(Illustration by Meriel Waissman/iStock)

Lawyer assistance programs are stepping up efforts to reach attorneys with alcohol, drug and mental health problems amid signs that pressures in the profession may be taking a rising toll.

“My sense is that things have gotten worse, and my view is shared by various people in the field,” said Patrick Krill, director of the legal professionals program at the Hazelden Betty Ford Foundation, a network of addiction treatment centers, which is conducting a wide-scale study of the problem with the American Bar Association.

Quiz: Do you have a drinking or drug problem?

“It will be very interesting to see what the changes have been given the consolidation, postrecession layoffs, downsizing and economic stressors that have come into the profession in the last 10 years that arguably made it more stressful than it ever has been,” Krill said.

Results from the American Bar Association/Hazelden study won’t be available until next year, he says. Studies in the 1990s found that lawyers have 3.6 times the rate of depression as other occupational groups, as well as higher rates of alcohol and substance abuse (roughly 15-20 percent, compared with 9 percent overall).

Alcohol is “far and away” the drug of choice for attorneys, judges and law students who are referred for substance abuse treatment, experts say. An ABA survey published last year found that 76 percent of issues addressed by lawyer assistance programs were related to alcohol abuse, followed by prescription drug abuse at 9.8 percent. Many clients are self-referred to LAPs and addiction treatment centers, but judges, disciplinary panels and employers refer many others. “More and more we are seeing people who are, shall we say, given an ultimatum to get some help or not have their job,” Krill said.

Signs of alcohol or drug impairment include missing court dates, failing to file documents and changes in hygiene, mood and behavior, as well as appearing in court intoxicated or impaired.

Caseloads are rising, according to lawyer assistance programs across the country, including those within bar associations (53 percent) and those independent of them. Colorado saw its caseload increase by about a third in the first five months of this year over the same period last year. Other states including Wisconsin and Ohio also reported increases, but recordkeeping across the state LAPs is inconsistent at best.

The Lawyer Assistance Program of the New York State Bar, the largest voluntary state bar association in the United States, with 75,000 members, said it received 150 calls in 2013 and more than 700 contacts through its website, but points out that the New York City Bar and some county bars operate their own LAPs. The New York City Bar Association, for instance, reported an intake of 253 clients in 2010, the last year for which figures were published on its website. As such, “it is hard to compare us to other states,” said Pat Spataro, a licensed mental health counselor and director of the lawyer assistance program for New York state.

Jerome Braun, 84, currently of counsel and a founding partner of Farella Braun + Martell in San Francisco, one of California’s largest, said he was a “functioning alcoholic,” who drank “around the clock” during an era when social alcohol use was even more prevalent in business than it is today. “It was fairly well known in the firm that I was a heavy drinker,” he said.

He quit alcohol nearly 18 years ago, after a series of crises that climaxed with a doctor testifying at a psychiatric hearing that Braun would be dead or institutionalized within three months if he didn’t enter rehabilitation. Since entering recovery, Braun has helped lawyers with similar problems through The Other Bar, a nonprofit lawyer assistance group, independent of the California bar, founded in the 1970s. Braun estimates that the group serves about 25,000 clients a year through continuing legal education seminars, hotlines and counseling groups, though it doesn’t keep detailed records. The California Bar funds its own lawyer assistance program.

“One of the remarkable things is that there are a lot of us walking around who are time bombs,” Braun said.

Mirroring trends in the general population, there’s also been an uptick in calls for assistance about drug addiction among lawyers and law students.

“There has been a rise in prescription drug abuse, and on the treatment side we are seeing an increase in the number of people referred for multiple dependencies,” Krill said, including addictions to prescription pain medications, antianxiety drugs such as Xanax and Valium, and stimulants including Adderall, particularly among younger attorneys and law students. A rising number of clients have multiple addictions, experts say.

Cross-addictions ensnared Stephen Compton, 49, an attorney in Lake Geneva, Wis., who says he earned up to $500,000 a year as an insurance defense litigator, until his alcohol and cocaine dependency spiraled out of control. “It finally swallowed me up, and I couldn’t keep it in check anymore,” he said. While receiving treatment for alcohol abuse, he became hooked on heroin, he said. Compton was arrested for felony possession of narcotics in March 2009, and his law license was suspended.

After pleading guilty to a felony count of drug possession and serving a short jail stint, he was sentenced to time served plus three years’ probation and released. He then became one of the first attorneys diverted to the state bar’s lawyer assistance program for monitoring in lieu of punishment under a Wisconsin program implemented in 2010 by the Office of Lawyer Regulation. The LAP monitors compliance with random drug testing, as well as attendance at Alcoholics Anonymous and similar groups. Compton’s license to practice law was reinstated in May 2013 after he fulfilled the terms of a monitoring contract, he says.

Compton says he’s now a solo practitioner, often earning $40 per hour as a public defender, and he serves as a peer counselor to others battling addictions.

“Some people don’t see it building and don’t see the destruction until the tornado has already gone through town,” says Linda Albert, manager of the State Bar of Wisconsin’s Lawyers Assistance Program, which fields about 60 calls per month.

“When they get the good treatment and connect with other lawyers, though, they can be remarkable and very determined to get better and to do well.”

Her observation was echoed by others. “Lawyers are fabulous clients. They really can make striking gains in recovering from both alcoholism and depression,” says G. Andrew Benjamin, clinical professor of psychology and affiliate professor of law at the University of Washington, who coauthored one of the seminal studies of lawyers’ mental health, “The Role of Legal Education in Producing Psychological Distress Among Law Students and Lawyers,” published in 1986. As one of the cofounders of Washington state’s lawyer assistance program, Benjamin has counseled thousands of attorneys with drug and alcohol problems.

“As long as there hasn’t been a disbarment, lawyers can rebuild their professional careers even if they have lost their jobs,” he said.

But, he added, it is hard to get lawyers to accept the need for help. (Click here for resources.) “There is a pervasive amount of denial and minimization going on in our profession,” he says.