Lisa F. Smith is a writer and a lawyer in New York City. Her memoir, "Girl Walks Out of a Bar," will be published in June.

(Deb Lindsey for The Washington Post)

The morning before I got sober, my breakfast consisted of nearly a bottle of red wine and a few thick lines of cocaine. I got dressed, checked my teeth for lipstick and my nose for stray coke, put my laptop in its case and picked up the paper on the way out to work at my law firm. I felt sick, afraid and completely alone. I know now that I was wrong about the alone part.

A newly released study conducted by the Hazelden Betty Ford Foundation and the American Bar Association Commission on Lawyer Assistance Programs reports an alarming statistic: Up to 21 percent of licensed, employed lawyers qualify as problem drinkers; for lawyers under age 30, it’s 31.9 percent. By comparison, only 6.8 percent of all Americans have a drinking problem. In addition to questions related to alcohol, participants were asked about their use of licit and illicit drugs, including sedatives, marijuana, stimulants and opioids: Seventy-four percent of those who used stimulants took them weekly.

More than 20 years ago, I became an associate at a big New York City firm and almost simultaneously spiraled into alcoholism and drug addiction. Top law firms are filled with academic overachievers who are realizing their dreams when they start work. Upon arrival, though, instead of making a brilliant argument before a judge, these young lawyers may find themselves competing with their similarly gifted peers for the privilege of proofreading documents for a high-ranking partner. If they do a great job, they may get to proofread all weekend. That’s what success can look like. Failure can look much worse. To cope with that life, many need an outlet. Over the years, I have known lawyers with eating disorders, out-of-control shopping habits and extreme exercise addictions. 

While many professions have similarly cutthroat environments filled with high-achievers, young lawyers suffer from uniquely high rates of addiction — twice the rate of problem drinking among surgeons — and high levels of depression and anxiety.

When I was 25 years old with the ink still drying on my law degree, the work hard/play hard environment of a top law firm was intoxicating, literally. Everyone drank. Being able to hold your liquor was a badge of honor, especially for women. Long days in the office turned into long nights in the bars and clubs. Unfortunately, another long and stressful day in the office was always just a few hours away. It was a terrible dynamic for someone like me with a Type A personality and a then-undiagnosed depressive disorder.

Given the intensity and demands of the legal profession, it’s no surprise that lawyers turn to stimulants. Like me, lawyers I knew fueled their late night and early morning efforts with cocaine and other drugs. While there is no reliable data on the use of doctor-prescribed stimulants, such as Adderall, Vyvanse and Concerta, among lawyers, the soaring rate of prescriptions for stimulants generally and their widespread availability from drug dealers is telling. Students who pulled top marks in college and law school using stimulants are now busy practicing law, where the stakes only get higher. The drugs are bound to follow.

Making matters worse, the study also reports that the most common barrier to a lawyer seeking treatment for a drinking problem is concern that others will find out they need help. The stigma of alcoholism and drug addiction in law firms is real. When I bottomed out, I was using drugs and alcohol around the clock. Somehow, I never lost a job or even received a negative performance review. I kept odd hours, but so did many others. I checked myself into a hospital for a medicated detoxification only because I thought I might die.

When doctors strongly suggested a 28-day stay at a rehabilitation facility, I refused to go. It would have meant telling my law firm the real reason I had been out “sick.” Instead, I went to outpatient rehab two nights a week. One week and one day after checking into the hospital, I was back at work. It was not a smart approach after being diagnosed with a chronic disease.

What if I had told the truth and gone away for a month? When I returned, would I have been viewed the way I had been before I left as a smart, hardworking member of the team? I had seen many people take medical and parental leaves over the years. For the most part, upon their return, they seemed to pick up where they had left off. But taking a leave to go to rehab? I had never seen it done and wasn’t going to be the first to find out what would happen after coming back.

During the course of my career, I moved from active practice to working with partners on business development, in part due to being miserable practicing and in part to accommodate my downward spiral of substance abuse. After hitting bottom and going to detox for five days, I went back to the job I was in and kept quiet about my addiction. I stayed sober, and about a year later, I joined my current firm.

Years later, when I started to write publicly about my addiction and recovery, I told my colleagues. I trusted and respected them. I didn’t want them to learn my story on the Internet. It was difficult to share, but the response I received was overwhelmingly positive. I am lucky to be in a compassionate and supportive environment. Not everyone is so fortunate, though. I still recommend thinking long and hard before opening up in a law firm. But, I hope, that can change over time.

When people learn that I’m in recovery, they often say that they wouldn’t have guessed “that” about me and that I don’t look like a drug addict. Somehow, I don’t think that similar comments are made to people with diabetes or rheumatoid arthritis. And just like people with those diseases, we look like anyone and everyone else. That mild-mannered lawyer down the hall? She might have poured vodka into her orange juice or tossed back a few wake-up pills this morning. I did everything right — got great grades, made the Law Review and succeeded in a big firm job. But my predisposition to addiction combined with the grueling and psychologically challenging life of a junior lawyer resulted in a brutal and damaging 10 years of substance abuse.

The conversation about substance abuse among lawyers needs to be structured and ongoing. The study tells us that those starting out in the profession are at the greatest risk of developing a problem. That was me. It may not have made a difference in the progression of my addiction or how I handled it, but if I had known about these statistics and the help that was available, at least I would have understood what I was up against and what my options were. Most employers, including law firms, offer Employee Assistance Programs that make confidential referrals to mental health professionals, including those who specialize in addiction. Law firms need to incorporate discussions about substance abuse and mental health challenges into their regular orientations for new lawyers, stressing the accessibility and confidentiality of EAP programs. Yes, it’s critical for a new lawyer to learn best practices for working with clients and how to get a duplicating job handled overnight. But it’s just as critical for them to know where to go when they feel overwhelmed or when they find themselves having those few extra drinks they never felt they needed before. Law firm rigors and cultures aren’t going to change anytime soon. The best we can do is provide information and education that will help young lawyers understand that they might need help — and that’s okay.