Lawyers are at risk for problems with addiction at almost twice the rate as the general population. Once considered a moral weakness, addiction is now understood to be a primary, chronic relapse disease with genetic, psychosocial and environmental factors influencing its development and manifestations. It is identified through abnormal behaviors characterized by continued use of substances despite adverse consequences, continuous or periodic abuse of a substance resulting in impaired control or preoccupation with the use of the substance.
The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM - IV), outlines the criteria for substance-related disorders. Substance dependence is identified by a maladaptive pattern of substance abuse leading to significant impairment or distress, as manifested by three or more of the following occurring at any time in a 12-month period:
tolerance (a need for increased amounts of the substance to achieve intoxication or desired effect or a diminished effect with continued use of the same amount of the substance);
withdrawal (displaying the characteristic withdrawal syndrome for the substance, or the same -- or a closely related -- substance is taken to relieve withdrawal symptoms);
the substance is taken in larger amounts or over a longer period than was intended;
there is a persistent desire or unsuccessful effort to cut down or control substance abuse;
a great deal of time is spent in activities necessary to obtain the substance (e.g., visiting multiple doctors or driving long distances), use the substance (e.g., chain-smoking) or recover from its effects;
important social, occupational or recreational activities are given up or reduced; or
use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance (e.g., current cocaine use despite recognition of cocaine-induced depression or continued drinking despite recognition that an ulcer was made worse by alcohol consumption).
Substance abuse is identified as a maladaptive pattern of substance use leading to significant impairment or distress. Symptoms may include one or more of the following occurring within a 12-month period:
recurrent substance use resulting in a failure to fulfill major role obligations at work or home (e.g., repeated absences or poor work performance related to substance abuse, substance-related absences or neglect of children or household;)
recurrent use in situations in which it is physically hazardous (e.g., driving an automobile or operating a machine when impaired by substance use);
recurrent substance-related legal problems (e.g., arrests for substance-related disorderly conduct); or
continued use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance (e.g., arguments with spouse about consequences of intoxication, physical fights).
Signs of substance abuse are sometimes subtle and can be mistaken for other problems, such as depression. Some of the observable signs are:
smell of alcohol,
bloodshot eyes or a puffy face,
slurred or rapid speech,
hyper-vigilance or suspiciousness,
failure to return from lunch or break,
pattern of being late or a no-show on Mondays,
leaving early from work,
failure to return phone calls,
missing appointments,
failure to meet deadlines,
change in mood or general demeanor or
deterioration or personal appearance or hygiene.
Most substance abusers are functional in the workplace. Nearly three out of four are employed, though the risks for the employer are high. Employees who use or abuse substances cost their employers twice as much in medical and workers' compensation claims as those who do not use. The defenses of denial, rationalization and justification often make it difficult for people abusing substances to recognize they have a problem. Making the decision to confront someone about his or her problem is difficult. For help in determining how to deal with the situation appropriately, call the confidential Lawyers Helping Lawyers helpline at 1-866-545-9590. Free, confidential help is available.