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Occupational stress and substance use-related stigma among criminal attorneys

Author

Listed:
  • Gerber, Garland E.
  • Bazzi, Angela R.
  • Beletsky, Leo
  • Pitpitan, Eileen V.
  • Reed, Mark B.
  • Smith, Laramie R.

Abstract

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.

Suggested Citation

  • Gerber, Garland E. & Bazzi, Angela R. & Beletsky, Leo & Pitpitan, Eileen V. & Reed, Mark B. & Smith, Laramie R., 2026. "Occupational stress and substance use-related stigma among criminal attorneys," Social Science & Medicine, Elsevier, vol. 388(C).
    • Handle: RePEc:eee:socmed:v:388:y:2026:i:c:s0277953625010883
    DOI: 10.1016/j.socscimed.2025.118757
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    1. repec:plo:pone00:0159015 is not listed on IDEAS
    2. Alexander C Tsai & Mathew V Kiang & Michael L Barnett & Leo Beletsky & Katherine M Keyes & Emma E McGinty & Laramie R Smith & Steffanie A Strathdee & Sarah E Wakeman & Atheendar S Venkataramani, 2019. "Stigma as a fundamental hindrance to the United States opioid overdose crisis response," PLOS Medicine, Public Library of Science, vol. 16(11), pages 1-18, November.
    3. Phelan, Jo C. & Link, Bruce G. & Dovidio, John F., 2008. "Stigma and prejudice: One animal or two?," Social Science & Medicine, Elsevier, vol. 67(3), pages 358-367, August.
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