Archive for August, 2014

Wealthy, famous, powerful, and addicted

Aug. 15th 2014

Why do those of us with so much, get so little from recovery programs?

Most people would assume that those with wealth, fame, or power could afford to do what it takes to stay clean and sober, but that is often not the case. Recovery rates for these groups are significantly lower than for other alcoholics and addicts, and there are a multitude of reasons how these seeming privileges end up hindering sustained sobriety – and happiness.

 

Given the recent deaths of Philip Seymour Hoffman, Peaches Geldof, and Robin Williams, it’s time for us to come out of the shadows and talk about it.

 

We are a community of recovering individuals and professionals with backgrounds in family businesses, affluence, and prominence – dedicated to educating, connecting with, and encouraging people living with addiction and significant resources, media visibility and status. If you are a substance abuser, family member, or concerned friend, you have come to the right place.

Our reality: Our resources are killing us

Money and power are an integral part of our addiction, alcoholism, and family dysfunction. The advantages and privileges of wealth or fame support and feed our substance use. When using, these very resources distinguishing us from others are, in fact, part of our disease and, in essence, killing us.

 

In many ways, we are like other addicts: We do whatever it takes to get our drug of choice; we can’t imagine life without alcohol; we use drugs to cope with our emotions; etc.

 

But unlike other addicts, we can use our resources, position, and influence to obtain our drug, manipulate the world around us, and – most dangerously – isolate and shield us from our consequences.

Money fuels the fire of addiction

The dangers are in our access to money, our lifestyle, our attitudes, and our family secrets. While these traits are present to some extent in most wealthy people, when addiction strikes, they can become toxic. They allow us to appear normal, while the obsession to drink or use continues to grow unabated. Unless examined and addressed, sustained recovery is almost unobtainable.

Barriers to recovery

In talking among ourselves, we’ve identified seven areas that are common barriers to recovery – barriers that keep us stuck in trying not to use rather moving on to the tranformation of soul and spirit that is the foundation for sobriety.

 

Being special: Feeling unique, different, and superior.

I’m not like those other lowlife addicts.

 

Lack of consequences: Using resources that enable us to deny our problem.

What problem? Talk to my lawyer!

Resentment and envy: Envy, perceived or real, hindering our recovery.

“If I had your money, I’d never be an alcoholic.”

 

Cultural and social rules: Cultural rules encouraging our addictions and preventing us from asking for help.

What shows is what matters; keep it in the family.

 

Materialism: Putting money and possessions ahead of self-care and recovery.

Doing and having, rather than being.

 

Myth of the “American Dream”: Expecting money and success to lead to happiness.

What’s wrong with me that my lifestyle and toys don’t make me happy?

 

Suppressed pain: Submerging the intolerable and denying our experiences.

Hey, it’s not so bad.

 

Fame: The personal and family impact of being prominent/famous.

Reconciling what is real versus what is imagined.

 

Above all, if recovery is about moving from isolation to relationships, how can reach our goal if so few people are trustworthy?  

 

In our next blogs, let’s explore these topics and see how they impact use and recovery.

 

Good enough for doctors – Part I

Aug. 13th 2014

Applying the PHP model for our impaired attorneys
Managing the recovery process

Like lawyers, impaired physicians were historically silenced by the overwhelming stigma of addiction. Today’s physicians’ programs have succeeded in lessening this barrier by providing a defined path to recovery and career restoration.

During my tenure as director of the Hazelden Legal Professionals Program, I first learned of the remarkable success rates for doctors (often enrolled in a specialized track at Hazelden) who continued to follow the medical profession’s structured recovery model. The governing bodies for pilots have also created a similar program. The facts:

  • Doctors have first time continuous abstinence rates of 78 percent at five years.
  • 92 percent of airline pilots are continuously abstinent at two years.

No other groups approach these recovery rates, and in fact, studies show one-year continuous abstinence rates at less than 25 percent for the general population. Because most of the literature discussing these programs comes from the Physicians’ Health Programs (PHP), we will use PHPs as our model.

In your current position, it is invaluable to be familiar with the reasons why programs for doctors are so successful and how to apply the same protocols to lawyers. As I mentioned, I will identify the key elements over the next month, but it begins today with one major reason:

Firms – not the impaired attorney – manage the recovery process.

Medical boards manage the recovery process for impaired physicians. In reality, it’s the boards that are achieving high outcomes because without their active oversight of the treatment and post-treatment process, success rates would be much lower. The boards:

  • Tell the doctors where to go to treatment,
  • Review progress reports,
  • Identify and oversee therapists and groups to attend after treatment; and
  • Receive reports from drug testing services.

This is in contrast to the current system for attorneys who either find resources on their own or talk to their health providers, often with goal of minimizing the length and intensity of treatment. The firm usually has limited knowledge regarding progress, whether treatment appears to be successful, and what changes are needed to support abstention upon return to work. This lack of accountability is a major cause of relapse and resulting risk to the firm. Firms need a much better handle on the risk of relapse, just as medical boards already do.

Case management system

Medical boards use a case management system to oversee doctors participating in their treatment and recovery programs to improve their chances for sustained recovery. “Case management” refers to the coordination and implementation of services on behalf of the patient by a case manager (CM).

The “case” being managed is actually the alcoholic/addict, so a more accurate term might be “patient or addict management.” Prior to leaving treatment, patients and their counselors prepare a list of activities to support continued abstinence and stable recovery. These activities comprise a post-treatment plan, discharge, or case plan.

If attorneys in early recovery would follow a suggested discharge plan and work to find productive activities in the community, the sustained abstinence rate for patients leaving treatment would likely be higher.

The problem – and it is a significant one – is that attorneys leaving treatment do not follow these plans and directions. Left to their own devices, lawyers race from treatment to practice law longer and harder than ever to prove they have been “cured.” This is called the “compliance problem” and, more often than not, results in relapse.

In order to improve recovery rates, we advise firms to employ a CM to encourage the addict to attend the activities specified in the post-treatment plan and otherwise support recovery. The idea is to improve compliance by the attorney with post-treatment plans through case management.

Case manager accountability

The CM works on behalf of the firm and keeps the firm informed regarding progress in recovery and drug and alcohol testing results. The CM also helps with communication between the firm and the recovering attorney in ironing out any issues – on either side – that may be jeopardizing abstention.

One consideration to keep in mind is that the CM needs to be given the authority by the firm to oversee attorney treatment and progress so there is a single point of communication. In too many firms, authority for attorneys with behavioral concerns is given to a committee, which often has trouble being decisive when confronted by an upset colleague.

The first and most important step

Understanding the importance of managing the recovery process and providing accountability/oversight – and knowing how and why to do those things – is the first and most significant step in restoring the work and the lives of impaired attorneys. Stay tuned for Part II, where I will discuss therapeutic leverage.