Substance abuse treatment for lawyers must change

We must revolutionize how the legal profession manages one of its most pervasive problems

Maureen Palmer

When Kelly, a Vancouver lawyer, went to UBC law school, law firms sponsored Friday beer gardens. “If you want to meet lawyers, you go to the beer garden. So I learned how to drink.”

Kelly got good at it. Alcohol was woven into every aspect of her career. “If I went to lunch with clients, better share the wine. The conversation continues at the bar. Better keep up. Drinks were served every Friday in the boardroom. There were career consequences if you were left out. I drank to fit in.”

Kelly’s drinking is part of a well-documented trend. A 2016 study found that one in three American lawyers engaged in heavy drinking. Drinking increased during the pandemic, and COVID-19 dealt a double whammy for lawyer parents: maintaining an often-crushing workload while home-schooling kids.

Brook Greenberg heads the Law Society of British Columbia’s mental health task force. “According to a Quebec survey, one in two lawyers struggles with mental health or substance use. Fifty percent. This is just not an issue of ‘bad’ lawyers. It’s an issue for lots of lawyers and lots of great lawyers.” 

Greenberg discovered how dangerous well-intentioned policy could be while teaching law at UBC. “The admission process forced students to disclose whether they had past mental health or substance use issues. As a result, some students stopped treatment or avoided getting help.”

That kind of stigmatizing, punitive policy is pervasive in law. People fear the shame associated with addiction so much that it’s estimated only one in 10 seeks treatment. “If someone found out about my drinking problem, I’m done,” says Kelly.

“Say Lawyer A has cancer,” says Greenberg. “A colleague takes over their files. Everyone wishes them well. Lawyer B has a depressive episode (possibly involving drinking) and needs a leave. People pitch in, too. But if lawyer B has another episode, resentment builds. This wouldn’t happen if lawyer A’s cancer returned. We need to treat mental health and substance use the way we treat physical health. Normalizing is destigmatizing.”

According to Greenberg, firms don’t want to admit they have a problem and don’t understand its prevalence. “Some are getting better, but they are grasping how to help. We can’t leave it to individuals to take care of things themselves.”

Which is exactly what Kelly did. “I found a Sober Mums group, listened to podcasts, and got a therapist. Sadly, I left the downtown law world.” She laments the lack of support at her firm for substance use disorders – which make up 33 percent of all mental health claims. “Health and wellness benefits must mean more than a subsidized gym membership.” 

In most law firms, treatment for substance use means expensive 12-step inpatient rehab, usually after a crisis. This approach counters what experts say: addiction should be treated pre-disability, like any potentially life-threatening disorder, with early intervention and plenty of treatment options.

“And confidentiality is key,” insists Kelly. “I went to a ‘confidential’ support group. I knew another lawyer there. I never went back.”

“We need tools that allow lawyers to get help without having to interact with a person,” says Greenberg. “Lawyers pride themselves on their problem-solving skills and can’t admit they can’t solve their own problem.”

Four major Canadian law firms are reviewing their benefits to provide that kind of tool. ALAViDA, a completely virtual evidence-based substance-use treatment provider, connects patients with a behavioural care team to deliver personalized support right to their smartphones. The platform’s success with the Fraser Health Authority, which gave access to the confidential service to all 32,000 employees, sparked these reviews. Like lawyers, healthcare workers are held to a higher standard because of their duty to serve the public, so they face extraordinary stigma if they disclose a substance use struggle. Nurses found the program helped them without their licensing body ever needing to know – a seismic shift in a profession where drinking often results in a disciplinary procedure.

The LSBC also decoupled health care from punishment by developing an alternative discipline program, voluntary and confidential, for those whose mental health or substance use contributed to their disciplinary action.

“Change must begin at the top,” says Kelly.  “We need leaders to set a tone of compassion, not condemnation. Otherwise, too many lawyers leave the profession. And that’s a tremendous waste of investment and talent.”

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