Combatting Substance Abuse in the Legal Profession, Part Three
Treatment and successful return to work
Addiction is a chronic disease that can be successfully treated. So why are so many lawyers choosing not to seek treatment or unable to stay sober afterward?
The first answer, as alluded to earlier, is that they deny the problem and believe they can handle the situation themselves. Typically, impaired lawyers appear high functioning for years, and career is the last part of their lives they lose to substance abuse.
Families, children, spouses, friends, activities, health and balance all are discarded before career. In the lawyers’ minds, they are not addicts or alcoholics as long as they are still working. They discipline themselves to complete assignments, meet deadlines and appear robust at the office.
The 2016 survey reports that a reluctance to seek help is the primary obstacle to treatment. Lawyers with substance-abuse problems usually don’t reach out unless the consequences have become serious enough to provoke assistance from others (e.g., an intervention) or to create a willingness or desperation that motivates them to seek help on their own.
Once that hurdle is cleared, the most effective route is for a professional to perform a chemical/behavioral health assessment to identify and quantify the addiction or mental health issue. Substance-abuse disorders, for example, can be mild, severe or somewhere in between.
This assessment is often coupled with a recommendation for level of care. The broad range of available options includes attending a sobriety program, meeting with an addiction therapist and attending intensive outpatient therapy.
Some people may need a residential treatment program away from work and family. Medication can also be an important part of recovery. The assessment, often conducted by a professional at an outpatient or inpatient facility, is usually free of charge. Many facilities accept insurance, so treatment is often available for attorneys with limited resources.
I have personally treated impaired lawyers for seven years now, all at residential facilities and participating in intensive outpatient therapy My own experience is that, generally, lawyers are acutely ill and deep into their disease by the time they admit they need help.
Because of this, the appropriate level of care for them starts with residential treatment, where they are away from their jobs and families for 30 to 60 days. Otherwise, they will remain enmeshed with their careers and homes as well as the stress – and its attendant drinking and drug patterns – that is part of their addiction.
Attorneys rarely believe they can afford to be away from work for that long, but in fact they can. The world will go on. A support system to monitor the lawyer’s work and clients can be quickly established, electronic devices can be strategically accessed on a limited basis during treatment.
The best way to get better is to receive intense and focused treatment, and 30 to 60 days in the context of a long career is comparable to the recovery time needed after a heart attack.
Another challenge is maintaining healthy, long-term recovery after residential treatment ends. Two elements are critical to long-term success: a robust aftercare program, and a safe and structured return to work.
As for aftercare, the treatment center will work with the individual lawyer to determine how much additional treatment is necessary. Potential recommendations include an extended period in treatment; living in sober housing for up to six months; outpatient or intensive outpatient therapy connecting with a good therapist; and attending 12-step meetings and finding a sponsor.
Recovery really begins after residential treatment, so a support system is an essential part of the continuum of care.
Not surprisingly, lawyers typically want to go back to work as soon as possible and hit the ground running. They feel bad about their prolonged absence and the caseload left behind for others to cover. They want to show they have been “fixed.” This mindset is an almost-guaranteed recipe for relapse.
I counsel all my patients to return gradually to work over at least six months so they will have time for all the recovery activity necessary early on, and avoid the massive stress of jumping into the same situation they left. There should be alcohol and drug monitoring in the first year, much like that required of doctors and pilots.
Monitoring can be accomplished through the treatment center or independent organizations. It can be organized so that employers know the lawyers are not using (and can feel comfortable about them working with its clients) and lawyers do not have to worry about not being trusted.
Each of the issues raised in this overview could warrant its own in-depth analysis. Hopefully, the global picture depicted here provides a snapshot of the problems and solutions for one of the most serious threats to the profession.
Just as other diseases and impairments have risen above stigma and shame, addiction and behavioral health problems can, and should, follow suit.
This series was authored by Link Cristin, executive director of the legal professionals program at Caron Treatment Centers. The article was originally posted to Westlaw Practitioners Insights M&A ($) site.