders throughout the country, this provider has a specialized program for attorney, judges and other professionals dealing with substance use and addiction issues.
IV. MISCELLANEOUS ONLINE RECOVERY RESOURCES
- Smart Recovery Self-Management & Recovery Training Smart Recovery is a science based, non-12-step program emphasizing self empowerment as a means to recovering from addictive substances and behaviors.
- Alcoholics Anonymous “A.A.” is “an international fellowship of men and women who have had a drinking problem. It is nonprofessional, self-supporting, multiracial, apolitical, and available almost everywhere.” This link will take you to AA’s official website where you can learn more about the 12-step program.
- Narcotics Anonymous “N.A.” is a global, community-based organization helping those recovering from the effects of addiction by working a twelve-step program similar to the program of recovery offered by AA. This link will take you to NA’s official website where you can learn more about the program.
SOBERING FACTS ABOUT ATTORNEYS & ADDICTION
Compared to other occupations and professions, attorneys show higher rates of substance abuse & dependence, depression and suicide. Factors unique to our profession are believed to contribute to these higher than average rates.
Attorneys present greater treatment and recovery challenges due to a range of cognitive and environmental factors such as impaired judgment, stigma and the belief we are or may be beyond help.
A. THE COMPANY WE KEEP
1. 1 of every 4 lawyers suffers from “toxic” stress levels & a strong correlation exists between work-related toxic stress and higher rates of alcohol consumption.
2. Lawyers have a higher rate of alcoholism than the general population. 30% of lawyers reportedly abuse alcohol.
3. Studies from numerous jurisdictions peg the rate of alcoholism in the legal profession at between 15% and 24%. Roughly 1 in 5 lawyers is addicted to alcohol compared to the national average of about 9%.
4. The National Institute on Alcoholism and Alcohol Abuse (NIAAA: www.niaaa.nih.gov) cites an ABA study in which 13% of lawyers surveyed admitted to drinking 6 or more alcoholic drinks in 1 day, compared to 7% of the population who are alcoholics.
5. The International Journal of Law and Psychiatry reports problem drinking developed in 18% of lawyers practicing between 2 and 20 years and in 25% of lawyers practicing 20 years or more.
6. Alcoholism among lawyers contributes to approximately 60% of disciplinary prosecutions. 75% of disciplinary proceedings in California in 2008 involved alcohol abuse. Similarly, over 60% of all malpractice claims involve alcohol abuse.
7. The ABA Commission on Lawyer Assistance Programs has concluded as many as 90% of all serious trust fund disciplinary matters involve substance abuse, primarily alcoholism.
8. The medical community reports 20% of all active attorneys are addicted to drugs or alcohol.
9. 26% of lawyers reported using cocaine at least once. This is more than TWICE the figure for the general population.
10. 33% of practicing lawyers suffer some form of mental illness and approximately 19% in one study suffer from depression. As a profession, attorneys rank first in depression— a principle co-occurring disorder aggravating substance use.
11. Lawyers have the highest suicide rates among the professions.
B. BARRIERS TO ATTORNEYS SEEKING TREAMENT
1. Denial: is a defense mechanism used when faced with a fact that is too uncomfortable to accept and so is rejected despite overwhelming evidence. Denial is both conscious and unconscious behavior with positive and negative roles in healthy relationships.
In the Addiction-Recovery setting, denial is often a thoroughly developed, organized and sophisticated alibi system an affected individual rehearses, refines and repeats to her or himself and to others. This alibi system includes
Denial is ignorance when we ignore the meaning of addiction as a disease – something over which we lack control and cannot correct with willpower or intellect alone. Denial is ignorance when we fail to appreciate the consequences of our addiction on others.
Without their intercession, we may be unaware of the chaos we bring into their experience. When we are aware, our shame may limit our willingness to accept our true condition and investigate our recovery options.
Denial is a defense mechanism used to deflect unbearable pain, anxiety and helplessness. Psychiatrists and Psychologists understand denial as an unconscious defense when the existence of unpleasant internal or external realities is denied and kept out of conscious awareness. By keeping the stressors out of consciousness, they are prevented from causing us anxiety.
Denial is deception when it is a calculated tactic to manage our self-image, manipulate others and avoid or shift responsibility and accountability for the havoc our addictive behavior creates. Deceptive denial includes lying about or minimizing our using behavior and its consequences, or trying to shift responsibility away from ourselves and to those most affected. As conscious deception, denial implicates our professional fitness.
Denial is delusional thinking reflecting our brain’s altered neural circuitry and its effects on our judgment, decision-making and related cognitive abilities. We may firmly– but mistakenly– believe we don’t have a problem, that we are in control of, can manage, or even quit our using activity anytime we want. Misjudging the impact of our addiction on ourselves and others, we lack the impetus to change.
2. Traits of the Person & Profession: may predispose attorneys to substance abuse or addiction as well as contribute to the difficulty attorneys have admitting to the problem and seeking treatment. These traits may include:
a. Traits of Personality:
1. A heightened orientation toward achievement, dominance, control & materialism;
2. A innate competitive adversarialism;
3. Interpersonal insensitivity manifest as objective neutrality;
4. Aggressive responses to stressors;
5. A “thinking” rather than “feeling” preference when decision making.
b. Traits of the Profession:
1. An emphasis on debate, argumentation, conflict & subterfuge– even against clear evidence;
2. A de-emphasis on self-revelation, self-insight and self-awareness in the guise of objective neutrality;
3. An strong & often inflated sense orientation toward self reliance — one at odds with mutually inclusive, and therefore favoring mutually exclusive– goal achievement;
4. The ability to remain high functioning while feeding our abusive & addictive behaviors
c. Enabling Alliances:
Enabling describes those actions of others that insulate the affected practitioner from the consequences of her or his substance related behavior. We can be enabled by family, firm partners & staff, colleagues, judges, even our clients!
Whether their conduct is intended to be supportive, assistive, defensive, or deflective, it is enabling when it prevents us from experiencing the consequences of our addiction and thereby delays our coming to terms with problem and taking voluntary steps to address it.
Fear of being shunned, disapproved of or held in a negative light by colleagues, clients or judges often prevents us from admitting to substance dependence; or, once admitted, from actively seeking comprehensive help to restore ourselves to wellness.
Stigma and denial may work in tandem telling us our professional reputations and careers are at stake should we “come clean.” Rarely do we weigh the alternative consequences of allowing our disease to progress to the point of criminal conduct, professional discipline, or post-treatment relapse due to poor or non-existent aftercare.
I.D.E.A.L. Recovery Coaching views substance abuse and dependency as a treatable condition rather than as a character failing. However, a knowing refusal to address the issue and its consequences in our own lives raises concerns about our honesty and integrity.
I.D.E.A.L. Recovery Coaching recognizes there are multiple pathways to recovery and offers the following resources to help you determine both your place and your direction on the path.
I. THE ADDICTION CONTINUUM: One Man’s Meat is Another’s Poison
“Experimenting” suggests we try something a few times and then don’t come back to it. Beyond that, we are probably “using.” The line between “using” and “abusing” is then largely circumstantial. One person’s pattern of casual or recreational use may be become progressively harmful enough to constitute “abuse.” However, even one who “abuses” alcohol or other drugs is not necessarily an “addict” who is “chemically dependent.”
The 4th Edition of the Diagnostic & Statistical Manual of Disorders (“DSM-IV”) offers the following definitions of substance abuse and dependence:
A. SUBSTANCE ABUSE: A MALADAPTIVE PATTERN OF SUBSTANCE USE LEADING TO CLINICALLY SIGNIFICANT IMPAIRMENT OR DISTRESS IS MANIFESTED BY ONE OR MORE OF THE FOLLOWING, OCCURRING WITHIN A 12-MONTH PERIOD:
1. Recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home (e.g. repeated absences or poor work performance related to substance use; substance-related absences, suspensions, or expulsions from school; neglect of children or household).
2. Recurrent substance use in situations in which it is physically hazardous (e.g. driving an automobile or operating a machine when impaired).
3. Recurrent substance-related legal problems (e.g. arrests for substance-related disorderly conduct).
4. Continued substance use despite persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance (e.g. arguments with spouse about consequences of intoxication, physical fights)
B. SUBSTANCE DEPENDENCE: A MALADAPTIVE PATTERN OF SUBSTANCE USE LEADING TO CLINICALLY SIGNIFICANT IMPAIRMENT OR DISTRESS IS MANIFESTED BY THREE OR MORE OF THE FOLLOWING, OCCURRING AT ANY TIME IN THE SAME 12-MONTH PERIOD:
1. Tolerance, as defined by either of the following:
a. a need for markedly increased amounts of the substance to achieve intoxication or desired effect;
b. a markedly diminished effect with continued use of the same amount of the substance.
2. Withdrawal, as manifested by either of the following:
a. the characteristic withdrawal syndrome for the substance; or
b. taking the same (or a closely related) substance to relieve or avoid withdrawal symptoms.
3. Taking the substance often in larger amounts or over a longer period than was intended.
4. Having a persistent desire or unsuccessful efforts to cut down or control substance use.
The DSM-V now combines substance abuse and substance dependence into a single condition that can be measured on a scale of mild to severe.
C. THE DISEASE CONCEPT OF ADDICTION
THE AMERICAN SOCIETY OF ADDICTION MEDICINE DEFINES ADDICTION AS A:
“…a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors.
Addiction is characterized by inability to consistently abstain, impairment in behavioral control, craving, diminished recognition of significant problems with one’s behaviors and interpersonal relationships, and a dysfunctional emotional response. Like other chronic diseases, addiction often involves cycles of relapse and remission. Without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death.”
D. RECOVERY: WHAT IT IS AND CAN BE
1. William Anthony, Executive Director of the Boston Center for Psychiatric Rehabilitation, calls recovery: “a deeply personal, unique process of changing one’s attitudes, values, feelings, goals, skills and/or roles. It is a way of living a satisfying, hopeful, and contributing life even with limitations caused by the illness…”
2. In 2005, the SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION (SAMHSA) offered a working definition of Recovery from alcohol or drug problems as: “…a process of change through which an individual achieves abstinence and improved health, wellness and quality of life.”
3. In 2011, SAMHSA revised its working definition of recovery as follows: “Recovery is a process of change whereby individuals work to improve their own health and wellness and to live a meaningful life in a community of their choice while striving to achieve their full potential.”