Bradley H. Jones Jr.
Massachusetts House minority leader, North Reading Republican
Despite ongoing efforts to combat opioid abuse, Massachusetts continues to face an epidemic that has claimed thousands of lives. In 2016 alone, the state’s Department of Public Health confirmed 2,094 cases of overdose deaths, a 24 percent increase over the previous year.
From January to September of 2017, DPH documented another 932 confirmed opioid-related overdose deaths. Although the numbers are trending downward, there are still far too many people dealing with drug dependency issues, and far too many lives being lost to this scourge.
Governor Charles Baker’s proposal to allow individuals to be involuntarily placed in a drug treatment program for up to 72 hours will help save lives. It will also address the all-too-familiar vicious cycle that occurs when a patient reports to the emergency room suffering from an overdose and is treated and released, only to end up back in the ER after another overdose.
Under previous legislation we adopted in 2016, ER patients treated for an opioid-related overdose, or given the overdose-reversing drug naloxone prior to arriving at the hospital must undergo a substance abuse evaluation within 24 hours. Patients are advised of their treatment options, but are not legally required to enter treatment. Individuals can be involuntarily committed to receive treatment for their addiction only with a court order.
During debate over the 2016 legislation, I offered an amendment to allow attending physicians to restrain a patient and place them in a treatment facility for three days if the patient had already received a substance abuse evaluation and returned to the hospital within seven days with another opiate-related overdose.
Governor Baker’s proposal would allow medical professionals and police officers to authorize the transfer of a patient to a substance use treatment facility without a court order if the patient presents a danger to themselves or others, and for the patient to be held in that facility up to 72 hours if deemed necessary by a physician. A court order would be required to hold patients beyond the 72 hours.
Governor Baker’s 72-hour proposal is intended as a “last resort” option, but will literally save lives, getting people into treatment and hopefully placing them on a path to recovery by reducing their chances of suffering a potentially fatal relapse. It deserves serious consideration as one tool towards addressing this epidemic.
Winchester resident; ACLU of Massachusetts legal director
Governor Charles Baker’s proposed legislation to combat opioid abuse has a lot to like — including provisions that seek to prevent addiction and ensure high-quality treatment — but it also contains a cause for real concern: an expansion of the Commonwealth’s law authorizing the involuntary detention of people suffering from addiction.
Advocates of involuntary commitment surely want to help people who are struggling with addiction. Who can blame them for wanting to help? Rampant opioid abuse has created arguably the worst public health crisis to hit Massachusetts in decades. People are losing their lives, and state officials are struggling to find sustainable solutions.
But proposing involuntary commitment is not, in fact, helpful. Instead, it paves the way for police to detain and transport drug users to substance abuse treatment centers against their will, where they would then enter a 72-hour lock-down if a doctor orders it after an examination. Such measures raise legal due process concerns and, worse, could endanger the very people we are trying to help.
Nearly four years ago, the ACLU of Massachusetts and other organizations challenged the imprisonment of Massachusetts women who were civilly committed for addictions to drugs or alcohol. When no suitable treatment facilities were available, hundreds of women who hadn’t been charged with a crime were sent to prison.
We argued then — and do so again now — that locking up people suffering from addiction not only imperils their constitutional freedom; it can also imperil their lives.
Mandating 72-hour detention and treatment for people suffering from addiction is dangerous. Especially if follow-up treatment or services are not guaranteed, coercing someone into detox can increase their risk of overdosing when they are released with the same addiction but a reduced tolerance for the drug.
In fact, the Commonwealth’s own data show that people who undergo involuntary treatment in Massachusetts are twice as likely to die from an overdose as people who undergo treatment voluntarily. As a result, expanding involuntary commitment can be worse than doing nothing at all.
At the ACLU of Massachusetts, we are committed to an approach that invests in public health, not punishment and prisons. If we are serious about addressing opioid addiction here in Massachusetts, we need to fund social services and treatment on demand, as opposed to coercion and detention.
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