Unrecognized substance misuse: clinical hazards and legal vulnerabilities

This paper explores clinical psychologists' relative lack of attention to alcohol and other drug problems, and examines clinical consequences as well as legal vulnerabilities. The ease with which manifestations of substance abuse readily imitate every other entity seen in clinical practice allows both use and abuse to influence treatment in ways which remain often unrecognized. Borderline personality disorder is a common example. Failure to assess and appropriately treat or refer places the psychologist in an increasingly untenable position, especially as sophistication about alcohol and drug problems increases among other professionals and the lay public. The paper outlines sources of legal vulnerabilities, such as negligence and deviation from the standard of care, as they could be arise in substance abuse cases.