Occupational Stress and Substance Use-Related Stigma Among Criminal Attorneys

Bibliographic Data

ID5954283
AuthorsGarland E Gerber (0009-0007-7979-6062, University of California San Diego, corresponding author), Angela R Bazzi (0000-0001-6828-1919, Boston University), Leo Beletsky (0000-0003-0726-0676, Northeastern University), Eileen V Pitpitan (0000-0003-0159-0981, San Diego State University), Mark B Reed (0000-0003-1750-2616, San Diego State University), L R Smith (0000-0002-5371-3229, University of California San Diego)
Year2025
Volume388
Pages118757-118757
Publication date2025-11-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueSocial Science & Medicine (JOURNAL)
Journal identifiersISSN: 0277-9536 • E-ISSN: 1873-5347
PublisherElsevier BV (PUBLISHER)
DOI10.1016/j.socscimed.2025.118757
PMID41252944
OpenAlexW7104463603
LanguageEN
Citations received1
References cited24

Problematic substance use is a national crisis in the United States. While criminalization of substance use places the criminal legal system (CLS) on the front lines of this crisis, little is known about how this impacts the CLS workforce. From October 2022 to March 2023, informed by the Health Stigma and Discrimination Framework, we conducted qualitative interviews with practicing criminal attorneys using a semi-structured interview guide focused on drivers, facilitators, and practices of substance use-related stigma. Stigma toward individuals with substance use disorders (SUD) has been shown to influence professional behavior, treatment access and outcomes. Inductive and deductive thematic analysis explored experiences of occupational stressors, personal substance use, and attitudes toward defendants in substance use-related cases. Interviews with 17 participants (7 women, 10 men; 88 % White; mean years of legal experience: 13.4, standard deviation: 7.8) revealed a demanding work environment characterized by severe pressures, high-volume caseloads, and the pervasive role of substance use in many cases. Occupational stressors diminished CLS attorneys' empathy towards defendants and minimized their attention to their own behavioral health. CLS work environments normalized substance use among attorneys (i.e., alcohol), fueling challenges faced by professionals and those encountered by defendants. Respondents lacked evidence-based SUD resources, resulting in ineffective case resolution and increased occupational stress. A sense of futility and emotional exhaustion was expressed about defendants with recurrent substance use-related cases. Overall, we found that failure to effectively address substance use-related harms drives occupational stress and stigma among CLS professionals. Further research is necessary to inform CLS-focused interventions.

Criminal justice · Criminalization · Empathy · Occupational medicine · Occupational safety and health · Occupational stress · Poison control · Qualitative research · Stigma (botany · Stress (linguistics · Stressor · Substance use · Thematic analysis · Healthcare professionals’ stress and burnout · Opioid Use Disorder Treatment · Substance Abuse Treatment and Outcomes

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