SUBSTANCE ABUSE, ADDICTIVE DISORDERS, AND… · substance abuse, addictive disorders, and/or mental health issues among attorneys. presented by: ... 10. case manager

SUBSTANCE ABUSE, ADDICTIVE DISORDERS, AND/OR MENTAL HEALTH ISSUES AMONG ATTORNEYS

Presented by: Robert Rosenthal, Esq. Howard & Howard Attorneys PLLC 3800 Howard Hughes Parkway, Ste. 1000 Las Vegas, NV 89169 702.257.1483 [email protected] Licensed in Nevada and California

Substance Abuse In The Workplace - Context National Overview • Substance abuse in the workplace results in: Absenteeism Diminished productivity On-the-job injuries Potential company liability

• The annual cost of alcoholism and drug addiction to U.S. businesses is in excess of $140 billion

Unhappiest Jobs In America

1. Associate attorney 2. Customer service associate 3. Clerk 4. Registered nurse 5. Teacher 6. Marketing coordinator 7. Legal assistant 8. Pharmacy technician 9. Technical support specialist 10. Case Manager

(according to www.careerbliss.com, 2013)

Occupational Hazards Facing Attorneys

• High degree of work stress • Depression • Suicide • Addiction • Burnout • Poor physical health • Unhealthy interpersonal relationships • Lack of appreciation

Work Stressors

Anticipated Stress • Long hours • Lifelong learning • Responsibility • Sacrifice

Unanticipated Stress • Unhealthy workplace • Devaluation of the

Profession • Diminished

compensation • Productivity /profit • Crushing workloads and

unrealistic deadlines

More Work Stressors

• Mistakes • Complaints, threats of suits/professional

discipline • Needs of clients • Needs of staff • Needs of other attorneys, partners, bosses,

shareholders, etc. • Needs of family • Needs of self (often ignored until burnout sets in)

Addiction Defined

Definition • A primary, chronic, neurobiologic disease with

genetic, psychosocial, and environmental factors influencing its development and manifestations.

Characterized by one or More Behaviors • Impaired control over use. • Compulsive use. • Continued use despite harm. • Craving.

Alcohol Abuse

Alcohol Abuse Among Attorneys Statistics • Estimated that 18-20% of attorneys have a

drinking problem (either alcohol abuse or alcohol dependence). This is higher than the general (10-15%).

• Liquor cabinets in law offices – is it time to rethink?

Alcohol Signs And Symptoms Reasonable Suspicion of Drug Use • Odor on breath or body, flushed skin • Eyes glazed or bloodshot • Slowed reaction time • Impaired motor skills • Stumbling, swaying, loss of balance • Speech is slurred, loud, thick, moody, irritable

Drug Signs And Symptoms

Reasonable Suspicion of Alcohol Use • Eyes red, pupils dilated • Mouth dry • Slowed reactions • Impaired motor skills • Sleepy • Skin cold, moist, blush in color • Heart rate, blood pressure, perspiration • Dizziness

Drug / Alcohol Abuse

Alcohol/Drug % Who Use Alcohol 88% Nicotine 60% Cocaine 29% Opiates* 26% Benzodiazepines* * 23% Cannabis 14% Amphetamines 8% Sedative-Hypnotics 1% *Heroin, Oxycontin, Hydrocodone, Percocet, Vicodin, Codeine, etc. **Ativan, Valium, Diazepam, Halcion, Klonopin, Xanax, etc.

Drug And Alcohol Testing Nevada Law • Private Sector: Currently, there are no laws in

Nevada which regulate private sector drug and alcohol tests

• Public Sector: There are very specific rules governing state employees (see NRS 282.4062 et seq.)

• EACH STATE HAS DIFFERENT LAWS! Federal Law • There are no federal laws governing private sector

employees – except those involved in the motor vehicle industry (taxis, trucks, limousines, etc.), and those who obtain federal contracts and/or grants

What Can Be Tested?

Alcohol Marijuana Cocaine Amphetamines Opiates Phencyclidine (PCP)

Barbituates Methaqualone Benzodiazepines (valium) Methadone Propoxyphene (codeine)

Are There Limits On What Can Be Tested? • Only genetic testing is forbidden in Nevada • Most employers test for the following:

States Where Medical Marijuana Is Legal

Medical Marijuana

Is Medical Marijuana Protected? • No. While medical marijuana is legal in Nevada and

other states, an employer has the right to terminate an employee who tests positive, even if he/she has a prescription. Ross v. Ragingwire Telecomm., Inc., (2008). California Supreme

Court upheld employer’s right to fire employee who failed pre-employment drug screen, despite fact that he had prescription.

Roe v. TeleTech Customer Care Mgmt., (2009). Washington Appellate Court upheld employer’s right to not hire applicant who tested positive for medical marijuana.

Johnson v. Columbia Falls Aluminum Co., (2009). Montana Supreme Court held that a state law permitting the use of marijuana for medicinal purposes does not require employers to accommodate the medical use of marijuana in the workplace.

Behaviors Suggesting Impairment • Unresponsive/neglectful behavior • Not returning phone calls to clients or opposing

counsel • Not available when clients or opposing attempt to

reach you at the office • Voicemail full • Incomplete, or incompetent work • Missed deadlines and/or court appearances • High absenteeism or fired from previous

employment

Depression

Signs Of Depression

• Less friendly • Withdrawn • Irritable • Negative/pessimistic • Less available • Less spontaneous • Loss of humor • Preoccupied, distracted • Change in physical appearance

Attorneys And Depression

Some Sobering Facts • Attorneys are more prone to depression than any

other profession • Forty percent of law students meet criteria for

clinical depression • The prevalence of depression among male

attorneys is 19% (ABA 2013) • The prevalence of depression among male

attorneys is twice that of males in the general population

• Due to lack of recognition or false attribution to “stress” treatment is often delayed

Attorneys and Suicide

• The rate of suicide among attorneys is twice that of males in the general population

• One study suggests suicide is the 3rd leading cause of death for attorneys*

• Ages 48-65 is the highest risk demographic

*(Canadian Bar Association)

Suicide

Some Miscellaneous Facts • 10th leading cause of death in US • 2nd leading cause of death between ages 35-44 • 3rd leading cause of death between ages 10-24 • Ratio of suicide attempts versus completed

suicides 25:1

Methods Of Suicide Percent

FirearmsSuffocationPoisoning/ODDrowningOtherCutting

Suicide And Mental Illness 90% w/ Mental Illness

Mental IllnessNo Mental Illness

Risk Factors For Suicide

• Single/divorced • Chronic illness • Stress/overwork • Career dissatisfaction • Conflicted relationships at home • Losses – personal/ professional • Conflict – personal/professional • Financial problems • Family history issues (abuse, neglect) • Family history of depression, suicide, substance

abuse, psychiatric problems

Deterrents to Attorney Suicide • Dependent loved ones (including pets) • Religious beliefs • New found hope (receiving good news) • New found resources • Changed perspective (e.g. A DUI is bad but most

attorneys aren’t disbarred for this)

Personality Traits

Personality Traits May Contribute to Mood Disorders and Suicide • Perfectionism Creates a chronic feeling that nothing is good enough Driven by an intense need to avoid failure Perfectionists are more vulnerable to depression,

anxiety and other health problems • Competitiveness Interferes with the ability to show vulnerability or

seek help Pessimism (a common trait among attorneys) Although skepticism may be good professionally, it

also leads to leads to stress and disillusionment

Typical Personal Traits Among Attorneys • Aggressive • Overly analytical • Not in touch with emotions • Defensive • Detached • Negative outlook • Unconcerned for the emotional suffering of

others

Workaholics

“Workaholism” = Substance Abuse • Disrupts sleep • Creates multiple family problems and destroys

marriages • Decreases efficiency and ability to concentrate • Causes irritability and fatigue • Increases risk of back problems, gastro-

intestinal disorders, heart disease and stroke

Attorney Burnout

Burnout can Cause the Following: • Depersonalization Detachment from others Protective Defense Mechanism

• Emotional exhaustion

• Diminished sense of personal accomplishment Work loses its meaning No longer feeling a sense of efficacy

Warning Signs Of Deteriorating Health • Decline in job performance • Absenteeism – emotional, physical • Attitude and/or mood • Troubled relationships • Professional boundary issues • Decline in appearance • Physical symptoms or illness • Financial problems • Staff turnover

If Concerned…

Trust your Intuition and Comment “I’ve noticed…” “You seem…”

Normalize their Feelings Sometimes when under the stress of a lawsuit it is

not that unusual for attorneys to feel depressed, not sleep, etc.

Ask: “Have you had thoughts like this?”

But Attorneys Are A Special Breed… • The attorney’s professional skills and position

permit him/her to mask impairment longer than others

• The attorney’s advocacy, intelligence and self reliance all help to avoid treatment

• Colleagues hesitant to confront one of their own • Support staff hesitant to jeopardize paycheck • Hope that problem will take care of itself • Confrontation leads to hyper-aggressive response

Professional Obligations

Duty to Monitor Conduct • Attorneys have a duty to monitor the conduct of people they directly

supervise, including other lawyers and staff (Model Rule 5.1) • There is also a duty to report misconduct (Model Rule 8.3) “But I Didn’t Know What He Was Doing!” • Lack of awareness by supervisory lawyer does not excuse a violation • Supervisory lawyer is required to take reasonable measures • A supervisory lawyer is responsible for the misconduct of another

lawyer in the office if the supervisor orders it, ratifies it, ignores it, or unreasonably fails to mitigate known misconduct

(See Model Rule 5.1)

The Good News!

• With treatment, recovery is possible • Recovery rates are much higher among

professionals than they are among the general population

• General population: 40-60% • Attorneys and other professionals: as high as 90%

Assistance For Nevada Lawyers • Lawyers Concerned for Lawyers Program: 866-

828-0022 or 775-322-2154 • www.nvbar.org • Professional AA Meetings at the Law Office of

Mitchell J. Cobeaga 240-2499 • SOLACE: Support of Lawyers/Legal Personnel,

All Concern Encouraged • National Suicide Prevention Lifeline: 1-800-273-

TALK (8255) • National Helpline for Lawyers: 1-866-LAW-LAPS

THANK YOU!