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Attorneys, Addiction & Barriers to Treatment

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 depressionAs 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

a.  Ignorance:

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.

b.  Defensiveness:

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.

c.  Deception:       

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.

d.  Delusion:

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.

d.  Stigmatization

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.

Dealing with Denial: An Attorneys First Step Towards Recovery

Denial is not a river flowing through Africa!
Our conscious refusal to admit to an uncomfortable or painful truth about ourselves or a loved one—THAT’S denial!  Denial is a psychological defense we use to maintain our self-image, esteem, and feelings of security, well-being and control.

Denial allows us to avoid acknowledging facts that are utterly indisputable to those around us.  For the legal practitioner, denial allows us to persuasively disavow, distort and rationalize all of the indicators of substance abuse or addiction in our lives despite the evidence confronting us.

What’s YOUR Plan?
planning the caseAs a trial lawyer, you wouldn’t begin jury selection without first having developed your client’s case through a comprehensive and thorough success strategy.

After investigating your client’s version of the facts, you’ll likely perform any necessary research into potential claims and defenses.  You’ll create a discovery plan for uncovering helpful evidence and punching holes in what you anticipate will be the evidence and arguments of the opposition.

At each stage of the litigation, you’ll likely have a standard list of items to be completed in the short term, all of which are designed to achieve a definable long-term goal: success!

bigstock-Lots-Of-Questions-6083651

If you’re good at what you do, you’ll have layered plans and multiple backup strategies in the event any particular course fails to yield its intended outcome.  In short, you’ll plan meticulously for success, anticipate and address the strengths and weaknesses of each element of both sides of your case, and leave nothing to chance that can be manipulated with proper planning.

General Denials & Affirmative Defenses
When it comes to confronting the dragon of substance abuse, what is your plan?

Sadly, for many attorneys, the plan is to deny that there is a problem.  Just Google “attorneys and substance abuse” and review the results.  Some “sobering” statistics emerge.

  • As a profession, attorneys have an almost 50% higher rate of substance abuse than the general population.
  • 75% of attorneys seeking assistance with substance abuse in 2008 were also involved in disciplinary proceedings.

When we add factors such as depression or other mood, personality or anxiety disorders into the mix, practicing law can be a recipe for self-medicating against the quiet desperation we find among a significant subset of our colleagues.

Equally sobering are studies showing substance-abuse and denial go hand in hand.  Not only are substance abuse and addiction considered occupational hazards in the legal and medical professions; the accompanying stigma– the perception such behavior is somehow evidence of moral failing– encourages those affected to hold fast to the denial defense.  As a result, the majority of those with substance-abuse problems do NOT seek help through mutual aid or professional treatment.   When they do:

  • Less than 50% actually complete treatment;
  • more than 50% resume their old patterns within 30-90 days;
  • in severe cases, recovery doesn’t  stabilize until 4-5 years of continued abstinence. 

Let me ask you a couple questions:  when 50% of substance dependent folks resume former use patterns within 30-90 days of formal treatment, who’s out there “stabilized” 4-5 years later?  What are THEY doing differently? Where will YOU land along this continuum?

The Profession IS the Problem
One problem shared by attorneys and doctors alike is the sense of omnipotence, power and influence bred by our professions.  However, the research doesn’t lie.  We are not immune because of our professional and social standing, our material success or the sheer force of our personalities and professional aptitudes.  The disease of addiction is an equal opportunity destroyer.

Additionally, attorneys are at higher risk of developing substance-abuse problems because of the characteristics unique to our practice. You know them. They include workplace cultures, workloads, stress loads, conflict and adversalialism, incivility from practitioners and clients alike, pressures to market, pressures to bill, pressures to make rain and, ultimately, to win.

Only, for most of us, we don’t, can’t or won’t admit we’ve been lying to trapped in addictionourselves and to those around us, until a truly life or career altering event forces us into the uncompromising truth of our condition: one or more D.U.I.’s, malpractice, professional discipline, divorce, bankruptcy even thoughts and attempts of suicide.

At some point, denial is no longer a defense, but a quiet co-conspirator of the deadliest kind.

Recovering In Stages
As a process, litigation has its discreet phases.  It proceeds along a familiar continuum from intake and investigation, to filing, discovery and settlement efforts, though trial preparation, trial or some other method of dispute resolution, and post-verdict or judgment operations.  Each phase of the continuum has its own set of unique considerations.

Recovering from substance abuse and addiction is also a process that proceeds along a continuum. And each phase of that process similarly carries its own cluster of unique considerations.

Pre-acceptance
Often when we’re in this mindset, we don’t consider, and have no intention of changing, our use patterns. Consciously or unconsciously, we deny we have substance-use problems or that there is a linkage between our substance-use and any personal or professional issues that may give us or others close to us concerns.

Even when confronted by friends, family or colleagues, we may argue, rationalize, evade or even justify the circumstances giving rise to their concerns.

Acceptance
Since addiction is viewed as a “progressive” phenomenon, the issues of concern it creates gradually increase in frequency and gravity.  As the process unfolds, we acknowledge the possibility of a linkage between our using behavior and issues of concern in our lives.

We begin a process of investigating and weighing options for addressing these concerns, considering the benefits and consequences of various courses of action, including continuing use.  Because prolonged substance use and abuse changes our brain chemistry and thinking, we may still be denying critical elements of our using behavior as the source of our problems.

However, we admit to ourselves that an issue tied to using behavior exists. Our blinders are becoming transparent.  This simple admission forms the foundation of a deeply critical surrender of ego that for many lies at the heart of successful long term recovery.

Planning
As we become increasingly convinced of the linkage between our using behaviors and problems we’re experiencing, and having investigated and weighed the options we’ve been considering, we are convinced some kind of change is necessary and we commit to pursue it.

We may perform additional research and inquiry into specific, formal or informal self-help or professional support and treatment options.  We may begin to take stock of our own “recovery capital,” inventorying the personal, professional and community resources available to support and enhance our change agenda.

However, our initial acceptance of a use-related problem has facilitated a commitment to change those facets of our use behavior that create concern for us.

Movement
This is where the rubber hits the road.  Convinced change is necessary, and having weighed the options, taken inventory of our available internal and external resources and decided upon a particular path, we now take decisive action and move toward our personally selected recovery solution.

Whether in formal or informal treatment and support environments, it is here that our understanding of the nature of substance abuse and addiction couples with an understanding of how our using behavior has affected our life and the lives of those closest to us, including our careers.

This phase typically lasts from 3-6 months where professional discipline or a co-occurring disorder are not present– longer where discipline or clinical treatment of a co-occuring disorder is involved.

It is here we confront the task of honest and unflinching self-appraisal. We experience extremes of joy, elation and release– sometimes called “the pink cloud” or “honeymoon period,” alongside the physical and emotional discomfort of detoxification, withdrawal and the guilt, humiliation and sorrow that often accompanies surrendering to the truth of how our prior substance use has affected our lives, loved ones and careers.

Aftercare
Aftercare Support Group Aftercare is directed toward preventing a relapse and reversion into prior using behaviors and occurs in individual and group settings. 

Many who complete a recovery treatment program, including attorneys and other professionals, entertain the delusion their lives and practices will immediately transform for the better; frayed relationships will be repaired and their mea culpas will be met with immediate forgiveness.

However, as Rome was not built in a day, the long-term transformations occurring in recovery occur over significant periods of time.  We can’t expect the damage from years of substance abuse to right itself in 30 days, 6 months or even the first year following treatment. And when the “good life” doesn’t materialize quickly enough, many of us return to our old habits.  Aftercare is our post-treatment defense against backsliding.

Ongoing aftercare is a demonstrated means of increasing our odds of successfully recovering from substance abuse, addiction and it physical and psychological effects. Aftercare provides ongoing structure, support and accountability as needed.  Aftercare connects us to the elements of our recovery capital that sustain our steadily progressive mental and physical transformation for the long term.

Aftercare also assists us to develop strategies for recognizing and addressing the prior thoughts, behaviors, emotions and situations that once triggered our using patterns.  Recovery involves long-term psychological and behavioral adjustments, some of which also involve co-occurring disorders.

Therefore, aftercare provides the critical support we need to maintain our recovery agenda for a period sufficient to permit meaningful change to occur in our lives and careers.

Where To Begin:
The first step for anyone addressing a personal substance-use issuebigstock-Sobriety--Freeway-Exit-Sign-25281065 is to penetrate the barrier of denial and admit a problem exists.  This notion is embedded in the “first step” of many 12-step programs– including Alcoholics Anonymous– which states “We admitted we were powerless over alcohol, that our lives had become unmanageable.”

As lawyers, we may have particular difficulty with this first step because of our inflated sense of our own power to manipulate people and the mechanisms of justice, and also because our material trappings may provide us the false sense that we are “managing” our lives, careers and substances of choice just fine.

We may need to be smacked over the head with substantial “competent” evidence.

Ladies and Gentlemen, The Evidence Clearly Demonstrates…  
Perhaps the most telling indicators of substance dependence are the stated concerns of friends, family, loved ones and colleagues– and our subsequent dismissal or denial of such concerns.

Additionally,  the ABA notes several symptoms that are accepted indicators of chemical or alcohol dependence. This means any combination of these characteristics may objectively point to “use” that has matured to “abuse” that now poses a problem requiring a response:

Chemical Dependence

  • Heightened degrees of evasive or secretive behavior;
  • A loss of interest & association with activities & people that brought pleasure;
  • Recurring financial, social or legal problems;
  • Changes in appetite or sleep patterns;
  • Noticeable decline in workplace attendance, performance & work product;
  • Changes in personality, attitude, acquaintances & routines;
  • Appearing fearful, overly anxious or paranoid without basis;
  • Increased mood swings, irritability & outbursts of rage or frustration;
  • A declining interest in personal appearance, grooming or hygiene;
  • Sudden or extreme variations in weight;
  • Frequent & prolonged periods of lethargy, disorientation & detachment;
  • Noticeable shaking, tremors, slurring of speech & impaired coordination.

Alcohol Dependence

    • An inability to limit alcohol intake once drinking begins;
    • efforts to limit or control drinking;
    • Experiencing a strong compulsion to drink;
    • Requiring increasingly more alcohol to feel its effects;
    • Secretly drinking on the job or when alone;
    • Experiencing nausea, tremors & perspiration when not drinking;
    • Forgetting commitments, prior conversations & blacking out;
    • Drinking regularly at predetermined times;
    • Ensuring alcohol is always close, including at home, the office work or even in your car;
    • Gulping drinks, ordering doubles or drinking to intentionally become intoxicated;
    • Drinking to feel normal.

(See:www.americanbar.org/groups/lawyer_assistance/resources/alcohol_abuse_dependence.html;
www.americanbar.org/groups/lawyer_assistance/resources/drug_abuse_dependence.html.).

YOUR Call to Action
I am entering my 10th year to practice in a relatively small Northern California community.  In the short time I’ve practiced law, I’ve witnessed several of my colleagues succeed in recovery. I’ve also witnessed just as many continue to deny their own substance abuse problems.

I’ve smiled patiently as they’ve rejected the repeated entreaties of those of us– myself included– willing to extend the confidential support, encouragement, experience and personal examples that might have saved them the trials of professional suspension, disbarment, jail time, prison and even suicide.  But they resisted and rejected these efforts.

It’s my personal opinion, but one informed by personal experience and by personal observation, that the deadliest mistake YOU can make as an attorney dealing with YOUR personal substance abuse issues is to convince yourself that your professional standing and intellectual aptitudes are a sufficient defense to the progressive nature of addiction. Too many have been taken down by this belief.

As a Recovery Coach who practices law and is also recovering from the disease of substance dependence, I am available anytime for consultation and support to attorneys and others at any stage of the recovery process.   

If you are in recovery or would like to discuss recovery issues and how a Recovery Coach can benefit YOUR recovery efforts, contact me TODAY at (530) 515-5198.   Lets talk about what Recovery Coaching is and what it can help you achieve.  

You can also email me at CoachPaul@Youridealcoach.com.  All contacts are safe, secure and strictly confidential.

I want to be YOUR Recovery Coach.Lawyer Recovery Coach Paul C. Meidus, Recovery Coach for Lawyers in Redding, California