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32 Winter 2016 The Mississippi Lawyer Addiction and Treatment in a Professional Population we discovered a number of unintended consequences and decided to live with the damage caused by alcohol as opposed to damage caused by the consequences. Addiction problems are widespread they know no social boundaries and they include a high cost to society and high mortality rates. There is no quick recov- ery from an addiction problem. Such problems follow a chronic disease model requiring lifelong management and moni- toring. All addictive substances affect and stimulate a very primitive part of the brain called the limbic system. This area lies just above the spinal cord and con- trols survival mechanisms such as thirst hunger and fear. Adjacent areas control the fight or flight mechanism and reward mechanisms. This area of the brain is present in all animals and necessary for survival. Addictive substances convince this area of the brain that it must have more of the drug in question as a matter of survival. Addictive substances also simul- taneously shut down the higher areas of the brain that control judgment executive function and a sense of right and wrong. The main neurotransmitter involved in all addictive substances is dopamine and this is also the main neurotransmitter involved in schizophrenia. All addictive substances increase the secretion of dopamine in the brain and an excess of dopamine is well known as an important factor in schizo- phrenia. All antipsychotics decrease the level of dopamine available to the brain. It should therefore come as no surprise that addictive behavior can look a lot of like schizophrenia with attendant poor judgment paranoia and impaired reality testing. It should also come as no surprise that addictive substances can cause some very intelligent people to do some very stupid and dangerous things. We as professionals are not immune from medical illnesses including addic- tions. We have a higher than average rate of addiction due to the higher levels of stress to which we are subjected. Our addiction rates must be seen within the context of significant long term drug problems within our society including an accelerating rate of prescription drug addiction. Fortunately we also have a high rate of success in treatment of addic- tions and availability of professional health programs like the Mississippi Bars Lawyers and Judges Assistance Program LJAP. A Professional Health Program has dual roles of enhancing public safety and assisting with rehabilitation and re- entry to practice of licensed profession- als with potentially impairing medical conditions including addiction. The Bars LJAP provides a confidential opportunity for its professionals to access compre- hensive and well supervised evaluation treatment aftercare and monitoring. It provides an alternative to severe licensing and disciplinary action with emphasis on rehabilitation and accountability carefully facilitated and documented over time. Professional populations including Attorneys Judges Physicians Nurses Pharmacists Dentists Accountants Engineers and others too numerous to mention all share a number of important characteristics. These include lengthy pro- fessional training a body of knowledge unique to the profession service to the public a fiduciary responsibility to the public and licensing boards which moni- tor professional performance throughout the professionals career. Professionals are held to a higher standard of educa- tion and behavior than the average citizen and live under much greater scrutiny. Professionals must master a large data- base of information which must then be applied in a high pressure environment requiring superior powers of observation judgment and executive function in a dynamic environment where the price for a mistake is very high. A universal policy among professional licensing organizations is prohibition of alcohol or controlled medications from legal or illegal sources while practic- ing the profession due to the potential for significant impairment and resultant erosion of performance. Side effects are variable and unpredictable but the dan- ger to the public greatly outweighs any possible benefit to the individual profes- sional from consumption of impairing substances while practicing the profes- sion. Important side effects often seen with controlled substances or alcohol