Volume 18, Number 1
In the Solution
GPSolo proudly presents a new standing column, "In the Solution," focusing upon lawyers’ experiences with substance abuse, mental health, stress, and quality of-life issues. For more information, please call the ABA Commission on Lawyer Assistance Programs at 312/988-5359.
A Return to Counselor
By Michael J. Sweeney
Many consider our number-one public health and public safety problem to be substance abuse. When combined, alcoholism and drug addiction account for 25 percent of all health care costs. They are the third leading cause of death behind cancer and heart disease and a major contributor to both of these illnesses. Due to the stigma attached to the disease, substance abuse may be underreported as a cause of death.
It is also a huge public safety problem. Two-thirds of all domestic violence is alcohol- and/or drug-related, while 80 to 90 percent of crimes are committed by people with alcohol and drug problems. The direct and indirect cost of alcoholism—lost productivity, absenteeism, medical claims, and accidents—is in excess of $140 billion each year. Many divorces and bankruptcies are the result of addiction.
In the 1970s, approximately 200,000 people were incarcerated in prisons in this country. Today, that number is more than 1 million. The large increase is related to chemical use and abuse. Enough prisons cannot be constructed to build our way out of this problem.
An estimated one out of three families in America has a relative that is affected by the disease of addiction. It is well-documented that spouses of alcoholics have shorter life expectancies. Studies have shown that when an addict receives treatment, health care costs for the whole family decrease.
While people do receive treatment, a large percentage experience relapse, contributing to the perception that addiction is not responsive to treatment. Most insurance policies have limited provisions for chemical dependency treatment, usually without coverage for additional treatment if relapse occurs. It would be inconceivable to treat other chronic illnesses, such as cancer, in the same fashion.
Lawyers at Risk
Addiction is clearly a problem within the legal profession. A study in Washington and Arizona found 19 percent of lawyers suffer from alcoholism, and another 3 percent are addicted to cocaine and other drugs—a cumulative 22 percent rate of addiction. These numbers are staggering.
There is also a high correlation between substance abuse and disciplinary and malpractice claims. Georgia estimates that more than 60 percent of its disciplinary complaints are alcohol- and drug-related. A study in Oregon, conducted by the Professional Liability Fund (PLF), the state bar’s malpractice insurance carrier, surveyed the first 100 lawyers to successfully complete the Oregon Attorney Assistance Program (OAAP) for alcohol and drug addiction.
The study found that 60 percent of the lawyers had malpractice claims pending when they entered the OAAP. After two years of sobriety, the claim rate among this group dropped to 3 percent. The OAAP, which is funded by the PLF, is one of many state lawyer assistance programs created in the last 20 years.
In 1986 the American Bar Association created the Commission for Lawyer Assistance Programs (CoLAP), to help other states develop programs for lawyers suffering from impairments. Approximately 15 years ago, only four states had created paying positions for directors of their lawyer assistance programs (LAPs). Currently, 38 states have paid directors and volunteer committees. Several other states are in the process of developing such funding.
The ABA Commission on Lawyer Assistance Programs, in partnership with the ABA Standing Committee on Substance Abuse, has decided to raise awareness about the problem of alcoholism and chemical dependency. In July 2000 at the ABA Annual Meeting in New York, the two committees cosponsored a presidential showcase program entitled, "Lawyers as Agents of Social Change: Battling Our Number-One Health Problem."
In her introduction to the program, ABA President Martha Barnett encouraged lawyers to become involved in addressing substance abuse in the profession. She told a poignant story of losing her doctor-sister to alcohol and chemical dependency. She then introduced the keynote speaker, General Barry McCaffrey, commonly referred to as the "drug czar," who heads up the office of National Drug Control Policy for the Clinton administration.
General McCaffrey spoke about the costs of addiction and the value of treatment. An untreated drug addict can cost $49,000 per year for associated costs, including property crimes and health costs. An addict who is incarcerated costs the public $26,000 per year. However, a high recidivism rate can result in yet another $49,000 cost to society per year, per addict. Meanwhile, the cost of treatment averages $6,000 to $8,000 per year. Clearly, getting addicts into treatment is the most cost effective.
He further discussed the increased number of drug courts across the country, as prosecutors and criminal defense lawyers realize the cost savings and value that result from combining jurisprudence and treatment.
Panel member Westley Clark, M.D., discussed the signs and symptoms of substance abuse in clients, family members, and colleagues. He stressed how important it is that lawyers be able to assess alcohol and drug dependency, and to influence individuals to obtain treatment. A Harvard Law graduate, Dr. Clark holds a master’s degree in public health and is director of the Center for Substance Abuse Treatment, which funds public treatment services throughout the United States.
A Catalyst to Recovery
The Dictionary of Occupational Titles lists psychologists, social workers, and lawyers in the same category, because the process of problem solving is common to all three disciplines. Years ago, a lawyer was referred to as "attorney and counselor at law." By reclaiming the helping aspect of our profession, lawyers are in a unique position to encourage and motivate clients to obtain treatment.
The greatest service that can be rendered to a client is not merely solving a specific legal problem, but addressing and getting help for an underlying alcoholism or chemical addiction. Lawyers involved in practice areas such as criminal law, family law, bankruptcy, and workers compensation have a unique opportunity to observe clients in legal difficulties that may be related to or exacerbated by addiction.
The Commission and the Standing Committee on Substance Abuse are in the process of developing educational materials, tools, and resources for lawyers to use in working with clients. One educational piece will illustrate how to do assessments and referrals. A video package that explains the disease of addiction and shows lawyers conducting assessments will be available next year. A related website will offer lawyers access to this information from their desks, with links to referrals and local resources. Also on the agenda is a handbook for lawyers regarding alcohol and chemical dependency.
Lawyers with practices that do not involve direct contact or interaction with clients suffering from alcoholism or chemical dependency may want to direct their energies to prevention. Historically, lawyers have been leaders in their communities, serving as board members for nonprofit or social service agencies or otherwise active in social issues. A list of resources for community prevention coalitions, programs, and organizations will also be available through a website.
Those of us involved in this battle hope that lawyers will learn about alcoholism and drug addiction so that they will be able to properly discuss the topic not only with their clients but also with their children, relatives, and peers. It is time to let the "counselor at law" reappear. Let us combine forces to address this public health and safety issue. Let us exhibit our greatness not only as individuals but also as a profession.
For more information visit the CoLAP website (www.abanet.org/cpr/colap) or that of the Standing Committee on Substance Abuse (www.abanet.org/subabuse), or call 312/988-5359.
Michael J. Sweeney has been a program attorney at the Oregon Attorney Assistance Program since 1989 and is a member of the ABA Commission on Lawyer Assistance Programs. He is a former member of the House of Delegates of the Oregon State Bar (OSB); served on OSB’s Combining Family & Career Committee; is past president of Columbia River Chapter EAPA; past chair of the Governor’s Council on Alcohol and Drug Abuse Programs; and co-chair of the Governor’s Task Force on Underage Drinking. He has written articles for various ABA, OSB, and other state bar association publications.