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The Mississippi Lawyer Winter 2016 33 include dizziness drowsiness insomnia vomiting anxiety blurred vision confu- sion decreased attention mood swings impaired executive function impaired judgment slurred speech and delirium. Any of these are incompatible with a safe practice of a profession. Professional licensing organizations in the 1950s would typically suspend or permanently revoke the professional license of a professional identified with a drug or alcohol problem. These prob- lems were considered moral ethical and legal problems at the time. This punitive policy had the unintended consequence of sweeping a huge problem under the rug and out of sight. Professionals were understandably reluctant to self-report and fellow professionals were reluctant to report a colleague despite clear knowl- edge of a problem. Professional monitor- ing programs were developed over the subsequent 20 years to provide an alter- native pathway involving identification evaluation treatment and aftercare with monitoring and random drug screens. The American Medical Association approved this policy for Physicians in 1974 and almost every state in our country now has a Physicians Health Program very similar to the LJAP in organization and mission. Licensing organizations such as Supreme Courts and Medical Boards as well as Nursing Boards and Pharmacy Boards now offer evaluation treatment and moni- toring as an alternative to licensing action and expulsion from the profession. Key to this change is the recognition of addiction as a chronic disease rather than a moral or ethical problem. The chronic disease model of addiction holds that addiction must be managed over a lifetime not cured in a short period of time. Like asthma hypertension or dia- betes addiction tends to recur without proper treatment and long-term manage- ment. Proper treatment for this long-term problem involves identification inter- vention detoxification treatment and a strong post-treatment monitoring pro- gram to include accountability and super- vision. LJAP endorses all of these well- established and research validated criteria for an effective treatment program. An attorney who volunteers for LJAP and complies with LJAP requirements has a very good chance of obtaining success- ful treatment for his addiction and that in turn may help facilitate a return to the safe practice of law with the full blessing of his Supreme Court provided that the attorney has not caused substantial harm to the public or the profession. Two generations of experience with similar PHP support a high probability of success in a professional population. LJAP in particular works closely with the affected attorney to identify and evaluate the problem intervene early detoxify if necessary treat with appropriate inpa- tient or outpatient programs and engage in aftercare including close monitoring and accountability to ensure sobriety and prevent relapse. A similar program for Physicians in Washington State with 90 days of inpatient treatment at a good facil- ity followed by PHP monitoring resulted in 80-95 sobriety at one year 85 continuous sobriety with 5 years of moni- toring and 85 continuous sobriety with 10 years of monitoring. By contrast a 30 day inpatient treatment with no follow-up yielded in 80 relapse rate at one year in this population. The effectiveness of a 90 day inpa- tient program should sound familiar to all of those with professional or military training because we learn best in 90 day increments. It takes about 90 days to internalize a new body of knowledge and a new set of behaviors. Military basic training across cultures and across time takes about 90 days to turn a young civil- ian into a soldier. A standard semester in high school college or professional train- ing takes a minimum of about 3 months. One does not master Constitutional Law or Gross Anatomy by reading a textbook in one evening and taking a test the next day. Virtually all studies of rehabilitation have shown that the patient who stays in treatment longer and attends the most treatment sessions obtains the best post- treatment outcomes. Length of stay is a robust positive predictor of treatment outcome as are intensity of treatment supervision length of monitoring and accountability after treatment. The FAA another licensing organi- zation with stringent policies regarding drug and alcohol impairment in profes- sional pilots has a program remarkably similar to LJAP designed to treat impaired pilots and return them to flying. The FAA program also involves identifica- tion evaluation treatment and after treat- ment monitoring. The program involves testing monitoring accountability and consequences if a pilot identified with a prior substance problem returns to the use of substances. The program also involves return to flying duties with the blessing of FAA if the pilot complies with a moni- toring program obtains treatment and remains sober. In conclusion the overwhelming body of evidence we have today indicates that a professional population benefits from programs like LJAP to identify and treat addicted professionals and return them to practice as quickly and safely as possible. ______ Jay Weiss MD is a graduate of University of Arkansas College of Medicine. He completed his residency in Psychiatry while serving in the United States Air Force for a total of 30 years. Dr. Weiss is ASAM certified 2005 and is board certified in Geriatrics 1994 AddictionsSubstance Abuse 1995 and Psychiatry 1991. He is a member of both the AMA and APA associations. His speaking engagements include the FAA conference on Aviation Psychiatry USAF on Combat Psychiatry and Celestial Navigation. Dr. Weiss believes that staff interaction on both a professional and personal level makes Palmetto an excep- tional place for treatment. He gives lectures throughout the coun- try. He is affiliated with the FAA. He has been at Palmetto 15 years. Addiction and Treatment in a Professional Population It takes about 90 days to internalize a new body of knowledge and a new set of behaviors.