Citation

Eisen JC. Virtual Mentor 2013; 15(10): 844-849.

Affiliation

Supervisor and instructor in psychiatry at Harvard Medical School and the Cambridge Health Alliance, and the 2013-2014 fellow in forensic psychiatry at the University of Massachusetts Medical School.

Copyright

(Copyright © 2013, American Medical Association)

DOI

10.1001/virtualmentor.2013.15.10.ecas4-1310

PMID

24152775

Abstract

Between 2004 and 2008, up to 5,000 Section 35 civil commitment cases were considered per year in Massachusetts. Nationally, 38 states have laws that permit civil commitment to inpatient or outpatient substance-abuse treatment programs. Of the remaining states, 8 permit some form of involuntary treatment that does not include civil commitment, such as emergency hospitalization due to substance-use concerns. Alabama, Pennsylvania, Virginia, and Wyoming do not offer any legal provision for involuntary treatment. Notably, Massachusetts law authorizes commitment to inpatient programs only and does not include an outpatient option.

Clinicians may express interest in this modality of treatment but are often uncertain about whether or not a particular patient is appropriate for mandated treatment, and many may not even be aware of the existence of such laws.

Determining which patients are appropriate candidates for mandated substance-abuse treatment remains controversial and complicated. Physicians must be aware of the criteria for commitment under the Massachusetts law. First, the individual under consideration must be a substance abuser, which is defined in the law by chronic or habitual ingestion, the loss of power of self-control over the use of substance(s), and interference with social and/or occupational functioning. Second, likelihood of “serious harm” as a result of the substance use must exist.

Language: en