Substance Abuse & the Bar: A Rare Approach to Treatment

Posted by Courtroom View Network on Nov 8, 2019 12:01:18 PM


Stock image.

Promoted Content: From time to time, CVN will highlight services our partners provide that we believe are of interest to our readers. 

Three years after a landmark study turned the spotlight on substance abuse problems plaguing the legal profession, lawyers and law firms alike struggle to find solutions. The problem is compounded by high hurdles lawyers face in seeking help in the first place. But one organization, Recovery Centers of America, takes an unusual approach to treatment that aims to lower those barriers for attorneys who need help.  

The National Bar Has a Substance Abuse Problem

A study published in 2016 by the Journal of Addiction Medicine put stark numbers to what many attorneys likely see among their colleagues every day: the national bar has a substance abuse and wellness problem. The study, commissioned by the ABA and a private foundation found:

  • More than 1 in 5 attorneys are problem or dangerous drinkers. 
  • Less than 1 in 10 respondents had sought treatment. 

The results sounded an alarm within the legal profession and spurred a movement among the nation’s largest law firms to combat substance abuse issues. 

But the study also showed attorneys were largely reluctant to seek the help they might need because they didn’t want their colleagues and others to know. That fear, combined with a general reluctance to acknowledge a substance abuse problem, can make it difficult to get lawyers the help they may need. 

Dr. Deni Carise, a national addiction expert and Chief Scientific Officer of Recovery Centers of America, told CVN she wasn’t surprised by those barriers. “These are all folks that have high-level, high-profile careers. And there’s a real stigma around saying, ‘You know, I’m struggling with this. I need help,’” Carise said.  

Tailored Care, Around the Clock

Carise told CVN addressing those fears is part of the Recovery Centers of America’s tailored approach to each patient seeking help. It’s an approach that begins when someone first calls RCA, whose representatives are available around the clock. 

“When a lawyer or high-profile person comes in for treatment, you really need to address those [concerns] head-on, and also make sure you’re taking care of that person in a way that addresses their unique needs,” Carise said, noting RCA professionals follow a strict confidentiality code. Regulations around confidentiality are “much more stringent in drug and alcohol treatment than they are in general medical health,” she said. 

That focus on discretion continues throughout an attorney’s stay at one of RCA’s six sites across Maryland, Massachusetts, New Jersey, and Pennsylvania, where attorneys may be placed in residential areas that help protect their privacy. 

“Privacy for those in treatment for a drug and alcohol addiction is not only one of the key components of treatment but it is the law. Treatment is voluntary and those in need of treatment need to feel safe and comfortable so they can focus on getting well,” she said. 

Recovery Centers of America

RCA’s around-the-clock response, counseling, and admissions process is a rarity in the field, Carise said. And it’s based on the fact that many people who struggle with addiction, lawyers included, often have a small window of time when they’re ready to admit they need help and take action. 

“In medical trauma work, they say you have this magical hour, the golden hour,” to most successfully treat a patient, Carise said. “In our field we basically have a golden minute: when you are ready to come in, we want to get you in as quickly as possible.”

The care regimen is customized to a lawyer’s individual needs and overseen by full-time medical directors — another rarity in the industry — as well as nurse practitioners specializing in psychiatry.  

The Full Continuum of Treatment

That tailored care may include medical detoxification and residential in-patient treatment before transitioning to outpatient care and follow-up. Medication-Assisted-Treatment is also offered at the inpatient and outpatient levels as well as at standalone MAT clinics. Treatment plans follow decades of evidence-based research, while facilities and personnel ensure patients are as comfortable as possible. 

“It’s all designed to help the person feel at home,” Carise said. “We want them to be very comfortable.”

But that comfort includes full days of activities for inpatient residents, including therapy sessions designed to address both the substance abuse itself and the issues that led to that abuse. “You get 10-12 hours of treatment and other services each day,” Carise said. “It’s like years of outpatient care in a month.”

RCA’s local model also allows for family involvement during residential treatment, and seamless outpatient care, which, Carise said, are both critical to continued recovery. 

“We really encourage the family to be involved. It’s one of the reasons why we feel so strongly about the local model of care,” she said. “If somebody is in treatment locally, they can get well, their family can be involved, they can maintain that involvement, and then they can also continue in support groups where they’ve met people, where they know people.”

Those connections, along with outpatient support and alumni groups are particularly important for attorneys, Carise told CVN. Attorneys reluctant to discuss their ongoing recovery with colleagues can turn to others they have met through RCA. 

“Creating a social bond with other people in recovery doesn’t just help. It’s really essential,” Carise said.

And RCA works to ease patient concerns regarding treatment costs throughout their care, with 90 percent of RCA patients able to use in-network insurance benefits, ensuring a single co-pay or deductible, while eliminating the stress and confusion of numerous separate charges found in out of network models.

Ongoing Recovery... Once You Take the First Step

Carise told CVN that RCA’s continuing care model is so important to maintaining recovery because treatment simply doesn’t end when a patient leaves their site. “This is a chronic medical illness. It’s not like a broken leg or appendicitis,” she said.  “You don’t go in, fix it, and come out. This is much more like hypertension, Type II Diabetes, asthma. 

“You typically enter treatment in an acute stage, you’re stabilized, you’re taught about your disease, and you maintain your recovery every day, one day at a time.”

But the critical point of recovery is the moment someone takes that first step, by calling the facility’s number.

“It’s never too late to get well,” Carise said. “I know many people who have had a [substance use] disorder for decades and they got well.

“It’s never too late to start your life over and to have a higher quality of life.”

Learn more about Recovery Centers of America. 

If you believe you may be struggling with substance use, call 


24 hours a day to speak to a trained professional.

Topics: Recovery Centers of America, Wellness