In a typical addiction recovery story, a person with an addiction reaches an emotional or physical low, and that person decides to get better through the help of a structured program.
We’ve seen this story told countless times on television programs and in movies. As a result, many of us believe that people must “hit rock bottom” and decide to get well before recovery can begin.
But what happens when someone with an addiction doesn’t seem capable of deciding to recover? What can the family do instead?
For some families, the answer involves involuntary commitment.
People who go through an involuntary commitment process are forced to enter a treatment program even if they don’t want to do so.
As the Partnership for Drug-Free Kids points out, this step can only be taken when families can prove that the person is addicted. There must often be evidence that the person has inflicted, or threatened/attempted to inflict, harm on oneself or others. In the absence of that proof, there must be evidence that the person cannot attend to basic needs due to addiction, and there is no suitable person that can provide for those needs.
Given this definition, it’s clear that the addiction must be in an advanced stage for involuntary commitment to take hold.
It may not be possible in all states either. The National Alliance for Model State Drug Laws reports that 37 states and the District of Columbia have statutes that allow for involuntary commitment for addiction treatment.
In most states, people are given the opportunity to fight back against the idea of involuntary commitment. They can fight for their rights in court, and they can have lawyers help them in the battle.
That means it can take quite some time to push someone into treatment. The person can keep using right up until the moment the commitment order comes through.
Many families are resorting to involuntary commitment for addiction. According to the Associated Press, Florida officials had more than 10,000 requests for this form of treatment in 2016. That’s a big jump from the more than 4,000 requested in 2000.
Changes in laws could make those numbers rise yet higher. At one point, most states had tight limits on who could request a step like this. Parents, spouses, and doctors were typically able to ask for help, but others were not.
According to The Daily Beast, new laws in places like Florida are allowing any adult who has seen the impairment to file a petition for up to 90 days of confinement.
The National Institute on Drug Abuse says that treatment absolutely does not have to be voluntary to be effective. As long as the treatment given is in accordance with best practices, it could be considered effective for those who have addictions, whether they want the care or not.
But some experts question whether the care given in some of these programs is really helpful for everyone with an addiction.
In a study published in the journal Psychiatric Services, researchers point out that there have been few well-crafted studies performed that could help experts to understand how long programs like this should last and what they should include within the treatment model.
Few studies have also been performed that pit people enrolled voluntarily against those enrolled involuntarily. That means we simply don’t have enough data to prove that these therapies are always good for those with addiction.
In addition, people who commit someone to these programs may have no say in the places or ways the therapy takes place. According to research from Mother Jones, some states send people into prison-like environments during their involuntary commitment. Sometimes, people do not get the therapy they need to change behavior. They are incarcerated, not treated.
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The organization Mental Health America suggests that involuntary commitment should be used only in extreme circumstances, meaning that someone must be in significant danger before this option is executed.
A doctor can help you to make that assessment. In some states, a doctor’s sign-off is required to get the process started.
Your doctor can fill out paperwork to keep the person within a hospital or psychiatric facility for a short time. Then, the doctor can lead the team that pushes for a longer confinement period.
Involuntary commitment isn’t the only way you can help someone you love to see the value in and get the benefit of addiction care. You can also try family forms of therapy, such as CRAFT.
According to the Center for Motivation and Change, CRAFT (which stands for Community Reinforcement and Family Training) is designed to help families push a loved one toward treatment, but the therapy works even if the person never engages in care.
In therapy like this, the family learns a great deal about addiction and how addiction impulses are rewarded or distinguished. Families learn how to use positive reinforcement techniques to highlight the behaviors they want while distinguishing those they do not like.
Families also learn how to communicate their needs. They learn how to show compassion to someone with addiction without perpetuating the destructive behavior.
A therapy like this doesn’t use threats or the legal system to bring about change. Instead, it builds on the love family members have for one another.
It helps families to move past an addiction even if the person they love never chooses to do so.
If you’re trying to help a loved one through addiction, but you’re not sure what should happen next, please reach out for help. Resources are available to help you get your loved one the treatment they need.
(September 2016). Many States Allow Involuntary Commitment for Addiction Treatment. Partnership for Drug-Free Kids. Retrieved January 2019 from https://drugfree.org/learn/drug-and-alcohol-news/many-states-allow-involuntary-commitment-addiction-treatment/
(August 2016). Involuntary Commitment for Individuals with Substance Use Disorder or Alcoholism. National Alliance for Model State Drug Laws. Retrieved January 2019 from http://www.namsdl.org/IssuesandEvents/NEW%20Involuntary%20Commitment%20for%20Individuals%20with%20a%20Substance%20Use%20Disorder%20or%20Alcoholism%20August%202016%2009092016.pdf
(May 2018). In the Addiction Battle, is Forced Rehab the Solution? Associated Press. Retrieved January 2019 from https://www.apnews.com/75a4822a714b43a5b6f7b7b988d641f6
(May 2017). New Laws Force Drug Users Into Rehab Against Their Will. The Daily Beast. Retrieved January 2019 from https://www.thedailybeast.com/new-laws-force-drug-users-into-rehab-against-their-will
(January 2018). Principles of Effective Treatment. National Institute on Drug Abuse. Retrieved January 2019 from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/principles-effective-treatment
(April 2018). Civil Commitment for Opioid and Other Substance Use Disorders: Does It Work? Psychiatric Services. Retrieved January 2019 from https://ps.psychiatryonline.org/doi/full/10.1176/appi.ps.201800066
(July 2018). Does Forced Rehab Work? Mother Jones. Retrieved January 2019 from https://www.motherjones.com/politics/2018/06/does-forced-rehab-work/
(March 2015). Position Statement 22: Involuntary Mental Health Treatment. Mental Health America. Retrieved January 2019 from http://www.mentalhealthamerica.net/positions/involuntary-treatment
What is CRAFT? Center for Motivation and Change. Retrieved January 2019 from https://motivationandchange.com/outpatient-treatment/for-families/craft-overview/