Professionals and Substance Use Disorder: An All-Too Human (and Regulatory) Challenge

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The Lawyer, The Addict is a heartbreaking story in the New York Times about the shocking prevalence of substance use disorder (an umbrella term covering “addiction”) in the U.S. legal profession. The piece focuses on the search for answers by the former wife of a Silicon Valley lawyer who died of complications related to his opiate addiction.

I’ve worked extensively in this area with professional regulators, including the College of Physicians and Surgeons of Ontario and the Law Society of Upper Canada, where I developed an array of resources and procedures for the regulator to use when dealing with lawyers and paralegals whose health problems interfere with their ability to practise.

All professions have trouble acknowledging and addressing issues such as mental illness, substance use disorder and dementia (a growing problem for baby boomers) amongst their colleagues. The health professions are at least able to see the problem as a health issue, but I believe that lawyers have historically tended to view it as a failure of will or moral courage. Nor does it help that many lawyers are so-called “high functioning” alcoholics, whose problem is quietly known and implicitly acknowledged but not necessarily addressed early on by colleagues.

Because professional regulators are charged with protecting the public, they have no choice but to deal with the problem—in some way—when a regulated member’s health problems affects his or her practice — for example by conducting an inquiry into the professional’s health status and taking the necessary steps to limit the professional’s practice. All too often though, regulators do not have a comprehensive strategy in place for responding to ill professionals, nor the benefit of an agreement with an assistance or monitoring program operated by the corresponding professional association. The Law Society of Upper Canada deserves praise for taking the bold step of explicitly incorporating professional mental health into its current strategic plan. At minimum, all professional regulators need to prioritize and enhance their ability to deal with the pressing health issues affecting their members.