Substance Use and Compulsive Behaviors

The use of alcohol in our culture is widespread, often associated with social events and as self-medication for stress, tension, anxiety, personal or professional problems, or even mental illnesses like depression.

The culture of law school and the law firm or other organization often incorporates alcohol use into celebrations, as an end-of-work release, and even as “relaxation” from the pressures of study and practice.  “Hard working and hard playing” is frequently a value in these settings.  Many people can drink without significant consequences.

But for many there’s a downside: DWIs, less productivity at work, inappropriate behavior, stressed marital and family relationships, physical consequences, and the increased risk of dependency.  The American Medical Association (AMA) defines alcoholism as a primary, chronic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations.  The disease is often progressive and fatal.  It is characterized by continuous or periodic impaired control over drinking, preoccupation with alcohol, use of alcohol despite adverse consequences, and distortions in thinking, most notably denial.

Our profession has problems with mood altering substances in addition to alcohol.  This may be an unintended dependency on a prescription drug, or it could be an intentional misuse of a drug for the mind-altering effect that occurs.  Street drugs are used for a high, or their use is mistakenly justified because of perceived benefits such as the ability to work on less sleep.

Is there a Problem?

The CAGE questionnaire (based on key words in the questions) is a quick tool to assess whether someone may have a problem.  These questions can describe the use of any mind-altering substance, whether it be drugs or alcohol.

• Have you ever felt you should Cut down on your drinking?
• Have people Annoyed you by criticizing your drinking?
• Have you ever felt bad or Guilty about your drinking?
• Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover (Eye opener)?

One “yes” response to the questions means there may be a problem.  If you answered “yes” to more than one question, there’s a greater likelihood that a problem exists and further assessment is appropriate.  The drop-down list to the left provides additional assessment tools.

It’s difficult to ask for help, especially in our profession where we’re used to solving problems for others.  If there is a problem, not getting help means the problem will only get worse.  Drug or alcohol addiction is a treatable illness; it is not a moral weakness. Identifying and treating the problem will result in improved quality of life and increased opportunities for good health and success. Yes, substance use disorders exist.  Many lawyers, judges and law students are living successful and satisfying lives in recovery.

Resources

• The ABA Commission on Lawyer Assistance Programs (CoLAP) has collected a number of articles that discuss substance use issues.
• The U. S. Department of Health and Human Services offers a great deal of information for individuals seeking help, professionals assisting those individuals, and researchers through the
• Substance Abuse and Mental Health Services Administration’s (SAMHSA) clearinghouse for alcohol and drug information.
• National Institute on Drug Abuse provides information on the science of drug and alcohol addiction.  There are links to a wide variety of substances.  An excellent pamphlet, The Science of Addiction, is available by mail or as a PDF.
• Minnesota Recovery Page is a directory of resources for recovery, including AA and Al-Anon information.
• Boynton Health Service, Alcohol and Chemical Health Services (U of MN) provides educational information about alcohol and other drugs, as well as chemical health assessments and individual counseling tailored to each person’s unique chemical health situation.
• Alcohol Screening.Org helps individuals assess their own alcohol consumption patterns to determine if their drinking is likely to be harming their health or increasing their risk for future harm.

Gambling

Gambling is normative behavior in many adults.  Approximately 3% of gamblers will experience problems.  Compulsive, problem, or pathological gambling is often called the “hidden illness” because there are few of the outward signs and symptoms that may be present with alcoholism or other dependencies.  Colleagues, families, and friends of problem gamblers are often shocked when they learn about a problem and how serious it has become.

A simple two-question test, called the Lie-Bet tool is a starting point for considering whether you or someone you care about has a problem:

1. Have you ever felt the need to bet more and more money?
2. Have you ever had to lie to people important to you about how much you gambled?

If the answer to either of these questions is yes, more assessment is appropriate.  Call LCL for an appointment to discuss your concerns.

Resources

• The Minnesota Alliance on Problem Gambling is a tremendous resource for people who are concerned about potential problem gambling behavior. Their site includes a two minute risk assessment test.
• Gamblers Anonymous is a 12-step program for problem gamblers.
• Gam-Anon is available for people who are affected by a problem gambler.
• Get Gambling Help provides immediate access to help for problem gamblers and those concerned about them.

Other Compulsive Behaviors

Gambling is one example of a compulsive behavior.  The cravings for someone who compulsively shoplifts, engages in compulsive sexual behavior, is a compulsive spender, or seems addicted to the internet is as strong as for an alcoholic or drug addict. LCL can be the place to start if you are concerned about your own feelings or behaviors, or if you are concerned about these behaviors in a loved one or colleague. There is no judgment, just help.