Adult and Adolescent Mental Health Blog

The team at Fifth Avenue Psychiatry aims to help both adults and adolescents with substance abuse and mental health issues.

Why More Attorneys Are Searching for an Addiction Therapist Near Me

The Lawyer: The Partyer and the Alcoholic

It’s a tired popular media trope: the attorney, burdened by the stresses of work, pours a glass of bourbon at the end of a long day. Maybe he is waiting for a verdict to come in after an impassioned speech in front of a jury, maybe she is prepping for a long day at the Supreme Court ahead. Alcohol as a coping mechanism in pop culture is as old as television itself.

The reality is much less glamorous. Rather than delivering rousing speeches, new attorneys are proofing technical briefs, competing with a dozen other colleagues to impress a senior partner. Instead of Supreme Court visits, there are demanding client calls, on vacation and over alcohol-fueled dinners. Alcohol use isn’t swirling a glass of single malt under a furrowed brow – it’s staying out all night under peer pressure, showing up drunk at work, and repeating the cycle all over again.

A Culture of Partying

Exposes of lawyer drug abuse tell a compelling story. Brian Cuban, author of “The Addicted Lawyer,” recounts his harrowing experiences: lines of coke in the bathroom of casinos during professional conferences, all night drinking binges flowing into long workdays. Self-doubt and depression arising every time sobriety set in, setting off another round of binge drinking and substance abuse.

Unfortunately, the reality of drug and alcohol abuse is problematic and ignored, if not condoned by the culture of the profession. Young attorneys, particularly women, receive their approval for their ability to “hold their liquor.” Groups of colleagues blow off steam by staying out all night. Lisa Smith, attorney and author of “Girl Walks Out of a Bar,” recalls waking up on the morning she decided to get sober and starting her day with almost an entire bottle of red wine and a few lines of coke. She checked herself into medically-assisted detox because she was afraid she might die.

When her medical team recommended inpatient rehab, Smith refused: “It would have meant telling my law firm the real reason I had been out ‘sick.’ Instead, I went to outpatient rehab two nights a week. One week and one day after checking into the hospital, I was back at work.”

A Culture of Acceptance…Until Someone Admits There’s a Problem

Drug and alcohol use are the legal profession’s not-so-hidden secret. For the most part, superiors turn a blind eye to partying, even engaging in it themselves. Heavy drinking can be a form of social acceptance at large, high-powered firms.  As long as performance remains acceptable, the partying can continue. Smith says she never missed a day of work, and never even had a negative performance review – speaking to the high level of function this population can have.

The personality traits and party culture inherent to the profession is a recipe for substance use disorder. Type A personalities, high levels of competition, and a “kill or be killed environment” cause extreme levels of stress. To cope with the pressure, attorneys need outlets. Some exercise compulsively, others develop gambling or shopping addictions. Still others struggle with eating disorders. The most common outlet among attorneys, however, is substance abuse.

Among young attorneys, the rate of problem drinking hovers around 30 percent. That’s right – one in three attorneys under the age of 30 has a drinking problem. While the ink is still drying on their law degrees, these lawyers are fueling themselves with alcohol and, sometimes, other substances to gain acceptance and keep up with the crowd.

A Deadly Combination

The qualities that make attorneys adept at practicing the law also might make them more susceptible to substance abuse. Eilene Zimmerman, the ex-wife of a prominent attorney who died of complications from intravenous drug use, wrote in the New York Times:

“In many ways, Peter’s personality and abilities read like a wish list of qualities for a lawyer. Trained as a scientist, he approached problems in a deliberative, logical way. He was intelligent, ambitious and most of all hard-working, perhaps because his decision to go to law school was such an enormous commitment — financially, logistically and emotionally — that he could justify it only by being the very best…. He also had a single-minded focus that could border on obsessive.”

Desire for achievement, intense focus, and ambition are all positive qualities. When coupled with a high-stress work environment, permissive attitude toward drug and alcohol abuse, and lack of tolerance for “weakness,” disaster can – and often does – result.

Losing Humanity

Research suggests that the foundation for addiction and substance abuse starts early, within the first few months of law school. Ironically, the average law student starts out healthier than the average population – they are less likely to have mental health problems, drink less, and use fewer substances. That’s according to Dr. Andy Benjamin, a lawyer and psychologist who teaches and studies at the University of Washington. But the culture of law school changes all of that.

Starting out with idealism and a strong sense of self, law students are taught to focus on extrinsic motivators such as class rank, comparative worth, and status. They are also encouraged to take the emotion out of their decision-making. Over time, the teaching has a detrimental effect.

“We have seven very strong studies that show this twists people’s psyches and they come out of law school significantly impaired, with depression, anxiety and hostility,” says Benjamin.

Some studies show that law students begin showing signs of depression as little as six months into law school. Mental health disorders are a large risk factor for later substance use – the Substance Abuse and Mental Health Services Administration (SAMHSA) estimates that three million adults in the workforce have a co-occurring substance abuse disorder and mental health condition. When law students enter a competitive environment where hostility and partying are encouraged, with hallmarks of a depressive disorder, disaster often results.

The Chosen Few

Many stories surrounding the culture of drug abuse in the profession – from the likes of Lisa Smith and Brian Cuban – are success stories. Yes, they struggled with substance abuse, but they sought treatment, got clean, and still have successful careers. Cuban, recognizing practicing law as a trigger, largely left the profession. Smith is a practicing attorney and specializes in client development. However, their success stories are a handful compared to the many that end unhappily or in tragedy.

For many, recovery comes with court fees and loss of licensure. Smith went into rehab voluntarily; others go to court-mandated treatment centers. Smith never missed work or received a negative review; so many others lose their credibility and even their ability to practice.

In reality, Smith and Cuban are “the chosen few:” by stroke of luck or good fortune, they made it to the road to recovery relatively unscathed, at least professionally. Unspoken in the tell-alls about lawyer party culture are the real-life consequences.

Lawyers lose their ability to practice. They get into trouble with the law. Burdened by skyrocketing student loan debt, they no longer earn the compensation necessary to make their payments. They owe money to the courts after facing their own legal battles. Bankruptcy and a blemished record can make it difficult for them to obtain any employment, let alone a job in the legal profession.

Then there are the people who never make it out alive. There is Zimmerman’s ex-husband, who billed $600 an hour but never had the time or lifespan to spend it. Before she got clean, in the height of her addiction at 32, Smith said she stopped contributing to her retirement account. She never expected to live past 40.

Some never do.

Tackling the Problem with Addiction Treatment

The legal profession, among all industries, has some of the highest levels of substance abuse. Attorneys struggling with an addiction to prescription drugs, alcohol, cocaine, or other substances are less likely to seek treatment. They face an uphill battle due to the competitive nature of the profession and lack of support. One attorney said, “If you admit you have a problem, there is a line of 10 people behind you waiting to take your place.”

Even if people do get clean, they return to a workplace where triggers are everywhere. A competitive environment where attorneys woo new clients over wine-filled dinners lays the groundwork for relapse. Untreated co-occurring disorders such as depression or anxiety can make the urge to self-medicate with substances difficult to ignore. To detox successfully and learn the tools to maintain long-term recovery, attorneys need professional intervention in the form of an addiction therapist or, perhaps, a psychiatrist in NYC.

Finding an Addiction Therapist Near Me

Finding an Addiction Therapist Near MeSubstance Abuse treatment should occur in two distinct phases. The first is a drug and alcohol detox. Alcohol detox symptoms, in particular, can be problematic and even-life threatening. A person struggling with a long-term alcohol use disorder can experience jitteriness, “the shakes,” nausea, vomiting, diarrhea, and abdominal cramping. Around 72 hours after detoxing from alcohol, some individuals can experience “delirium tremens,” which causes confusion and over-activity of the autonomic nervous system. Left untreated, DTs can lead to fatal seizures and cardiovascular collapse. Long-term users of alcohol should use medically-assisted detox under the guidance of a licensed health professional.

For some individuals, such as those with an addiction to opioid medications, Medication-Assisted Treatment (MAT) may also be helpful. MAT combines psychotherapy and other evidence-based interventions with FDA-approved medication to control withdrawal symptoms and manage cravings. It is discreet and can help attorneys return to the work environment, despite the triggers there that can create temptation.

The Importance of Individualized Therapy

Some treatment centers utilize a group therapy approach, which can be a form of social support. For some professions, however, individualized, one-on-one approaches are more effective. Tailored, individualized therapy has several benefits:

  • Discretion. For many attorneys, privacy is paramount. Individualized therapy allows attorneys to taper off substances in private while learning important coping mechanisms for maintaining sobriety.
  • A tailored approach will allow individuals to learn specific strategies aligned with their needs. For example, many attorneys have a dual diagnosis, or a substance use disorder and mental health condition, simultaneously. Treatment modalities will include therapeutic approaches to both the behavioral health disorder and the substance use disorder.
  • Stress Management Approaches. For attorneys, stress is often a trigger for relapse. Lawyers are unique in that their jobs are highly stressful and competitive. Surgeons, for example, have a high level of stress, but being an attorney is like having another surgeon on the other side of the table waiting to take your place if you fail. Learning healthy techniques for coping with job stress will be one of the most important aspects of maintaining recovery.

Finding the Way Back from Addiction Is Possible

Substance abuse in the legal profession is rampant for a number of reasons: permissive culture, encouragement of hostility and stress-fueled competition, stigma surrounding mental health issues, and lack of support from the institution.

Leaders in the profession should take steps to prioritize mental health in the workplace, starting as early as when law students walk into their first class. Since signs of depression and other mental health disorders start in law school, classes addressing stress management and healthy coping strategies would allow students to better take care of their mental health and recognize signs of a problem in others. Rather than being thrown to the proverbial wolves, students would enter the professional environment better poised to contend with the environment.

Unfortunately, systemic changes take time and persuasion. In the meantime, it is up to each individual to monitor their mental health and those of their colleagues. For those struggling with substance abuse or a mental health condition, seeking high quality treatment is the first step to recovery. Outpatient, individualized therapy approaches can minimize professional disruption, preserve anonymity, and give attorneys the tools they need to achieve and maintain sobriety.

Fifth Avenue Psychiatry Offers Help for Attorneys

Attorneys don’t have to suffer alone. Fifth Avenue Psychiatry specializes in providing evidence-based therapies for mental health conditions and substance use disorders to high-achieving professionals who value their privacy. All interventions focus on providing individualized attention and holistic treatment, addressing all factors contributing to the disorder. Outpatient treatment options allow professionals to continue their daily lives with little disruption. At Fifth Avenue Psychiatry, attorneys can learn how to break the cycle of addiction and achieve long-term recovery with the benefit of privacy and discretion.

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