Information on Substance Abuse Treatment for Medical & Legal Professionals

Created On Monday, 15, August 2016
Modified On Friday, 17, September 2021

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Substance abuse and addiction impact countless people working within the medical and legal professions. Like many other working professionals facing addiction, the are many reasons why they turn to drugs or alcohol. Substance abuse treatment for medical and legal professionals are specific programs providing treatment for these professionals. For example, counselors and addiction specialists are knowledgeable in treating legal and medical professionals. For example, this could include support services through the hospital or legal office. Treatment centers may offer more with confidentiality and specific counseling for the issues these professionals are struggling with.

There are many unique reasons why doctors or nurses would become addicted to drugs or alcohol. Misusing prescription medication is a common problem to manage anxiety, sleep deprivation, and stress. Legal professionals are subject to significant ridicule and stress, and many work long hours, especially when involved with high profile legal cases. Many young legal professionals who begin their careers put in long hours and struggle with sleep deprivation and anxiety. Prescription drugs and alcohol become a common method to cope for professionals in both fields.

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It is important to be aware of addiction signs because most professionals struggling with addiction are highly functional addicts. There is often a gradual decline in responsibility and making mistakes continuously. Also, there could be a decline in physical appearance and no longer maintaining a certain professional standard level. While attending work functions, they may drink heavily and pass it off as unwinding and relaxing. Obvious indicators would include missing work or showing up to work intoxicated. People working in these professions are usually held to higher standards, and the stigma surrounding addiction prevents them from reaching out for help.

The Prevalence of Addiction Among Medical Professionals

The problems with addiction and substance abuse among physicians and others have largely escaped the public's attention. Although medical professionals have been shown as having similar rates of addiction as the general public, it is not often brought forward because of stigmas. Medical professionals tend to protect their workplace performance and image well beyond the time when their life outside of work has fallen apart. According to an article published by the Mayo Clinic Proceedings, approximately 10% to 12% of physicians will develop a substance use disorder during their careers.

However, the social stigma surround addictions prevent medical professionals from asking for help. Also, the fear of disclosing an addiction could result in the loss of their licenses or the ability to work in the medical field. There is often a combined effort with family members and co-workers to protect everyone from what they see as a financial ruin or a loss of status. In a study mentioned in the article, over 900 physicians in 16 state physician health programs were examined. Approximately 50.3% were abusing alcohol, 35.9% misused opioids, 7.9% abused stimulants, and 5.9% abused other drugs. Moreover, 50% reported missing more than one substance, 13.9% had a history of intravenous drug use, and 17% had previous addiction treatment.

Some professions were more prone to substance abuse than others. For example, some study authors found that anesthesiology, emergency medicine, and psychiatry have a disproportionate propensity toward addiction. Some of the reasons for this include the job stressors and ready access to narcotics and other psychotropic drugs. Overall, medical professionals in different specialties tend to abuse different classes of drugs. However, per the study, alcohol is the drug of choice for most.

Additionally, the study mentions that only around 10% of anesthesiologists enter treatment for alcohol addiction. The vast majority of professionals in this field are addicted to potent intravenous opioids. Unfortunately, medical professionals preserve their work performance above all other aspects of life. By the time peers discover the addiction, the rest of their social, family, and personal life is in shambles.

The Prevalence of Addiction Among Legal Professionals

Anyone working within the legal professions faces heavy workloads and conflicts with their value system right when they enter law school. Unfortunately, like many other people, drugs and alcohol become a means of coping. Legal professionals also struggle with higher rates of mental health problems. The Journal of Occupational Medicine stated that lawyers are in the top three professions for developing problems with depression and anxiety. Unfortunately, many of these issues begin in law school after the reality of the workload sets in. Students turn to alcohol and drugs to relieve tension and relax.

According to an article in the Journal of Addiction Medicine, close to 13 000 licensed, employed attorneys complete surveys assessing alcohol use, drug use, and depression symptoms, anxiety, and stress. The results revealed that actual rates of behavioral health problems were found. Approximately 20.6% screened positive for hazardous harmful, and potentially alcohol-dependent drinking. The study concluded that attorneys experienced problematic drinking that is hazardous, harmful, or otherwise consistent with alcohol addiction. It also concluded that mental health stress is significant.

Numerous studies have been done exploring the issues surrounding people in the legal profession struggling with addiction. The study mentioned above cites research done in 1990, showing 18% of the attorneys surveyed were problem drinkers. Moreover, around 19% of Washington lawyers suffered from elevated levels of depression. Unfortunately, there is a culture of problem drinking within this profession. The American Bar Association discovered that one in three practicing lawyers meets the criteria for problem drinking. An article published in the New York Times noted similar problems stating lawyers in law firms had the highest alcohol abuse rates. Junior associates reported the highest rates of problem drinking, and senior associates had the second highest.

The work habits developed within this profession force many professionals to turn to drugs or alcohol to work longer or cope. According to research looking at long working hours and alcohol use, someone who works more than 48 hours per week is 11 times more likely to misuse alcohol. Those working more than 55 hours a week were 13 times more likely to develop an alcohol addiction.

It is important to be aware of the indicators, including making mistakes at work, absenteeism, missed deadlines, missed court dates, lost clients, and damage to reputation. Unfortunately, some legal professionals are functioning alcoholics and can use drugs or drink hard at the end of the day and still make it to work on time.

How Does Substance Use Treatment for Legal and Medical Professionals Operate?

The rehabilitation process does not differ from other standard or non-traditional approaches to treatment. The first step should be to inquire about what is covered under health insurance or of the hospital, law firm, or medical office has resources for support, such as an employee assistance program. However, not everyone is willing to admit there is a problem and family intervention becomes an option. Interventions are also done among co-workers if they feel the problem has gotten out of hand.

The first step with rehabilitation involves an assessment, and this could be done over the phone or in-person. The purpose of an assessment is to determine the extent of addiction and what treatment options are available. Before counseling or therapy, most addicts have to go through detox, which is a process of managing withdrawal symptoms. Typically, the severity of the withdrawal symptoms determines what method of detox is needed. Someone addicted to alcohol, opioids, or prescription drugs may require a medically supervised detox and withdrawal management.

Medically supervised detox usually administers medication to control withdrawal symptoms. However, street drug addiction benefits from a conventional detox program because withdrawal symptoms are not overly severe. The length of time needed with detox is different for each person. Detox should not be considered the only treatment approach because it will not manage underlying issues and treat the reasons why.

The next phase of treatment involves attending inpatient or outpatient drug rehabilitation. Centers for medical or legal professionals offer services geared towards the needs of these individuals. Also, these programs may offer a higher level of confidentiality for their clients. Long-term drug rehabilitation usually lasts three to six months or more, whereas short-term programs last three to six weeks. Lengthier treatment is usually better for someone with an extensive history of addiction. Many legal or medical professionals seek out short-term programs or an outpatient facility.

Risks of Substance Abuse Among Legal and Medical Professionals

An unaddressed substance abuse problem places anyone at risk, whether a person is a lawyer or medical professional. Some studies from the United States and Canada have shown that 50% of discipline prosecutions and 60% of malpractice claims involve alcoholism. These two professions require strong focus and concentration, and drug or alcohol addiction impact this significantly.

Some of the things that have led to attorneys receiving sanctions include public intoxication, driving while under the influence, felony DWI conviction, engaging in violent behavior while under the influence, or threatening violent behavior while under the influence. Moreover, it could involve improper handling of client funds due to substance abuse, improper handling of professional duties because of addiction, and court appearances while under the influence.

Risk factors are also significantly high for healthcare professionals. Because of the increasingly stressful environment due to manpower shortages, for example, many healthcare professionals struggle with substance abuse. According to an article published in the Substance Abuse Treatment Prevention Policy, some of the risk factors included professional invincibility, family history of alcohol and drug use, social networks, drug access, negative prescriptions, and professional and social influences. Most studies suggest that young adult healthcare professionals had a higher risk of substance abuse compared to older adults working in the profession.

In an article released by the Michigan Health Lab, it points out that healthcare professionals experience the same risk of developing an addiction as the general population. They are also at a higher risk for addictive behaviors involving opioids because of their increased access. Physicians are five times more likely to abuse opioid pain medication and benzodiazepine anti-anxiety drugs than the general population. Healthcare professionals tend to use more than the prescribed amount, even if the medication is legitimately prescribed.

Common Terminology with Addiction Rehabilitation for Legal and Medical Professionals

Term Definition
Acute Stress is usually brief stress that is most common and does not last long. Acute stress is most often caused by reactive thinking, such as having negative thoughts about certain situations or events.
Episodic Stress frequent triggers of stress cause episodic stress, which is frequently suffering from acute stress and living a life of chaos and crisis. Legal and medical professionals may do everything to keep their work-life in order, but their family and social life are in shambles.
Chronic Stress is considered the most harmful type of stress and could damage physical health and mental health. Chronic stress would cause an individual to feel hopeless and lead to a poor work environment.
Professional Invincibility is having the idea or have created an invincible career. For example, the individual may feel they have removed single points of failure from their career aspect, and no single event can disrupt them for very long. Unfortunately, this is dangerous when struggling with addiction because you could become convinced the addiction cannot affect you.
Prescription Drug Abuse is the abuse of prescribed medications for the intent of achieving a euphoric effect. Prescription drug addiction is common among legal and medical professionals to cope with stress.
Alcoholism is an addiction to drinking alcohol, and unhealthy alcohol use can range from mild to severe. Alcohol is a commonly abused drug among legal and healthcare professionals.
Binge Drinking is excessive alcohol use and leads to an increased risk of health problems. Binge drinking is consuming enough alcohol within a short time to become intoxicated. The problem is common among young working professionals.
Self Prescribing medical professionals who are addicted to certain drugs, may self-prescribe to fuel their addiction. Self-prescribing also occurs when a medical professional gives themselves a diagnosis and prescribes medication to themselves.
American Bar Association is a voluntary bar association of lawyers and law students and is the legal profession's national voice.
Addiction Stigma are negative attitudes or beliefs about addiction, which could include labeling, isolating, or stereotyping addiction and addicts. Unfortunately, stigma prevents many addicts from asking for help.

CONTRIBUTORS TO THIS ARTICLE

Marcel Gemme, DATS - Author

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Marcel Gemme has been helping people struggling with addiction for over 19 years. He first started as an intake counselor for a drug rehabilitation center in 2000. During his 5 years as an intake counselor, he helped many addicts get the treatment they needed. He also dealt with the families and friends of those people; he saw first-hand how much strain addiction puts on a family and how it can tear relationships apart. With drug and alcohol problems constantly on the rise in the United States and Canada, he decided to use the Internet as a way to educate and help many more people in both those countries. This was 15 years ago. Since then, Marcel has built two of the largest websites in the U.S. and Canada which reach and help millions of people each year. He is an author and a leader in the field of drug and alcohol addiction. His main focus is threefold: education, prevention and rehabilitation. To this day, he still strives to be at the forefront of technology in order to help more and more people. He is a Licensed Drug and Alcohol Treatment Specialist graduate with Honours of Stratford Career Institute. Marcel has also received a certificate from Harvard for completing a course entitled The Opioid Crisis in America and a certificate from The University of Adelaide for completing a course entitled AddictionX: Managing Addiction: A Framework for Succesful Treatment.


Michael Leach, CCMA - Medically Reviewed on September 17, 2021

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Michael Leach is a Certified Clinical Medical Assistant, who has over 5 years of experience working in the field of addiction. He spent his career working under the board-certified Addictionologist Dr. Rohit Adi. His experience includes working with families during their loved one’s stay in treatment, helping those with substance abuse issues find treatment, and teaching life skills to patients in a recovery atmosphere. Though he has worked in many different areas of rehabilitation, the majority of his time was spent working one on one with patients who were actively withdrawing from drugs. Withdrawal and the fear of going through it is one biggest reason why an addict continues to use and can be the most difficult part of the rehabilitation process. His experience in the withdrawal atmosphere has taught him that regardless of what approach a person takes to get off drugs, there are always mental and emotional obstacles that need to be overcome. He believes having someone there to help a person through these obstacles can make all the difference during the withdrawal process.