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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.