Over-Prescription as Normalcy

The Attorney General’s I-STOP bill, proposing the institution of a computer system that would track the medical history of patients to prevent against drug abuse, is facing backlash from some members of the medical community. As the article notes, New York “ranks 11th in the nation for admissions to chemical dependence programs for abuse of opioids other than heroin”.

The article’s discussion of the dangers inherent in over-prescription retains a focus on “crooked doctors, street-level drug dealers, and doctor-shopping addicts”. Little attention is paid to the addiction that rages within the employed upper-middle class. This focus perpetuates the stereotype that drug problems are confined to a particular subset of society that doesn’t include ‘us’.

This drug problem extends to law school and often starts there. The use of caffeine and alcohol for coping with work and social situations is normalized and embraced. After all, who would knock a good cup of joe and rum and coke? A person who does that would be stigmatized as a radical for not self-medicating daily.

Self-medication – through prescription drugs, alcohol and caffeine – is pervasive in the legal profession. It is used to disassociate from the ‘soul splitting’ to cope with the times when a lawyer is working on a deal that will ruin the lives of thousands of people. Dependency on these substances to cope with moral compromise and cognitive dissonance is accepted by the profession, not rejected as an addiction.

The lack of resources to truly address soul-splitting further drives the problem of self-medication and over-prescription. Good luck finding a psychologist or therapist who is not a psychiatrist. If you do, it won't be long before you are refered to a psychiatrist for medication. It's cheaper for the insurance company to give you pills instead of treating the problem.

A separate but related problem is the prescription of drugs based on ties with pharmaceutical companies. It is unsettling to watch a doctor prescribe a drug while writing on a clipboard that bears the logo of that drug. There is no good reason why prescriptions for OxyContin? have gone up 82% in 3 years. The drug is notoriously abused, and according to the article, has "contributed to more deaths than any other prescription opioid there since 2006". If reform is to come, changes to the marketing practices of pharmaceutical companies are necessary.

There is a stigma in the United States that you're a weakling if you can't function due to internal strife; it's your own fault not to be able to deal with your issues. That in part leads to the normalization of self-medication. After all, our society wouldn't function with lawyers and other professionals being unable or unwilling to do their job due to internal conflicts or strife.

Still, a morning cup of coffee or evening cocktail may not be a manifestation of a subconscious attempt to cope with soul-splitting. It may instead be the result of social conditioning to use. But if all you’re selling is time, not judgment, who cares? If we dismiss the econodwarf and start measuring our worth by judgment proffered instead of time spent, society might take notice of our profound substance dependence instead of the tacit endorsement of whatever it takes to pawn our license and bill our hours.

-- MeaganBurrows, PrashantRai, AgnesPetrucione, and HarryKhanna 03 April 2012

Just days ago the entire law school student body received an email from Career Services titled, "How To Survive Your Law Firm Summer With Your Liver Intact and a Warm Fuzzy Offer." At first I, like most others, just found the titled amusing. But after reading this article, I realized how disturbing it truly is. We are being taught in law school not only how to "sell our degrees," but also that it is expected that we use substances such as alcohol to help along the way. We are being desensitized to the idea that lawyers, at least lawyers in the private sector, use substances such as alcohol to be able to work in their professional field. Lawyerland, furthermore, shows how alcohol is also used as a means to disassociate from harsh realities, such as "realizing at 2AM that you are on the wrong side of the case." I do not believe CLS is endorsing us to go down that path, but it sure is not helping us avoid it.

When I tell other law students that I do not drink coffee (due to the fact that I dislike the taste, not because I do not need the extra boost), they often look at me as though I am a mythological creature. A law student who dislikes coffee and absolutely refuses to drink energy drinks? Usually the next thing I hear is, "How do you survive?" Easy. I am too tired too much of the time. By overwhelming us with volumes of reading, which we barely have time to read much less comprehend, law students are being trained to rely on any energy boost they can find (except for actual sleep). Worst of all, this behavior is seen as training for our future demanding careers. I agree with Meagan, Prashant, Agnes and Harry that at this point, as law students, the "morning cup of coffee or evening cocktail" have been socially engrained in us as simply being part of a hard day's work (if I correctly understood what you all wrote).