Alberta Lawyers' Assistance Society

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Harm Reduction Strategies for Lawyers

The National Study on Psychological Health Determinants of Legal Professionals in Canada, a project commissioned by the Federation of Law Societies of Canada, the Canadian Bar Association and Université de Sherbrooke, was released this week. It paints a picture of significant distress in our profession with lawyers across Canada disclosing high rates of psychological distress, depression, anxiety, and substance use. There is a lot to digest—the report is 380 pages long!
We will be exploring Study findings over the coming weeks. You can access a copy of the Study here,  or a Canadian Lawyer article about the Study.
Our Red Mug Coffee Circle will be discussing the impact of stressors in the legal profession on demographic groups including women, ethnicized lawyers, members of the LGBTQS+, Indigenous lawyers, lawyers with disabilities, articling students, young lawyers, and lawyers in early years of practice. Please join us on Monday at noon if you would like to participate in exploring what these findings mean for Alberta legal community members and for Assist.
This week, I was exploring a topic that is linked to the National Study: use of alcohol and drugs within the legal profession. I had pulled out the 2016 ABA study results about alcohol and drug use among American lawyers and, in the first draft of the blog, mentioned that Canadian data would be released soon. And then the Study was released yesterday so I now have a better context about Canadian lawyers and drug and alcohol use.
We know that lawyers have higher rates of addiction and substance use disorder at a rate much higher than the general population. According to the ABA research in 2016, 20.6% of survey participants screened positive for ”hazardous, harmful, and potentially alcohol-dependent drinking”.
The National Study used the same instrument as the ABA study which enhances comparisons. Canadian lawyers, both male and female, are slightly more likely to meet thresholds for alcohol dependence (page 248.) However, researchers note that the Canadian survey occurred during the pandemic when consumption of alcohol may have been higher.
It can be difficult to get accurate data about use of drugs since people can be reluctant to admit to illegal (and possibly criminal) conduct. However, the National Study reports that more than 22% of survey respondents used drugs for non-medical purposes. About 95% of these lawyers used cannabis (which is legal), while about 18% used cocaine and almost 11% used prescription drugs for non-medical purposes. Many of the lawyers who reported using drugs for non-medical purposes used more than one substance and many combined drug use with alcohol use.
Earlier this month, lawyers who attended the Well-Being in Practice Summit heard from a Calgary lawyer who shared the story of his recovery from cocaine addiction. His story is inspirational, and it is powerful for all of us to see that a lawyer can recover from addiction and return to active and successful practice and a rewarding personal life.
However, not all stories have happy endings. I read this week about a young New York City lawyer who, along with a financial trader and a social worker, died after using cocaine which was laced with fentanyl. This tragedy raised the spectre of drug dealers seeking to cement their clients’ dependence on them by cutting cocaine with fentanyl to make it more powerful and also more addictive.
This story is tragic. The young lawyer graduated from Columbia Law School in 2020 and, after passing the New York bar, began working for a prestigious large firm. She was involved in pro bono work with refugees, domestic abuse victims and prisoners, and was able to meet her idol, Ruth Bader Ginsburg, through a law school organization. The world must have been this young woman’s oyster.
Media coverage of this sad incident do not disclose how often she used cocaine. She may have been an occasional user, as opposed to an addict, but she had a dealer with whom she communicated. On the night of her death, she contacted him asking if he could “come through” for her. He said yes and sent his courier to make a delivery. That evening, the dealer received similar messages from the financial trader and the social worker, and the courier made deliveries to them as well.
Then the dealer started reaching out to these three individuals, warning the social worker by text that this batch was particularly potent. None of the three responded to these texts and were later found either unresponsive or dead. The financial trader’s partner was pregnant and gave birth to a baby boy three weeks after the trader passed away. The lawyer left parents and siblings, and the social worker’s photos show her with her dog.
The dealer and the courier face charges including causing the death of three people. Prosecutors believe that the dealer and courier had knowledge of the danger in this batch of cocaine and that their communication attempts with these three individuals indicated an awareness of guilt.
Assist provides non-judgmental professional counselling assistance to lawyers, articling students, law students and their dependent families. We urge lawyers, students and family members who are concerned about their substance use and potential dependencies to contact our counsellors (1-877-498-6898). Telling people not to use drugs (the “just say no campaign”) does not seem to be effective with many populations.
And if you are concerned about drug use by someone in your family, friends, or work circles, you can meet with a counsellor to discuss how you can have a conversation with them about their usage—or about any other matter. Providing support to friends, family and co-workers is part of what Assist does. And people who struggle with substance use issues need support.
No one wants to enable drug use, but there may be harm reduction strategies that concerned people can adopt.
First, if you are using a substance like cocaine that can be cut with fentanyl, please consider purchasing fentanyl testing strips—you can order them online from a variety of suppliers. These products were designed to drug test urine samples in monitoring programs and using them to identify whether other drugs have been cut with fentanyl is an off-books use. This may be a step drug users can take to enhance their safety. Unfortunately, these products do not detect carfentanol or other dangerous substances but a recent Canadian study indicates that home use of the testing strips has a similar positivity rate to use by trained staff.
 If I were concerned that someone close to me was using drugs that could be laced with fentanyl, I would consider sourcing a product like this. I would tell the person that I want them to stop using the substance they are using and offer to provide support, but I would also ask them to use the strips if they continue to use at any time for any reason.
Health Canada cautions Canadians, however, that testing strips do not guarantee the safety of street drugs. They do not test for carfentanol or other analogs, and accuracy is not 100%.
Health Canada urges a multi-faceted approach to drug safety:
Use every precaution, even if you or your friends use fentanyl test strips:

  • Never consume alone.
  • Consider consuming a smaller dose: start low and go slow.
  • Go to a supervised consumption site if your community has one.
  • Carry naloxone, which can temporarily reverse an opioid overdose. Make sure that you, and the people with you, know how to administer it.
  • Call 9-1-1 or your local emergency help line if you think someone is having a drug overdose.
  • Get your opioid overdose wallet card and carry it with you. Know what to do.

Secondly, if I thought someone might use substances that could be cut with fentanyl, I would also obtain a naloxone kit. Naloxone kits are available at pharmacies across Alberta free of charge and can successfully reverse fentanyl overdoses. To learn more about naloxone kits and how to use them, check out this resource prepared by the University of Alberta.
A lawyer-friend of mine obtained a Naloxone kit because the distance from their home to a hospital is long. While not believing anyone in their household or who might be a guest at their home was likely to use fentanyl or fentanyl laced products, they wanted to ensure that if there was an overdose at or near their home, they were able to respond.
Being able to respond with a life-saving treatment does not condone drug use. It just provides a safety net for someone else who may have made a poor decision. I would rather have a difficult conversation with someone after an overdose and reversal than be too late to have the conversation.
I am not a brave person—I have been terrified about addiction since I learned of it and managed to avoid drugs because of this fear. This had certain limitations on my social circles at different times in my life, and I was okay with that. My fear of becoming addicted to something dangerous outweighed my desire to be popular! But I am willing to be brave and have an awkward conversation to try to help someone who is in medical distress and could die without lifesaving treatment
We can also urge someone who may persist in using a substance to use the buddy system, always having a non-judgmental friend with them who can intervene if an overdose occurs, but we must be aware that while interventions like Naloxone can reverse many overdoses, it cannot reverse all.
Assist has excellent resources about addiction and recovery on our website and through our professional counsellors. Dr. Forbes, who heads up our professional counselling program, has extensive contacts in the drug treatment community and can help link individuals who want to overcome their substance use disorders through treatment with the best facility for their circumstances. And since Assist arose out of the recovery community, we can also connect you with a group of lawyers who have walked that journey and can provide support.
Assist can provide a lunch and learn session or webinar about substance use issues for your office. Please email me if you are interested. While presentations by our volunteers or by me are free, we must charge a fee for our outside experts--but helping everyone in your workplace understand signs of substance use and knowing how to connect someone using substances dangerously is an excellent use of well-being budget resources.
In an ideal world, we would eliminate both dangerous substances and the individuals who prey on people’s dependencies. But we don’t live in an ideal world. In our world, we have lawyers using dangerous substances so they can work long hours as well as to help them come down from the hyper-aroused state they need to meet increasing demands at work. And we have dealers whose interests are unlikely to align with lawyers’ professional responsibilities.
Let’s work together to ensure that we don’t have a tragedy like the three New York City professionals who inadvertently overdosed on fentanyl. The shame isn’t in using substances—it is in the loss of lives that could do so much good in our world.