It is a myth that an individual seemingly functioning well at work could not also be an addict and suffering from severe emotional trauma. My own experience painted a picture of an individual who continued to maintain the façade of functionality at work despite the extent of my alcohol and drug use. I looked like a functional lawyer, but I was living a double life while hiding my pain. I was a medical malpractice attorney trying lawsuits while hiding my use and abuse of alcohol and drugs. I also saw the same or similar situation with many of my peers. Although they appeared to be functioning, like me they were also suffering from severe health issues, addictions, and even suicidal ideation. Sadly, some of my peers died because of their mental health or substance use disorders.
Studies indicate that 21 percent of all lawyers and more than 33 percent of lawyers under 30 years of age have a substance use disorder (SUD). The National Institute of Health defines five subtypes of alcohol dependence, and the functioning addict is one of the subtypes.1 The functioning addict makes up about a fifth of the total population of addicts. There are certain characteristics used to describe high-functioning addicts:
1. High level of education;
2. Stable job;
3. Supportive family;
4. Most commonly of middle age; and
5. Family history of addiction.2
The American Society of Addiction Medicine (ASAM) defines addiction as a “treatable, chronic medical disease involving complex interactions among the brain circuits, genetics, the environment, and an individual’s life experiences.”3
Maintaining a life of active addiction while working in a high-pressure field, such as law, frequently translates to leading a double life. The functional addict may spend extensive amounts of time double-checking their work following a hangover, having to stay up long hours into the night sending out emails and documents, or going to great lengths to conceal their unhealthy behaviors. They may be using their intelligence, legal rationalization, and self-reliance skills to minimize and hide the consequences of addiction and deny their problem both to themselves and others. People with addictions use substances or engage in behaviors that become compulsive, and they continue injurious behavior despite harmful consequences. The absence of legal problems is not a gauge for the severity of the addiction.
A functioning addict or alcoholic may keep up appearances for a long time, but the disease progresses. By maintaining the myth of a functional addict, we perpetuate the myth that addiction is a choice or character flaw. If one user can function and another cannot, then it must be a flaw specific to that one user who isn’t functional. But this is wholly inaccurate. Remember, drug addiction is a progressive disease. The longer a substance is used, the more severe the symptoms and side effects will become.
Whether you feel you may have a substance use problem or think someone else in your life may be struggling with a substance, it’s important to spot the signs of addiction before it progresses.
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), some signs and symptoms of a substance use disorder (SUD) include:
1. Drinking or using more than you originally intended;
2. Being unable to cut down your substance intake;
3. Spending a lot of time trying to obtain, use, and recover from the effects of a substance;
4. Cravings, or feeling strong urges to use;
5. Being unable to meet obligations at home, school, or work due to substance use;
6. Continuing to use a substance despite ongoing social or interpersonal problems caused by substance use;
7. Giving up activities you once enjoyed because of substance use;
8. Using substance(s) in situations where it is hazardous to do so (e.g., driving or operating machinery);
9. Continuing to use despite having physical or mental health issues related to your use;
10. Experiencing symptoms of withdrawal; and
11. Developing a tolerance.
A person may have an SUD if they meet at least two of the above listed criteria within a 12-month period.4
Addiction doesn’t go away on its own. A highly functioning addict may feel they have everything under control but are living a false and potentially dangerous life. A key indicator of addiction is continuing to use drugs and alcohol even though it’s causing negative consequences in your life and/or to your mental and physical health. There’s no way to escape the dangerous and deadly long-term effects of drug and alcohol abuse. Health consequences of excessive alcohol use include high blood pressure, liver disease, stroke, heart disease, digestive disorders, and mental health problems.
Addiction to drugs and alcohol can turn an individual into a person their loved ones hardly recognize. They may sacrifice their morals, health, safety, and the safety of others in the pursuit of their addiction. When I was in active addiction, I used substances even though it was wrong and knew they were injurious. My health consequences included GI disorders, high blood pressure, and mental health problems.5
Prevention efforts and treatment approaches for addictions are generally as successful as those for other chronic diseases. The good news is that by following these recommendations, lawyers with addiction do achieve better outcomes than the general population.6
Recovery from alcohol or drugs helps restore healthy functioning without the need to change the way one feels with a substance. It is always better to start treatment early, before the disease of addiction causes major consequences in a lawyer’s personal and professional life. My personal experience has shown that lawyers with SUD who ask for and accept help are more productive, more profitable, and overall happier people.
Legal professionals in recovery for SUD can learn tools and cultivate a program designed to cope with the inherent stresses of the practice of law and better handle life on life’s terms. Stopping alone is extremely difficult. However, there is hope with help from peers, behavioral health/medical professionals, and evidence-based therapies. If you’re ready to seek treatment for an addiction, would like to know more about your treatment options, or if you know someone who has the signs or symptoms of a functional addict, call or text the Texas Lawyers’ Assistance Program (TLAP). TLAP is a confidential program dedicated to providing hope, resources, and recovery for Texas lawyers, law students, and judges. We are available 24/7. All calls are 100-percent confidential. To speak with us, call or text 1-800-343 (TLAP).
Every second Monday, Jacobs hosts a free one-hour CLE on Zoom, Attorney Stories of Remission and Recovery. No registration is necessary; follow the link us02web.zoom.us/j/81275272552. Each of these CLEs is approved for 1.0 ethics. Upcoming CLE: Oct. 14, Oct. 28.
Endnotes
1 https://www.nih.gov/news-events/news- releases/researchers-identify-alcoholism-subtypes.
2 https://www.docgoldenberg.com/blog/high-functioning-addicts-who-they-are-and-who-is-at-risk.
3 https://www.asam.org/quality-care/definition-of-addiction.
4 American Psychiatric Association. (2013). Diagnostic And Statistical Manual Of Mental Disorders (5th ed.), 490-492.
5 https://www.cdc.gov/alcohol/fact-sheets/alcohol-use.htm.
6 https://www.docgoldenberg.com/blog/high- functioning-addicts-who-they-are-and-who-is-at-risk.