Substance Use Disorder Among Legal Professionals

Legal professionals, such as lawyers and judges, face enormous amounts of pressure and stress in their jobs. And this intense stress often begins in law school.

As such, legal professionals have higher than average rates of substance abuse and dependence. Mental health challenges are common as well.

‍One out of every five lawyers will experience a drinking problem that can include alcohol abuse and alcohol use disorder (AUD).[1] Drug abuse is less common, although around one in every ten lawyers reports abusing prescription medications.[2] Prescription medication use is common for legal professionals, most often involving stimulants, sedatives, tobacco products, marijuana, and opioids.

Prevalence of SUD Among Legal Professionals

‍The legal profession is a fast-paced, high-pressure, and stressful environment, which can be grueling and demanding. Lawyers face pressure to perform well, be close to perfectionists, and work hard to get and stay ahead.

Alcohol is the top “drug” of choice for legal professionals; however, prescription medications are also commonly used and misused. The main issue is that alcohol and prescription drugs are commonly used together, which increases the risk for overdose and developing SUD.

Alcohol

Alcohol is the most commonly abused substance among lawyers. As many as one in three abuses alcohol, and close to half of these lawyers indicate that problem drinking began in law school or throughout their first 15 years of practicing law.

According to a study in 2015, over 20% of lawyers were classified as problem drinkers with potential alcohol use disorder.[3] Lawyers are two times more likely to abuse alcohol than the general population.[4]

Alcohol is a common method of relieving stress. It is therefore often used as a coping mechanism to help legal professionals “unwind” after a particularly stressful day. Alcohol is also a large part of the legal professional culture with attorneys often spending time together outside of work to drink and commiserate together.

Stimulants

Stimulant drugs include both prescription medications for ADHD, such as Adderall (amphetamine and dextroamphetamine) and Ritalin (methylphenidate), and illegal drugs like cocaine and methamphetamine.

The high demand and intensity of the legal profession, starting in law school, can make these drugs appealing to legal professionals.[5] Stimulants are some of the most commonly used prescription drugs by lawyers.

Stimulants are often used as “study drugs” to help people stay awake and focused through the night. They may be used for hours at a time to prepare for a test in law school or for a legal brief or trial down the road.

Stimulant drugs are widely prescribed and regularly misused by legal professionals looking for a professional “edge.” These drugs are highly addictive, and regular use and especially abuse can lead to physical dependence and addiction.

Sedatives

Popular sedative medications include benzodiazepines and sleep aids. These are often prescribed to dispel anxiety and aid with sleep.

Legal professionals often work long and crazy hours and then have trouble sleeping when they can and need to. Anxiety, depression and mental health conditions are also prevalent among legal professionals, and these medications can be misused in an effort to self-medicate undiagnosed issues.

It is estimated that a large percentage of lawyers use and misuse sedative medications. This problem is largely underreported and overlooked.

Marijuana

While still illegal at the federal level, recreational use of marijuana has been legalized in many states. State bar associations are also loosening the reins, allowing legal professionals the ability to partake as well — just not to excess.[6]

Marijuana is a depressant substance that can cause a euphoric and relaxing effect. It can also be addictive when used in large quantities over an extended period of time.

Opioids

Opioid drugs include prescription painkillers and illegal drugs like heroin. These are highly addictive drugs that can lead to opioid use disorder (OUD) quickly.

Law students often drink and use drugs while in law school. Once they get their first real job, they typically stick with alcohol until they reach senior associate or partner and then they may turn back to opioid drugs.[7]

Challenges That Legal Professionals Face

Law school and the legal profession in general involve high expectations and immense pressure to perform at a high level. This can cause mental health issues and also lead to using drugs or alcohol as tools for managing this stress.

Lawyers are often of a certain personality type as well. They may be described as controlling, compulsive, judgmental, ego-driven, argumentative, grandiose, anxious, and pessimistic. These characteristics also correlate with the “addict” personality and can make lawyers more vulnerable to developing SUD.[8]

Law students often start out passionate and with a desire to help people and change the system. Over time, the emphasis on financial gain within a law firm compounded with an overwhelming workload can shift this focus, and legal professionals may lose sight of why they started practicing in the first place. This can cause a sense of hopelessness and a desire to drink or use drugs to ease tension and escape.

Legal professionals can get caught up in ethical dilemmas, as they are forced to represent clients who do not align with their beliefs or that compromise their inherent value system. The work pressure itself can be overwhelming, and the long hours can compromise family time and interpersonal relationships.

High levels of stress and anxiety in the legal profession create a culture centered on alcohol as a means to cope and try to keep some balance. Legal professionals often socialize at bars and drink heavily while together.

Junior partners are most likely to have issues with alcohol followed by senior associates and then junior partners. Problematic drinking often starts in law school and persists throughout one’s career.

Use of “study drugs,” which are used to get and stay ahead, is prevalent in law school and among legal professionals. ADHD medications and cocaine are both stimulant drugs that can enhance focus and help legal professionals to combat fatigue and lack of sleep, enabling them to perform as needed.

Alcohol helps to take the “edge” off, while stimulant drugs work to bring you back “up.” As a result, many legal professionals use both together. The combination of these substances can be especially dangerous.

Mental Health Disorders & the Legal Profession

‍Legal professionals have higher than average rates of mental health conditions, such as stress, anxiety, and depression, compared to the general population. Nearly 30% of practicing lawyers surveyed in 2016 suffered from depression, close to 20% had severe anxiety, and almost 12% had suicidal thoughts in the prior year.[9]

Lawyers are most likely to suffer from the following mental health disorders:

Depression

Lawyers are often inherent perfectionists drawn to a demanding and difficult profession. The demands of the job can exacerbate personality traits that also predispose them to depression and feelings of inadequacy.[10]

It can be difficult to keep up with competition at work. The legal profession has a constantly moving world of climbing the ladder, getting clients, going to battle in the courtroom, and working to stay on top. Add to this ethical burdens and the responsibility of having someone’s fate in your hands, and the pressure can be overwhelming.

The financial burden can also be heavy with law school debt. Long hours, less time with family and friends, demanding partners and clients, and the idea that to show any kind of vulnerability is weakness can all compound depression.

Lawyers are often the butt of jokes. Though the profession is associated with advanced education and high salaries, lawyers are not always held in high regard by the public. This can be draining and lead to further feelings of depression.‍

Anxiety

Similar to depression, high levels of stress can lead to chronic or persistent anxiety. Legal professionals face enormous amounts of stress on a daily basis, which can cause anxiety.

Anxiety disorders can impact a legal professional’s daily life functioning. Greater irritability, sleep disturbances, trouble concentrating, heart palpitations, muscle tension, fatigue, a constant feeling of dread or worry over impending danger, sweating, obsessive thoughts, and feelings of inadequacy are common side effects.

Legal professionals with anxiety often turn to drugs or alcohol as a form of self-medication and a temporary relief from symptoms. This only serves to make both the anxiety and substance use more problematic.

Signs of Substance Abuse Among Lawyers & Legal Professionals

‍One of the first steps toward getting help for a lawyer or legal professional for substance abuse is to recognize the signs. These are some warning signs to be aware of:

• Drinking to excess regularly
• Using medications outside of the bounds of medical need and a legitimate prescription
• Missing work, being late, or not fulfilling obligations as regularly
• Lack of concentration and memory issues
• Keeping alcohol or drugs in easy-to-reach and multiple locations
• Substance abuse leading to legal or financial issues
• Using substances in risky or hazardous situations
• Physical injury or frequent sickness
• Mood swings
• Interpersonal relationship issues
• Changes in eating and sleeping habits
• Drinking more frequently
• Finding excuses to use substances
• Spending time worrying about where to get the substance and protecting their supply
• Changes in social circles and social withdrawal
• Lack of interest in activities that were previously important

Barriers to Treatment

‍The legal profession has high expectations and also a culture of stoicism. This can make seeking help feel like a weakness or that a mental health or substance abuse issue will be stigmatized.

Legal professionals often fear losing the job that they have worked so hard for over anything else, and this can be a large barrier to treatment. Judges, for example, often fear disclosure of a mental health or substance abuse issue. They feel a great deal of pressure to continue performing despite these concerns, which prevents them from seeking help.[11]

Drugs often come from criminal connections, which can potentially put a legal professional’s career in jeopardy if acknowledged. The stigma of mental health conditions is still prevalent, and legal professionals are often expected to be near perfect, creating barriers for seeking and gaining help and entering treatment.

Treatment for Legal Professionals

‍Treatment options for legal professionals typically involve finding healthy ways to cope with the pressure and stress of the job. This can include behavioral therapies, such as cognitive behavioral therapy (CBT), which helps individuals to learn what their stressors and triggers are, how they respond to them, and how to manage them in a more positive manner.

Behavioral therapies are often available in both individual and group sessions throughout a professional treatment program, offering legal professionals the chance to connect with peers who can work through similar issues together. In this same vein, peer support groups made up of other legal professionals can be highly beneficial.

Mental health and substance use disorders commonly co-occur. If they do, dual diagnosis treatment that aims to manage both disorders at the same time can be optimal.

Medications are often part of SUD treatment. It can include Medication for Addiction Treatment (MAT) to manage cravings and withdrawal symptoms on a long-term basis.

Levels of care range from outpatient programs that can provide a variety of options in varying degrees of structure to full-time inpatient programs where a person stays on site for the duration of the program. Both treatment models can provide a high level of care and a variety of treatment modalities.

The level of care needed will depend on the amount of flexibility in scheduling that is needed as well as the significance of the mental health disorder and/or SUD.

Resources for Legal Professionals

• Lawyer Assistance Programs: The ABA provides confidential support and services to lawyers, law students, and judges with mental health and/or substance abuse concerns. Local LAPs are listed by state [12]
• Law firm or organizations: Individual law firms and organizations may offer support programs and services to employees.
• Individual state bar associations: These local bar associations offer resources and support for legal professionals who are licensed to practice in the state.
• National Suicide Prevention Lifeline: This hotline provides free and confidential crisis resources and support 24/7.[13]