The Legal Burnout Solution: Substance Use Disorder, an Open Conversation
By Rebecca Howlett and Cynthia Sharp
In last month’s column, Becky revealed her struggles and ongoing recovery from burnout, depression, and anxiety. We greatly appreciate the positive feedback and encouragement that we received and are now even more motivated to continue our mission. This month, we delve into a mental health issue that has wrecked many a life and career—substance use disorder (SUD). Even though much of our focus—for today—is on alcoholism, most of the material applies across the board in the SUD arena.
I had my first drink in December 1975 (six days before my 21st birthday), and from that moment on I never had a healthy relationship with alcohol. I began working on Capitol Hill in Washington, D.C., in 1976 and started the night program at Georgetown Law a year later. Alcohol was readily available, and I was off to the races.
Despite the impediment of alcohol, I was successful in my career and later discovered that I am classified as an HFAA: Highly Functioning Alcoholic Attorney. HFAAs habitually drink inappropriate amounts of alcohol while maintaining a level of professional and personal success. My pattern was to drive myself work-wise and then reward myself with a drink. Work hard again and then drink.
I experienced the gamut of emotions—anxiety, depression, shame, loneliness, a seemingly endless cycle. The thought of suicide went through my mind more than once. I tried many times to get sober, but it just didn’t stick.
Finally, I was fed up with being fed up and was at the end of my rope. On September 23, 2009, I had my last drink. Knowing that I could not do it alone, I checked myself into Caron Rehab in Wernersville, Pennsylvania, on September 25 and committed to a 31-day program. I have not had a drink since that day—one day at a time.
Although I have been a professional speaker and attorney coach for the past 11 years, I haven’t publicly disclosed my struggle with alcohol until recently because I didn’t want it to distract from my message. As the pandemic took hold in spring 2020, I made a commitment to share my insights publicly and to do further research into SUD, along with my partner Becky. If we save even one person from the years of unnecessary misery that I experienced, our efforts will have been worthwhile.
Substance Use Disorder
Formerly termed substance abuse, the American Psychological Association now classifies medical addiction as substance use disorder. SUD is a medical disease that affects a person’s brain and behavior so that they are no longer able to control their drinking or substance use. SUD can be mild, moderate, or severe, but critically, even those who aren’t suffering with a debilitating addiction may need help.
Signs of SUD include using more frequently and in higher quantities, developing intense cravings for the substance, and an inability to control one’s usage (even when the harm is evident). Additional indicators of problem drinking or substance use disorder include using alone or in secret, losing interest in activities and hobbies that formerly brought pleasure, as well as legal problems and issues with relationships, employment, or finances due to the substance use.
Although a person may start out drinking or using drugs recreationally or socially, it may escalate to chemical dependence such that they must drink or use to stave off physical withdrawal symptoms and function “normally.” Addiction is a medical disease, not a moral failing, although it can lead to immoral and unethical behavior, especially if left untreated.
Attorneys and Alcohol
The landmark 2016 study on lawyer impairment conducted by the ABA Commission on Lawyer Assistance Programs and the Hazelden Betty Ford Foundation affirmed attorneys are disproportionately impacted by alcohol and SUD. According to this study of more than 12,000 attorneys across 19 states, 20.6 percent screened positive for hazardous, harmful, and potentially alcohol-dependent drinking. Lawyers most at risk for developing an alcohol use disorder include those working in private firms, under 30 years old, and with few years in practice.
Although attorneys were found to be three to five times more likely than the general population to develop an alcohol use disorder, 93 percent did not receive any help or services for alcohol or drug addiction. This trend is truly incompatible with sustaining a professional culture as attorney substance use disorder often goes hand-in-hand with misconduct that leads to professional discipline. Indeed, the root cause underlying many violations of the Rules of Professional Conduct is alcoholism or SUD. In some jurisdictions, between 25 percent and 35 percent of disciplinary actions fall into this category.
Especially during these times of heightened stress, it is imperative to be aware of the warning signs of impairment. A major impediment to recognizing these signs is denial.
It’s hard to admit to a problem with alcohol or drugs, especially if the person is still achieving at a reasonably high level. After all, people in denial have impaired insight into the reality of their situation. Indeed, denial, in and of itself, is a symptom of substance use disorder.
This partial list of classic signs of denial will no doubt be familiar to those suffering from SUD:
1. Covering up: “No, I haven’t been drinking,” or “I only had 2 drinks at the party,” or “I didn’t realize I’m slurring my words. I must be having a bad reaction to my medication.”
2. Blaming circumstances or other people: “I am under so much stress at work that I deserve a drink,” or “My partner/spouse/parent made me so angry that I had to have a drink to calm down.”
3. Downplaying by comparison: “I am on time for work every day and make a good living. If I were really an alcoholic, I wouldn’t be able to achieve so much. A true alcoholic wouldn’t even be able to hold down a job.”
4. Reacting with defensiveness: “It’s really none of your business. What I do with my body is my decision.”
Friends, family, and colleagues can also become participants in denial and perhaps even enablers. For example, they may make excuses for absenteeism or provide rescue from legal and financial problems.
If you or a legal professional you know exhibit the signs of SUD outlined above, help is readily available.
The difficult part is reaching out, particularly if the person remains in denial. It’s tough to
admit that your life has become unmanageable and that you can’t fix things on your own.
A good place to start is your state’s lawyer assistance program, where you can receive confidential assistance and access appropriate resources. A list of these program can be
found on the website of the ABA Commission on Lawyer Assistance Programs. You may also want to
explore private therapy or counseling, as well as substance use support groups, such as Alcoholics Anonymous. If nothing else, phone a friend and tell them that you may have a problem and really don’t know where to start.
In addition, cultivating a mindfulness practice can be an effective tool to supporting recovery and preventing relapse. According to a 2018 study available on the National Institute of Health website, mindfulness-based interventions may become a mainstay of addiction treatment.
If you or someone you know has relapsed again and again, please do not lose hope. Cindy relapsed again and again for close to two decades. Finally, the time was right.
As an aside, an attorney who knows that the mental impairment of another lawyer is affecting their fitness to practice may be ethically required to take certain steps. E-mail us at firstname.lastname@example.org, and we will send you cites to opinions on this topic.
We shared this information to let lawyers and others who are struggling know that you are not alone. Everyone deserves to lead a happy and fulfilled life. However, it’s up to you to reach out, seek support, and take advantage of all available tools.
Tune in next month, when we will explore the role of mindfulness in building a culture founded on principles of professional civility.
© 2021. Originally published in GP Solo eReport, January 2021 Issue (Vol. 10, No. 6) by the American Bar Association. Reproduced with permission. All rights reserved. This information or any portion thereof may not be copied or disseminated in any form or by any means or stored in an electronic database or retrieval system without the express written consent of the American Bar Association or the copyright holder.