Students enter law school knowing they will face high levels of stress and demanding workloads, but the situation may be worse than many people once thought. A comprehensive study in 2016 confirmed a widespread problem with drug and alcohol abuse disorders and mental health conditions among lawyers and recommended steps to help with recovery and reduce the associated stigma.
Attorneys and Substance Use Disorder
In 2016, the American Bar Association Commission on Lawyer Assistance Programs and the Hazelden Betty Ford Foundation released the results of a study that looked at substance abuse and other behavioral health problems among lawyers in the United States. Published in the Journal of Addiction Medicine, the research found that 28 percent of licensed and employed attorneys cope with depression, 19 percent show signs of anxiety, and 21 percent fall into the category of problem drinkers. Young attorneys who are in their first decade of practice face the highest risk for these issues.
The study, which was the most far-reaching ever completed, reported that one in three practicing lawyers have drinking problems based on the amount and how often they drink, and the problem is worse among those who work in law firms. In the past, researchers thought drinking problems worsened the more time someone spent as a lawyer, but the new numbers proved that not to be true.
The research involved almost 13,000 lawyers who were in practice at the time of the study. In addition to issues with drinking, depression, and anxiety, 23 percent were struggling with stress. Survey respondents reported issues with things like suicidal thoughts and attempts, social anxiety, panic disorder, bipolar disorder, and ADHD. The figures and issues reported painting an alarming future for people entering this career track.
Law Students and Substance Use Disorders
In further research released in 2016, over 3,000 law students in 15 schools answered questions asked by the Survey on Student Well-Being. The results showed that 22 percent of respondents reported that they were binge drinkers. Researchers flagged one in four as being at high risk for alcoholism and recommended additional screening.
Among the total number who participated, 14 percent reported intense anxiety, 18 percent had been diagnosed with depression, and 37 percent had some form of anxiety.
Conclusions of Researchers
Both 2016 studies revealed above-average risks of substance abuse and mental health disorders that overlapped with a social culture that encouraged social drinking. It is important to notice that only a minority of attorneys and law students have substance abuse or mental disorders. At the same time, those who didn’t report disorders did say they had mixed feelings about their work. They were not necessarily happy or thriving with their careers, but work and personal satisfaction varied in different sectors of employment.
As a response to the data, the National Task Force on Lawyer Well-Being called on leaders of the legal profession to pay attention to the issue and to act on behalf of their peers who were dealing with substance use and mental health disorders or not performing up to their ability. Both studies called for action to reduce risks to the troubled lawyers and to the communities they serve.
Attorneys Versus Other Professionals
Researchers looked at lawyers, doctors, and other professionals. They found alcohol use disorder and mental distress far more common among attorneys than other professionals. The American College of Surgeons, for example, reported in 2012 that just over 15 percent of surgeons abused alcohol, and the general population (of those 18 and over) showed that 6.2 percent had an alcohol use disorder in a 2015 survey by the National Survey on Drug Use and Health.
Evidence shows attorneys often do not get help because they are concerned about their treatments not remaining confidential and hurting their careers. Issues affecting lawyers varied by their age, sex, experience, position, and work environment.
Researchers recommended availability of lawyer-specific assistance programs, education for the purpose of prevention, public awareness programs, and promises of confidentiality for those seeking help. It is the job of the American Bar Association (ABA) Commission on Lawyer Assistance Programs to make sure everyone in the legal field is aware of the dangers facing attorneys and to guide bar associations and assistance programs in the search for solutions.
Lawyers and Drug Use Disorders
Although most substance use disorders among attorneys result from the abuse of alcohol, some also have problems with illegal or prescription drugs. Use of tranquilizers or opioids sometimes starts as a legitimate treatment for a mental health disorder or an injury and becomes an addiction. Lawyers may also turn to illicit drugs to help them cope with stress or to keep up with a demanding workload.
As attorneys give up personal time and care to meet increasing requirements at work, they also have less time for family and friends. Relationships often fall apart, making other problems more difficult to handle. Because attorneys excel at persuading and leading others, it may be difficult for their loved ones and co-workers to talk them into getting help or admitting they have a problem.
While the side effects of drugs vary, the ABA Commission on Lawyer Assistance Programs warns attorneys and co-workers to watch for these symptoms:
- Bloodshot eyes or pupils that are smaller or larger than normal
- A decline in personal hygiene
- Rapid weight gain or loss
- Changes in sleep habits, eating, or mood
- Odors on clothes, body, or breath
- Drop in performance or attendance at school or work
- Slurred speech, lack of coordination, or tremors
- Stealing or borrowing money
- Sudden changes in interests or friends
- Unexplained personality changes
- Legal problems
- Angry outbursts, aggressiveness, or mood swings
- Hyperactivity or anxiety
- Lack of energy or motivation
- Unexplained paranoia
Drug use disorder and addiction are chronic illnesses that get worse over time if they are not treated. Whether it involves over-the-counter cough syrup, cocaine, or prescription pain pills, substance use changes the way the brain works. Individuals can recover, however, with the help of treatment plans that target specific behaviors and any co-occurring conditions, such as depression or anxiety.
The American Bar Association Commission on Lawyer Assistance Programs (CoLAP) is available to help law students, attorneys, and judges who have problems with mental health issues, alcohol, or other substances. They work with local and state lawyer assistance programs to provide counseling, support groups, and other kinds of support.
Attorneys and Mental Health
Not only are individuals who face high levels of stress more likely to suffer from substance use disorders, but people who have mental disorders, such as depression or anxiety, are also more likely to become addicted. The American Bar Association recognizes that substance use and mental health disorders are common in the legal profession.
An article in the Michigan Bar Journal discusses the causes and increased risk of lawyers to suffer from post-traumatic stress syndrome (PTSD). In a 2011 abstract in PubMed.gov, researchers found that attorneys had higher rates of PTSD as well as secondary traumatic stress (STS) than their office staff. PTSD and STS occur when people are exposed to traumatic events or when they hear stories of trauma and abuse.
Symptoms of PTSD include the following:
- Flashbacks or nightmares
- Avoidance of reminders
- Suspicious behavior or distrust
- Numbing with drugs or alcohol
Depression, however, is the most common coexisting mental health condition for attorneys. In a five-part series by the American Bar Association in 2018, attorneys offered their opinions on the causes of their depression, including:
- Witnessing trauma like arrests, divorce, or assault
- Feeling responsible for the fate of others
- Stress, long hours, isolation, and the need to be tough
- Personality types that foster overachievement and perfection
A former U.S. Marine, now a practicing attorney, compared the stress of his job to his experience in combat. Lawyers, he says, need a way to release the anxiety that comes from feeling obligated to keep clients free and safe from harm.
Depression, of course, works two ways. Depressed people are more likely to turn to alcohol or drugs to numb their feelings, but substance use also acts as a depressant on the central nervous system. After the effects of drugs wear off, individuals are left to deal with the emotions they were hiding from and the new struggles caused by their addictions.
The signs of depression can be difficult to distinguish from other disorders, but the following signs are common:
- The feeling of despair or guilt
- Changes in eating habits
- Fatigue and lack of interest
- Inability to focus
- Thoughts of suicide
Individuals who think they have coexisting disorders should discuss their symptoms with a doctor. Giving up a substance that masks depression can make the condition worse and increase risks of substance relapse. For some people with two disorders, medical support, peer groups, and counseling may be enough for recovery. For others, comprehensive outpatient or inpatient support may be needed.
The most effective recovery programs use group counseling, individual counseling, medications, customized treatment plans, and ongoing support to prevent relapse. Relapse may occur, but treating both illnesses is the best way to fight the odds.
Deciding to Get Help
Individuals who wonder if they have a problem with substance use may need help if they encounter these problems:
- Inability to cut back or stop
- Use of drugs or alcohol for longer times or in larger quantities than planned
- Cravings for a substance
- Excessive time devoted to getting, using, or getting over highs
- Disruption of daily routine, school, or work
- Continued use despite relationship-related problems
- Putting oneself or others at physical risk
- Need for increasing amounts to achieve desired results
Addiction Treatment for Lawyers
The National Bar Association (NBA) works with local and state organizations to provide addiction treatment for lawyers across the U.S. These services are confidential, free, and available to law students, attorneys, judges, and family members. The group deals with drug or alcohol use disorders, other kinds of addiction, anxiety, depression, stress, and other mental health conditions. A confidential hotline is available 24 hours a day, seven days a week at (212) 302-5787. The site also has an online registry with links to states and international treatment programs.
The National Bar Association website has a link to national resources, videos, podcasts, research, reports, and local events like Alcoholics Anonymous meetings. Resources include topics like compulsive behavior, compassion fatigue, depression, stress, suicide prevention, drug and alcohol disorders, and wellness. In addition to providing help, the American Bar Association is working to get rid of the stigma that accompanies mental illness and addiction treatment for lawyers. Recovering from a substance use disorder is challenging, but with the right type of care and assistance, achieving sobriety is possible.