The practice of law has always been one of the most widely respected and vital professions in our country, yet it has also been well-documented that a significant percentage of lawyers struggle with alcoholism and/or substance abuse, depression, and other mental health concerns.

In 2016, the American Bar Association and the Hazelden Institute co-sponsored a study of this issue, the results of which were published in the Journal of Addiction Medicine. This survey of roughly 15,000 attorneys revealed that between 21 and 36 percent drink at levels consistent with an alcohol use disorder—a figure that’s about three to five times higher than the average population. The study also showed similarly alarming rates of depression and anxiety, along with a reason why many afflicted lawyers don’t seek help: the pervasive fear of damage to one’s reputation, which may lead to loss of a job, clients, or one’s license. As a result, lawyers struggling with these issues tend to hide them from public view or simply deny their existence.

Some lawyers are better at this than others. For example, in March Kentucky lawyer David Gray was suspended from practice by the Kentucky Supreme Court. It found that on the last day of a civil trial in December 2017, Gray had delivered an hour-long closing argument in which his “demeanor and performance” so concerned the trial judge that—after the jury returned a verdict against Gray’s client—the trial judge asked Gray to submit to a Breathalyzer test. Gray agreed, and blew a 0.337; at that point, emergency medical personnel were summoned and the lawyer was taken by ambulance to a local hospital. Gray subsequently entered a medical detox facility and afterwards a 60-day alcohol rehab program.

Gray is not the only one to have a judge order a blood-alcohol test at trial. In 2006, Las Vegas criminal defense lawyer Joseph Caramagno showed up to court smelling of alcohol and slurring his words. When the judge asked for an explanation, Caramagno gave several different attempts at once, including sustaining a head injury in a car crash on the way to court. He even turned to his “ex-girlfriend Christine” for corroboration, only to have the woman state that her name was Josephine, and that she wasn’t an ex-girlfriend but had been with him 20 minutes earlier at a nearby bar. The judge ordered a Breathalyzer test on the spot, which indicated Caramagno’s blood alcohol level to be 0.075 (just below Nevada’s legal limit). The judge declared a mistrial on the kidnapping case Caramagno was there to argue, telling the lawyer, “I don’t think you can tell a straight story because you are intoxicated.”

And if you’re wondering how ironic it would have been if it had been a DWI case, well, that’s happened too. In 2013, New Mexico DWI attorney John Higgins attracted the judge’s suspicions that he was drunk—in part, because he showed up to the wrong courtroom in the first place. Albuquerque Judge Julie Wies ordered a Breathalyzer test, which showed the lawyer’s blood alcohol to be 0.11 percent (above New Mexico’s legal limit of 0.08). Higgins was taken to a local hospital, but not before being found in contempt for disrupting the court proceedings.

How much worse can it get then showing up in court while impaired? Try showing up intoxicated for your own disciplinary hearing. In February, lawyer Justin Holstin appeared before a hearing panel of the Kansas Board for Discipline of Attorneys, where his behavior led to concerns that he was intoxicated. The panel recessed the hearing and asked Holstin to submit to testing at a local facility. The lawyer agreed, and that same morning his blood alcohol content was determined to be 0.200. Not long after he argued at a rescheduled disciplinary hearing, Holstin surrendered his law license and was disbarred.

And don’t think that lawyers are the only ones to have shown up drunk to court—judges have done it, too. In 2012, the Iowa Supreme Court suspended Judge Emily Dean following an incident at the courthouse in which she was too intoxicated to physically take the bench (Dean had purportedly been drinking while her court reporter drove her to the courthouse that day). In 2016, Miami-Dade County Judge Jacqueline Schwartz resigned (after being suspended) following two instances of public intoxication, including one at a local restaurant, where she had berated a waiter for refusing to serve her more alcohol. The other incident occurred at the courthouse, where the chief judge ordered Schwartz to go home after court personnel and litigants observed that the judge was unsteady on her feet, slurring her words, and unable to concentrate. Schwartz’s bailiff drove her home, and the judge could not remember her own address.

While examples like this may be extreme illustrations of the risks of alcohol abuse, the fact remains that the legal profession has always been a magnet for “Type A” personalities who often prioritize success over personal well-being, and who don’t always exhibit healthy coping skills to deal with the stress that accompanies this work. The profession itself is doing more to increase awareness of the problem of alcohol and substance abuse, as well as to devote meaningful resources to help impaired lawyers. The Texas Lawyers’ Assistance Program or TLAP (www.tlaphelps.org) provides confidential help for law students, lawyers and judges who are dealing with alcohol or substance abuse problems or mental health issues. If you need help and don’t want to be another cautionary tale, help is out there waiting for you.

John G. Browning is a shareholder at Passman & Jones in Dallas, where he handles a variety of civil litigation in state and federal courts.