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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 Research on the short- and long-term outcomes of involuntary treatment for substance abuse is “surprisingly limited, outdated, and conflicting.”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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