Substance Use Disorder as an Occupational Hazard for Attorneys

Know the risks; reach out for help 

COLUMN > MEMBER WELLNESS CORNER
Illustration © Getty/Francescoch
BY LESLIE HAGIN

I am an attorney and an alcoholic/addict. It took me decades to admit the last two “As” in that description, or even consider that my drinking and drug “habits” might have had any sort of adverse consequences in my life or the lives of others.

I am now in recovery and have been for some time. But my ignorance, fear, ego, and denial almost cost me everything I had ever worked for and held dear, including my career, personal relationships, and my own life. I am writing this article in the hope that my experience and what I have learned may help someone else.

MY STORY

After being a go-getter and career driven for as long as I can remember, the progressive and chronic nature of the disease of alcoholism (and other substance misuse) took me down a very slippery slope. My use went from being (what I could pass off as) a professional networking and social lubricant, with the occasional binge and hangover, to my go-to tool for “managing” depression, anxiety, stress, and any other emotions, the effects of legal wins and losses, and finally everything I encountered and tried to control in my life. Then (suddenly, it seemed) I became a daily and constant user, not caring whether I lost my career, law license, and everybody and everything else in my life—as long as I could escape from myself and into my substances.

In short, when I tried to control my drinking and substance use, I could not enjoy it and when I enjoyed my drinking and substance use, I could not control it. I had no shut-off valve or stop button, no matter my will power and problem-solving skills. And I did not want to stop, even after waking up very sick in an emergency room with no idea how I got there.

After decades of living like this, I finally had to admit that my way was not working in any aspect of my life or career. I created an increasingly miserable series of humiliating and painful experiences. And I finally hit a point of futility. I was hopeless and living, literally, only to drink and use. I was in enough pain and so out of ideas to help myself that I paused digging my own demise just long enough to make an initial ask for help, unsure that help might even exist for me. 

From that first inquiry, I began a journey of learning and healing. I learned that alcoholism and substance use disorder (unless treated) are without exception equal opportunity progressive, chronic, and fatal diseases affecting every sort of person and profession. I learned the challenges I faced were neither unique nor unconquerable. 

More specifically, I learned that alcoholism and substance use disorder are diseases that are related to a number of risk factors such as depression, anxiety, and stress, and the diseases and the risk factors are especially prevalent among lawyers. But most importantly, I learned there is hope and a way out of the addiction abyss.

THE BROADER PROBLEM

One of the first comprehensive studies of substance use disorder and related risk factors in the legal profession was published in 2016 in the Journal of Addiction Medicine, entitled “The Prevalence of Substance Use and Other Mental Health Concerns Among American Attorneys” (“2016 Krill Study”).11 Patrick R. Krill, Ryan Johnson, and Linda Albert. “The Prevalence of Substance Use and Other Mental Health Concerns Among American Attorneys,” Journal of Addiction Medicine 10, no. 1 (Feb. 2016): 46-52, https://doi.org/10.1097%2FADM.0000000000000182. Patrick Krill is an attorney as well as a board-certified alcohol and drug counselor. It surveyed 12,825 licensed attorneys and found that 20.6 percent of those self-reported hazardous, harmful, and potential alcohol-dependent drinking (also called problematic drinking). This compared to 11.8 percent in the wider highly educated workforce. 

In addition, attorneys surveyed reported some level of depression (28 percent), anxiety (19 percent), and stress (23 percent). Sixty-one percent of lawyers reported having concerns with anxiety at some point in their careers, and 46 percent reported having concerns with depression. Eleven percent reported having suicidal thoughts at some point during their career. 

I self-medicated to progressively greater degrees for decades (from my teens to early 50s) with alcohol (and other mood-altering substances) in the effort to manage my feelings of depression, anxiety, and suicidal ideation. For a long time, I was able to function highly and have apparent career success. But I now know that alcohol is a depressant, so I was literally pouring fuel on the fire and progressing deeper and deeper into the chronic abyss of addiction and my other mental health issues. I was also underreporting and being dishonest about my actual usage, even with the mental health therapist I finally agreed to see (after waking up with an alcohol overdose in the emergency room). The anti-depression and anti-anxiety medications prescribed to me could not work while I was still abusing alcohol and other substances—but I could not imagine my life without these substances. 

In recovery, I have heard the stories of many others with substance use disorder, depression, anxiety, and suicidal ideation, and found that my experience is common. I therefore suspect the numbers self-reported by lawyers in the Krill survey and other surveys are lower than they actually are. The 2016 Krill study was conducted and published before the COVID-19 pandemic. Not surprisingly, given the increased stress, isolation, and access to home-delivered alcohol brought about by the pandemic, the lawyer-specific studies since then are even more alarming. 

In 2021, another study by Patrick Krill and fellow researcher Dr. Justin Anker, conducted through a National Institutes of Health (NIH) grant, was released. The study was based on self-reported data collected from lawyers randomly sampled from the California Lawyers Association and the Bar Association of the District of Columbia.22 Justin Anker and Patrick R. Krill. “Stress, Drink, Leave: An Examination of Gender-Specific Risk Factors for Mental Health Problems and Attrition Among Licensed Attorneys,” PLoS ONE 16, no. 5 (May 2021), https://doi.org/10.1371/journal.pone.0250563. 

This study found that for both men and women, the impact of COVID-19 and the long-standing permissiveness toward alcohol at legal workplaces and functions were the primary predictors of risky drinking relative to other factors (e.g., overcommitment, work-family conflict). In addition, results indicated that the prevalence and severity of risky/hazardous drinking are now significantly higher among female attorneys than among male attorneys. “This finding is at odds with several other studies outside the legal profession indicating that men typically exceed women in terms of problematic alcohol use …,” the authors stated.33 Id. The women surveyed also reported higher levels of anxiety, depression, and stress than the men surveyed.

The legal profession in the U.S. is “in the midst of a cultural reckoning related to the mental health and well-being of its members,” the study authors stated. “However, this problem extends beyond the individual lawyer and has the potential to impact not only clients but also the legal system more broadly.”44 Id.

HOPE AND SOLUTIONS 

While alcoholism and substance use disorder are especially prevalent in the legal profession, lawyers are also inclined toward and trained in problem-solving. However, as I and many others have learned, this problem cannot be solved alone or in isolation. 

The very good news is that there are free solutions available for anyone in the legal profession who may be concerned or even simply curious about their own substance use and risk factors, or those of a friend or colleague. All it takes, in my experience, is a willingness to ask for help and take the first suggested steps once they are pointed out. 

Moreover, there are several impactful steps that law firms and other legal organizations can take to help their employees. For example, it is now recognized that systemic peer support, education, and changing the alcohol-centric legal culture are important parts of the solution. And while there is much more work still needed in these areas in both law school and within the legal profession, there are signs of progress.

For example, national and state task forces have been formed, including the WSBA’s Member Well-Being Task Force, which officially launched earlier this year, and the ABA National Task Force on Lawyer Well-Being. In its comprehensive and powerful 2017 report, the ABA Task Force laid out specific recommendations for those in the legal profession to consider implementing.55 See ABA National Task Force on Lawyer Well-Being Report (“The Path to Lawyer Well-Being”), and corresponding ABA Board of Governors Resolution 105, at https://lawyerwellbeing.net/. 

In addition, hundreds of legal employers—including companies with in-house counsel, bar associations, and law schools—have now signed an ABA-sponsored pledge to reduce substance use disorder and other mental health problems in our profession, by reducing if not eliminating alcohol-centric workplace and networking events.66 The Pledge can be found at www.americanbar.org/content/dam/aba/administrative/lawyer_assistance/ls-colap-working-group-pledge-and-campaign.pdf. See also www.americanbar.org/groups/lawyer_assistance/well-being-in-the-legal-profession (Pledge Toolkit for Lawyers and Legal Employers); Patrick R. Krill, “The ABA Well-Being Pledge Turns 5: Progress Made, Progress Needed,” ABA Journal, Oct. 23, 2023, at http://www.abajournal.com/voice/article/the-aba-well-being-pledge-turns-5-progress-made-progress-needed. I hope other legal workplaces, bar associations, and law schools will soon make the same or similar pledges.

Further, several state bar associations including the WSBA have developed effective models of accessible and completely confidential lawyer-assistance programs, separate from the disciplinary functions of their associations. The WSBA, for example, provides free and confidential addiction and psychological counseling as well as other programming. In addition, the State Bar of California and some others now require CLE reported credits (and associated CLE trainings) on substance use disorder. I hope the WSBA will consider doing the same. 

. . .

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About the author

Leslie Hagin is a lawyer with over 25 years’ experience in litigation and public policy. She has been in recovery since 2019. She can be reached at: 

highland7@msn.com

NOTES

1. Patrick R. Krill, Ryan Johnson, and Linda Albert. “The Prevalence of Substance Use and Other Mental Health Concerns Among American Attorneys,” Journal of Addiction Medicine 10, no. 1 (Feb. 2016): 46-52, https://doi.org/10.1097%2FADM.0000000000000182. Patrick Krill is an attorney as well as a board-certified alcohol and drug counselor.

2. Justin Anker and Patrick R. Krill. “Stress, Drink, Leave: An Examination of Gender-Specific Risk Factors for Mental Health Problems and Attrition Among Licensed Attorneys,” PLoS ONE 16, no. 5 (May 2021), https://doi.org/10.1371/journal.pone.0250563. 

3. Id.

4. Id.

5. See ABA National Task Force on Lawyer Well-Being Report (“The Path to Lawyer Well-Being”), and corresponding ABA Board of Governors Resolution 105, at https://lawyerwellbeing.net/. 

6. The Pledge can be found at www.americanbar.org/content/dam/aba/administrative/lawyer_assistance/ls-colap-working-group-pledge-and-campaign.pdf. See also www.americanbar.org/groups/lawyer_assistance/well-being-in-the-legal-profession (Pledge Toolkit for Lawyers and Legal Employers); Patrick R. Krill, “The ABA Well-Being Pledge Turns 5: Progress Made, Progress Needed,” ABA Journal, Oct. 23, 2023, at http://www.abajournal.com/voice/article/the-aba-well-being-pledge-turns-5-progress-made-progress-needed. 

7. I am a volunteer peer counselor.