Is Involuntary Treatment The Next Tool in The Fight Against The Opioid Epidemic?

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Civil commitment, or involuntary commitment, allows health professionals, members of law enforcement and relatives to petition a court for the treatment of a person who has mental illness and is seen as a danger to themselves or others. 37 states and Washington, D.C. have civil commitment laws in place that allow the state to commit people for substance use disorder. However, these laws are far from perfect. They vary greatly in commitment criteria and the length and type of treatment.

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Lawmakers in several states are pushing proposals that would force a person who abuses opioids into involuntary treatment to cope with skyrocketing overdose rates, but the potentially widespread use of civil commitment as a tool in the fight against the opioid epidemic raises some valid concerns. It strips people of their liberty, bars them from receiving quality, evidence-based treatment and could leave them more vulnerable to overdose risk.

In fact, involuntary treatment is less effective regarding long-term outcomes, and it increases the risk of overdose. Dr. Andrew Kolodny, co-director of opioid policy research at the Heller School for Social Policy and Management at Brandeis University says someone suffering from opioid abuse may not be ready for discharge after the short window of involuntary treatment.

Although they go a short time without opioids and receive some treatment, their lower tolerance upon release puts them at a higher risk of opioid overdose, so involuntary commitment could be doing more harm than good. According to Massachusetts overdose data, people who were involuntarily committed were more than twice as likely to die from an overdose than those who completed treatment voluntarily.

Civil commitment laws have been widely adopted in states across the country, but we still don’t fully understand their impact. In other words, we don’t know if civil commitment works. Research on the short- and long-term outcomes of involuntary treatment for substance abuse is “surprisingly limited, outdated, and conflicting.”

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Murky territory requires more research. For example, how long should involuntary commitment last? What treatment services should be used? How can we ensure a patient immediately transitions from involuntary treatment into long-term treatment? Without concrete data that answers these pertinent questions, it’s impossible to create a worthwhile solution that effects change.

We’re in the midst of a national public health emergency, and many lawmakers are scrambling for immediate solutions. If civil commitments become more commonplace in the fight against the opioid epidemic, lawmakers could end up choosing to fund civil commitments instead of laboring over a more comprehensive treatment system that leads to reform and better treatment outcomes.

Involuntary treatment may seem like a good option–or the only option–for families or health care providers of a loved one or patient with substance use disorder. Still, it’s critical to understand the logistics and implications of involuntary commitment because it’s a process that strips a person of their liberty just as prison would.

For now, the most effective way to combat the opioid epidemic is to get more people into treatment voluntarily, because we know recovery is much more likely when someone seeks it on their own volition instead of being coerced into it.

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Reviewed professionally for accuracy by:

Ryan Soave


Ryan Soave brings deep experience as a Licensed Mental Health Counselor, certified trauma therapist, program developer, and research consultant for Huberman Lab at Stanford University Department of Neurobiology. Post-graduation from Wake Forest University, Ryan quickly discovered his acumen for the business world. After almost a decade of successful entrepreneurship and world traveling, he encountered a wave of personal and spiritual challenges; he felt a calling for something more. Ryan returned to school and completed his Master’s Degree in Mental Health Counseling. When he started working with those suffering from addiction and PTSD, he found his passion. He has never looked back.

Written by:

Cayla Clark

Cayla Clark

Cayla Clark grew up in Santa Barbara, CA and graduated from UCLA with a degree in playwriting. Since then she has been writing on addiction recovery and psychology full-time, and has found a home as part of the Guardian Recovery team.

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