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March 15, 2017

Substance abuse and other addictions in the legal profession

by Anne Chambers, LCSW and Anne McDonald, JD

Commonly used substances

According to the National Council on Alcohol and Drug Dependence (NCADD), alcohol is the most often-used addictive substance. One in 12 adults faces an alcohol concern; several million more engage in risky drinking. The Substance Abuse and Mental Health Services Administration (SAMHSA) reports an 8.8 percent rate of substance use disorders in the United States. Alcoholism ranks as the third-leading lifestyle-related cause of death in the U.S. Half of adults report a family history of problem drinking.

The NCADD estimates that 20 million Americans used an illegal substance in the past month. Illicit drugs include substances like marijuana, hashish, methamphetamine, cocaine, heroin and so forth. Marijuana appears to be the most commonly used illicit substance at this time. Currently we are hearing a great deal about the problem of prescription addiction in our country. Accidental addiction occurs when a person receives treatment for a specific medical concern with a valid prescription and becomes addicted over time. Some accidental addicts see multiple physicians to obtain additional prescriptions or turn to illegal substances over time. NCADD estimates of the total overall costs of substance abuse in the U.S. exceed $600 billion per year. 

Substance concerns in the legal profession

Attorneys have above-average rates of substance concerns, depression and suicide. The incidence of lawyer substance concerns, particularly alcohol concerns, is high. Alcohol continues to be the most frequent problem chemical for legal professionals. A recent landmark study titled “The Prevalence of Substance Use and Other Mental Health Concerns Among American Attorneys” was published in the January/February 2016 edition of the Journal of Addiction Medicine.  It summarizes the results of a 2015 study by the Hazelden Betty Ford Foundation and the ABA Commission on Lawyer Assistance Programs, providing valuable insights regarding the current state of mental health among attorneys in our country. 

Attorneys completed survey measures assessing alcohol use, drug use and mental health symptoms. Data was analyzed on a final sample of more than 12,000 licensed attorneys working in the legal field. 

Over 11,000 attorneys completed a 10-item self-report tool to screen for hazardous use, harmful use and potential dependence. One in five screened positive. Findings included a significantly higher proportion of positive screens among men, younger lawyers and those working in the field for a shorter duration. Over 22 percent of the participants reported they felt their use of substances was problematic at some point in their lives. The largest chunk reported the concern presented during their first 15 years of practice. 

Responses were limited on the self-administered drug abuse screening test. Most were identified as low risk. One in five appeared to be at intermediate risk and one in 33 appeared to be at substantial risk. Of those reporting use of a specific substance group within past year, the highest weekly rates were stimulants, sedatives, tobacco,marijuana and opioids, in that order. 

About 7 percent of participants reported past treatment for alcohol or drug use. One in five reported they had participated in a treatment program specifically tailored to legal professionals. This group had significantly lower substance use than those who attended a more general program. Participants reported barriers to treatment as not wanting others to find out they needed help and concerns about privacy or confidentiality. 

If you are concerned about substance use, please contact the Missouri Lawyers’ Assistance Program at 800-688-7859 for free, confidential assistance.

References:

1.        Commission on Lawyer Assistance Programs, American Bar Association Website, http://www.americanbar.org/groups/lawyer_assistance.

2.        DSM-5:  Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. American Psychiatric Association, Washington, DC, 2013.

3.        Krill, Patrick R. JC, LLM; Johnson, Ryan, MA and Albert, Linda, MSSW. “The Prevalence of Substance Use and Other Mental Health Concerns among American Attorneys,” Journal of Addiction Medicine, http://journals.lww.com/journaladdictionmedicine/pages/currenttoc.aspx, Vol.10 (1), Jan/Feb 2016, pp. 46-52.

4.        National Council on Alcoholism and Drug Dependence, “Signs and Symptoms,” www.ncadd.org, site last visited 8/26/16.