Pills, pot, and legalized impairment

04/12/14 5:52 PM

Cautions for parents, family offices, and wealth advisors

At recent conferences in Colorado and California, several colleagues asked for my thoughts on legalizing marijuana and how it might impact families and the workplace. It’s all over the news and one everyone’s mind, but frankly, it’s not just pot that’s a concern – there’s a whole range of substances family offices and advisors should be aware of.

 

So it’s time to introduce a new concept into our lexicon: legalized impairment. This term refers to society-sanctioned drugs that significantly alter mood, behavior, and judgment. As they become more widespread and readily available, more and more people are using these drugs to excess. This group includes underage users, who, as we know, have easy access to all kinds of substances.

 

Due to their legal or quasi-legal status (often doctor-prescribed), these substances pose a significant risk to family office integrity. As a family office executive or wealth advisor, the last thing you want do is explain odd, unprofessional, or improper behavior by a colleague or employee to clients. While you may want to address the concern in family members, increased drug use is growing and impeding efficient professional-client interactions.

 

So, what drugs are we talking about?

 

Pain killers, benzodiazepines, ADHD meds, sleeping pills, e-cigs, weed, salts/herbs, and alcohol.

 

It’s quite the list and growing weekly. No doubt these drugs have already invaded your office and befriended your clients. As an advisor said to a friend of mine in recovery, “You mean when you wake up in the morning this is the best you will feel all day?” This question reflects the reality that in our culture, we routinely use drugs to feel better. And now we have more and more-potent options that bring with them greater risk of abuse and dependency.

 

Let’s look at these drugs in greater detail:

Pain killers: oxycodone, Percocet, hydrocodone

Over-prescribed in large quantities for relatively minor injuries or procedures, they are easy to get hooked on and hard to quit. When doctors do restrict refills, pills are available from dealers but are often more expensive or harder to obtain than heroin. Substituting more readily-available heroin for pills is a main reason why apparently well-off and functioning people die of opioid overdoses. (Dealers offer free samples, so why not give it a try?) Pain pills are also highly sought after by students to come down from Adderall and Ritalin and other stimulant-induced study or test-taking highs.

Benzos: Xanax, Klonopin, Valium, Librium, Ativan

Commonly prescribed for anxiety, these drugs are known as “alcohol in a pill.” Contrary to the opinions of some doctors, they do lead to increased tolerance and dependency. They’re also known for their boomerang effect: Over time, they produce the same symptoms they are designed to alleviate. Supposedly prescribed for the short-term, many are in it for the long haul, with mind-boggling withdrawal symptoms when users run out or try to ease off.

ADHD medications: Adderall, Ritalin, Vyvanse

Known as study drugs, parents seek them out for their children to give them an advantage on tests. Whether used for legitimate ADHD or just for a leg up on the competition, these drugs open the door to illegal stimulants such as cocaine, ecstasy, or meth. Coming down from the high can be a problem, and kids resort to fighting the high with depressants. Common “antidotes” include pain medication, weed, or alcohol.

Sleeping pills: Ambien, Lunesta

Touted as risk-free, when taken regularly these drugs cause restlessness, anxiety, memory loss, and occasionally bizarre nighttime behavior. When taken with alcohol in the blood stream, it can be difficult to wake up in the morning.

E-cigarettes: nicotine

E-cigs contain varying doses of nicotine – a highly addictive stimulant. They’re a go-to for people who’ve overdone it the night before and need to shake the cobwebs off in the morning. Other users believe nicotine helps them concentrate, so it can serve as an alternative to Adderall and other stimulants.

Marijuana

The younger generation believes it’s benign. The older generation is getting back into it (or never quit) – for medicinal purposes, of course. So what do we know about it? Marijuana can interfere with memory, perception of time, and motor function. Repeated use during adolescence can result in long-term changes to brain function. Available in increasingly higher percentages of THC (the active ingredient), drug-induced psychosis is becoming more prevalent.

Salts and herbs

Claimed to be unregulated and largely flying under the DEA’s radar, they are often as potent and destructive as the other drugs discussed here and can be highly hallucinogenic. Available online, from head shops, and from your friendly shaman, these substances run the gamut from bath salts to rue plant derivatives and ayahuasca.

Alcohol

Alcohol is easily the most prevalent of the legalized impairment substances. As the accepted social lubricant among the affluent, you’d be hard pressed to find a work, family, or social gathering that doesn’t serve cocktails before, during, and after the event at hand.

 

It’s no secret that excessive drinking is considered a major public health problem, but most of us in the affluent community would scoff at the medical definition:

  • For men, it’s five or more drinks in one sitting or 15+ in a week.
  • For women, four drinks in one sitting or eight in a week.

In our culture, these suggested limits are exceeded regularly and with little awareness that tolerance is increasing. We ultimately can become dependent, particularly as we age. After age 40 or so, alcohol takes longer to leave our system, meaning drinking the same amount will have greater effect.

What to do?

I encourage drug testing because it is the only way to truly determine actual substance use. It also has a preventive effect because people are less likely to use when they know they will be tested regularly.

 

For the family office:

 

Because of fiduciary responsibilities and client relationships, it’s important to regularly drug test all employees. There’s nothing more maddening than trying to figure out why an employee is acting strangely and mishandling client interactions. I also recommend establishing a policy for persons using prescription narcotic medications – and include marijuana as well. Of course, these procedures will need to be vetted and approved by a lawyer who is familiar with state and federal employment and disability laws.

 

I’d also recommend an educational program for staff on different types of narcotic prescription drugs, dosages, and their effects and side effects. This will help with self-awareness and also with client relations because many clients discuss medical conditions with their account representatives.

 

For clients:

 

Encourage your families to establish effective provisions in their policies and governing documents to address substance and behavioral health disorders (see my article, “Model Language for Addressing Substance Use Disorders [Addiction] in Trust Documents: Best Practices for Treating Substance and Other Behavioral Disorders). Educational programs are also helpful, as are discussions among the younger generation about what they would like to see happen if someone is abusing alcohol or drugs. Taking a strong stand on alcohol and drug use can set the tone for the family, especially if it is backed up by moderate, responsible drinking at family events.

 

For families with a history of addiction or mental health issues, a joint project such as a family genogram can help trace these disorders through the generations to the present (see: www.2164.com). It really helps illustrate the concept of “genetic load,” meaning that when the gene linked to addiction is present, there is good chance that the next generations will be susceptible to the disease.

 

This may sound very controlling and Machiavellian, but drug testing young adults as a condition of receiving funding might also be appropriate, given the widespread substance use in this group. Family members don’t like to see a relative destitute, so there might be two levels of payment for compliance and non-compliance (e.g., minimum subsistence for positive test and the regular payment for passing the test).

Address legalized impairment head on it will steamroll you!

Addiction is already the primary threat to family stability and well-being. With more heavy-duty drugs legalized, legitimatized, and available, this risk is only going to increase. Your choice, as an advisor, leader, or family member is to attack this issue head-on, or it could very likely become the predominant driving force in your clients or your own family system.

 

Due to popular demand, a future blog will explore in detail the topic of marijuana. Before doing so, I wanted to place weed in the overall context of legalized impairment.

2 Comments on “Pills, pot, and legalized impairment”

  1. Kathy King Says:

    This view should be obvious, but it not. It realistically states the reality and risk for legal impairment that has been ignored. I would like to continue to read your thinking. Why is it that it is so appealing to ignore this? Why don’t addiction professionals take on the job of broadcasting this to the community at large? Why is it never addressed?

    Is it not obvious again that the traditional 12 Step view of abstinence is the goal? There are time tested ways that people in long term 12 Step recovery manage the need to temporarily take medication. They put a priority on minimizing any and all drug use.

    It is a deep subject, and thanks for bringing it up.

  2. Ken Says:

    nicely done. thanks.

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