Addiction Treatment Commitment Laws

addiction

Opioid use disorder is a deadly manifestation of the disease of addiction. The condition leads to the premature deaths of over a hundred Americans, every day. In 2016, some 64,000 people died from overdose across the country — more are expected to succumb in 2017. An "epidemic" is perhaps the only word to be used in describing the severity of the opioid crisis in America.

As with most serious health conditions, finding solutions is particularly tricky. However, if experts and lawmakers agree on one thing it’s that addiction treatment is our best recourse. Substance use disorder treatment works, having helped a significant number of people break the cycle of addiction. Those who keep on the path of recovery can live meaningful and productive lives into old age. Without that type of assistance, there isn't a guarantee that an individual will survive to the end of a given year.

Encouraging people with opioid use disorder to seek treatment is more critical than ever. The rise of synthetic opioids like fentanyl and carfentanil has dramatically increased the risk of overdose. More times than not, individuals are unaware that the heroin they just bought contains an iteration of synthetic opioid. They administer their heroin as usual, which under normal circumstances carries the risk of overdose, only to find that they bit off more than can be chewed. Synthetic opioids are exponentially more potent than what’s seen in the typical bag of heroin. So toxic that the overdose reversal drug naloxone often proves an ineffective antidote.

A heightened prevalence of synthetic opioids begs the question: Is it possible to protect opioid addicts from this invisible foe? That may seem like a simple question, but answering the poser is philosophical.

Are Opioid Addicts a Danger, to Their Self?

We could rephrase the above question to say: How can an addict be protected from their self? Hopefully, we can all agree that addiction treatment services are the most effective tool at our disposal. Individuals with opioid use disorder are no longer at risk of overdose when they are in recovery. Treatment is the surest way to develop the skills necessary for a program of lasting recovery.

Under ideal conditions, a person with alcohol or substance use disorder seeks help on their own accord. They see that the path they are on is only leading to one inevitable end, prompting them to make moves to correct course. Unfortunately, the disease of addiction is both cunning and baffling; even when someone knows they need assistance, they often resist. When that occurs, some suggest mandating individuals to treatment.

Persons exhibiting signs of being a danger to their self and others are often committed to psychiatric evaluation. The standard for commitment is 72 hours, giving clinicians time to assess the level of threat. After that period patients are usually released, but there are times where longer lengths of commitment are in order. Some people view opioid use, or overdose more specifically, as a form of suicide. With that in mind, there is an argument to be made for mandating addiction treatment. Court ordered addiction rehab is a practice that occurs more often than you would think.

Addiction-Related Civil Commitments

The practice of asking the courts to protect individuals from him or herself is happening across the country. Parents, at their wit's end, will turn to the judge and plead for help in saving their child’s life. In fact, over 30 states have laws allowing for addiction-related civil commitment, The Washington Post reports. There were more than 6,000 civil commitments in Massachusetts last year, alone. While it can be easy for some people to see the benefits of mandating treatment, the policy may not have the desired outcome.

Michael Stein at the Boston University and Paul Christopher at Brown University examined this subject. They wrote an opinion piece warning that the efficacy of civil commitment is unknown, potentially doing more harm than good. They bring up three valid points worth consideration:

  • Research is lacking and there isn’t any evidence that civil commitment saves lives. Those forced into treatment may just bide their time until release. With diminished tolerance, the risk of overdose death is particularly high.
  • Given that civil commitment is a response to the level of imminent risk, shorter stays may be warranted. How can a judge be tasked to decide what length of stay is most effective for a given individual?
  • As the number of civil commitment instances grows, greater funding will be needed to pay for beds and facilities.

Stein is chair of health law, policy, and management at the BU School of Public Health. He is the author of “The Addict: One Patient, One Doctor, One Year.” Christopher is an assistant professor of psychiatry and human behavior at Brown University.

Opioid Use Disorder Treatment

We need studies to guide the crafting of new commitment laws and the revision of existing ones. How long should commitment last? What services should be required during commitment that increase the chances of a safe release back to the community? Without data, judges will face desperate parents and their children and continue to direct commitments one by one, restricting civil liberties without knowing whether they are reducing overdose deaths or if the clinical and public health resources are justified.”

Even without science to back up the effectiveness of civil commitment, it’s relatively easy to see problems. It’s well established that mental illness doesn’t respond well to force. Compassion is considered to be the most effective method of encouraging people to seek treatment. Mandates imply that an individual has done something wrong. Mental illness is not a crime, over 2 million Americans have an opioid use disorder.

Despite the fact that commitment is not a criminal charge, it’s likely that individuals subject to it will feel punished. It may not be a criminal charge, but it’s a decree backed by the force of law. If one violates the terms of the commitment, it’s probably safe to assume there will be repercussions. There are many different roads one can take to find addiction recovery, force and ultimatums have rarely led to beneficial outcomes.

Consider an Intervention

At PACE Recovery Center, we offer a multi-pronged approach to our men's addiction treatment program and philosophy because we understand that our clients are complex beings. Having a place where men can delve into their underlying issues, which have caused them to resort to substance use and self-defeating behaviors, is the core philosophy of PACE.

Often accepting treatment is prompted by an intervention. Should you need guidance in arranging an intervention for your loved one, call our team.

Addiction Recovery In An Environment Hostile to Abstinence

addiction recovery

Young people in recovery have several different forces to contend with, compared to those a little bit older. Some of the apparent obstacles include navigating the drinking and drug culture pervasive to young adulthood. Most teenagers look forward to coming of age, escaping the oversight of one’s parents. As well as, making their own decisions, partying with their peers without fear of parental admonishment—some would call it a rite of passage. However, for people coming of age whose down spiral into addiction has already begun, such freedoms are fraught with peril. Unless an introduction to addiction recovery commences, one’s early twenties are typified by heartache and disappointment.

Coming to terms with one’s addiction is not easy in young adulthood. It’s impossible to avoid posing questions to one’s self, ‘Why me? Why can’t I drink like my peers?” These questions are easier asked than answered; even if you did have the answers, it wouldn’t change anything. If you have been touched by the disease of addiction early in life, it’s best not to reason why. What’s important? Acknowledging that a problem exists and commencing to work on the problem. When one’s search for meaning ceases, your only recourse becomes clear—recovery. Those who seek it, honestly, undergo what can only be called a transformation on a mental and spiritual plane.

Young adults who set a path for recovery find spheres of opportunity open up. What was impossible a short time ago, is now within reach because of one’s program. Those who stay on a course for recovery find few limits to what is achievable, especially young people. Self-betterment requires more than working spiritual maintenance; higher education is the complimentary catalyst for achievement. Breaking the cycle of addiction unlocks the doors of possibility, college opens and lets you through—pursuing any conceivable dream.

Obstacles to Young Adult Addiction Recovery

At PACE, we prepare young men for the obstacles to addiction recovery, including a college culture unsympathetic to sobriety. Just because you are working a program doesn’t mean the gravitational pull of drugs and alcohol will vanish. College is equal parts learning both beneficial and harmful behaviors; campuses are rife with substance use, after all. We teach our clients proven relapse prevention techniques, how to stay clear from dangerous environments. Naturally, the college substance use culture is the farthest from being an ideal environment.

Young people in the Program must be vigilant in protecting their sobriety. While in school there are forces that will attempt to throw you out of orbit. It’s vital that you choose a school that values the needs of young people recovering from use disorders. Of the 20 million students who embarked upon higher learning this fall, recovering addicts and alcoholics are a minority. Meaning, from the start, you need to find peers who share your goal of abstaining from drugs and alcohol. Fortunately, scores of university campuses have addiction recovery support programs now. CRPs (college recovery programs) significantly improve one’s ability to avoid the pitfalls of their mental illness. They offer peer-to-peer support, counseling, and group meetings. Equally important, CRPs facilitate sober social activities providing young people an avenue to have fun in recovery.

One college that has long understood the importance of catering to people in recovery is Rutgers University. In 1983, Rutgers began their student recovery program, The Chicago Tribune reports. The school has a dedicated residence hall for abstinent students, known as the Recovery House. Today, 150 colleges offer CRPs and 50 offer substance-free dorms to students.

Addiction Recovery Oasis

In the United States, Lisa Laitman, director of the Alcohol & Other Drug Assistance Program (ADAP) at Rutgers University, points out, 30 percent of university students have substance use disorders, according to the article. “That’s a lot of students who need help,” said Laitman.

Laitman says that CRPs for young men and women in recovery are “a kind of oasis in the desert.” The more you can do to protect your recovery, the more likely you will be to succeed. For those planning to attend university this winter, we implore you to investigate what your college offers—recovery-wise.

If you’re young man with substance use disorder, whose ambitions include a college degree, please reach out to us. We designed our PACE Academy program with you in mind. We will help you break the cycle of addiction, provide you with the tools and support needed for successful outcomes. Alcohol and substance use disorder doesn’t have to keep you from fulfilling your dreams for the future.

Mental Health in the Workplace: Exercising Compassion

mental health

From National Alcohol and Drug Addiction Recovery Month to Mental Illness Awareness Week (MIAW), significant efforts have been made of late to shatter stigma and promote mental health treatment. We can all lend a hand in encouraging others to seek help. By promoting wellness, lives can be both mended and saved. It’s vital that such efforts continue, there is much work to be done.

On numerous occasions over the years, we have written about the importance of mental health parity, mental illness treatment and the negative impact that stigma has on society. We are all affected by the well-being of our peers, demanding that everything in our power is done to inspire others to seek help. Whether someone is suffering from depression, battling addiction or both; treatment works, recovery can become a reality for the millions of afflicted individuals.

Regardless of where you live or how old you are, the odds are that you know someone affected by mental illness. Or, you may be struggling yourself. With depression affecting more than 300 million people worldwide (just one of the many forms of mental illness), the odds are high. There are over 260 million living with anxiety disorders, according to the World Health Organization (WHO). It is next to impossible not to know someone touched by mental illness.

Mental Health In The Workplace

With such a high prevalence of mental health conditions, it stands to reason that most workplaces employ people affected. Unlike other typical illnesses, people with mental illness are far less likely to share what they are going through with an employer. Conversely, many employers are not keen on the idea of hiring people with mental health conditions. Creating closed-mouthed environments, one has to omit information to get a job. Then, has to do what they can to disguise their issues to keep it.

Obviously, it’s illegal to fire someone because of mental illness. But, that doesn’t mean that openly talking about it is typically welcomed in the workplace. This code of silence makes not only employees iller, but it also has an impact on the business itself. If someone feels that they can’t talk about what they are dealing with, they are less likely to seek treatment. For fear of repercussions to their career, individuals will do whatever they can to hide what they are going through on the inside. A trend that can have grave implications for the individual in the long run.

Without treatment and continued maintenance, people living with untreated mental illness will take desperate measures. Drugs, alcohol, and self-harm are conventional vehicles of coping with untreated mental health conditions. Behaviors that often lead to addiction, overdose, and premature death. Employers who promote environments of well-being can have a hand in reversing such outcomes.

World Mental Health Day

Some of our readers may remember that we discussed the topic of mental health in the workplace back in July? An exchange involving employee and employer. Yes, talking about needing time off for mental health, mirabile dictu, and it went unbelievably well. If you didn’t get a chance to read our post, below you can see the fantastic exchange:

Employee:

Hey team, I’m taking today and tomorrow to focus on my mental health. Hopefully, I’ll be back next week refreshed and back to 100%.”

Employer:

I just wanted to personally thank you for sending e-mails like this. Every time you do, I use it as a reminder of the importance of using sick days for mental health – I can’t believe this is not standard practice at all organizations. You are an example to us all, and help cut through the stigma so we can bring our whole selves to work.”

The above discourse can serve as an inspiration to everyone. We can all promote mental health in the workplace. Mental health in the workplace is the theme of World Mental Health Day 2017 (October 10, 2017). Depression and anxiety disorders, alone, cost $1 trillion in lost productivity each year, according to WHO. The organization would like to raise awareness for mental health issues, and the impact such conditions have on society:

Employers and managers who put in place workplace initiatives to promote mental health and to support employees who have mental disorders see gains, not only in the health of their employees but also in their productivity at work. A negative working environment, on the other hand, may lead to physical and mental health problems, harmful use of substances or alcohol, absenteeism and lost productivity.”

Dual Diagnosis Therapy

AT PACE, we would like to acknowledge all the employers who treat mental health with compassion. You are a model for all employers around the globe, promoting the facts. Mental illness is treatable; kindness pays off in the end.

A significant number of the millions battling anxiety and depression also meet the criteria for addiction. When that is the case, treatment can be complicated. In such cases, long-term recovery is dependent on treating both the addiction and co-occurring mental health condition. If you are struggling with a dual diagnosis, we can help. Please contact PACE Recovery Center to begin the lifesaving process.

Winnie-the-Pooh’s Mental Illness: How to Treat Others (in spite of their “flaws”)

mental illness

All of us in recovery have a story. Our stories go back to before we began walking down the treacherous road of addiction. Many of us had, for the most part, decent childhoods. Growing up in houses full of love. Parents who bent over backwards to ensure we would be afforded every opportunity in life. After all, that is the role that parents are expected to take in a child’s life. Two people who teach you how to be a good person, to yourself and to others.

However, our guides in early life had no way of knowing that deep inside their children something was amiss. Rather than a philharmonic orchestra, a syncopated jazz ensemble was on stage. The music sounded great, but it was off-beat. While there is certainly beauty in organized chaos, left unchecked the lines of discord and harmony become blurred. Truly, the number of variables that lead one toward the grips of addiction are numerous. Each individual case with unique roots, but the trees that would grow up were similar in appearance. Everyone recovering from addiction has unique experiences, but what brought us to surrender looked the same.

The signs may not have been picked up on early on. But, it can’t be denied that a significant number of people living with addiction met the criteria for mental illness. In one form or another, early on. Such conditions, and a lack of treatment, likely played a part in many people's path to drugs and alcohol. Verily, those touched by mental illness, but don’t have tools to cope or even talk about it, turn to self-medication. It doesn’t have to be in the form of substances, it can be behaviors as well. Patterns of risk-taking behaviors, specifically, resulting in co-occurring disorders.

What Does Winnie the Pooh Have to Do With People In Recovery?

When you were a kid, your parents likely read you children stories. Regardless of which decade you spent your childhood, A.A. Milne’s stories were probably read to you. Winnie the Pooh and his pals of the Hundred Acre Forest danced through your mind before falling asleep. We couldn’t see it then, but Milne was trying to reach us—even if it was inadvertently. You see, Milne fought in both world wars, which scared him. At the time “experts” would have called it bullet wind, soldier's heart, battle fatigue, or operational exhaustion. But, most people called it “shell shock;” what we would call post-traumatic stress disorder.

A new biopic ‘Goodbye Christopher Robin,’ explores A. A. Milne’s battle with post-traumatic stress disorder (PTSD) and the creation of Pooh. Milne’s inspiration being his son and his toys, TIME reports. The Winnie the Pooh series has been dissected and has even been applied to schools of philosophy (i.e.The Tao of Pooh and The Te of Piglet) over the years. Helpful for those in recovery, to be sure. Perhaps even more relevant to the field of addiction is a study from 2000, published in The Canadian Medical Association Journal (CMAJ). Pathology in the Hundred Acre Wood: a neurodevelopmental perspective on A.A. Milne.

In the study, Dr. Sarah Shea Read and colleagues started out with the intention of having a bit of fun. They assigned a mental illness to each character, using criteria from the DSM, according to iNews. Dr Shea claims that she hadn’t any knowledge Milne’s struggle with PTSD, at the time of the research. Milne’s characters were likely the author’s way of processing his own struggle with mental illness. Untreated mental illness, that is.

Concept of Comorbidity (Co-Occurring Disorders)

For some of you, decades may have passed since you read or watched something with Winnie the Pooh. Still, there is good chance you remember the attributes of the characters. iNews compiled some of the researchers’ insights on the characters:

Winnie the Pooh: Attention Deficit Hyperactivity Disorder

This unfortunate bear embodies the concept of comorbidity [the presence of more than one disorder].
Most striking is his Attention Deficit Hyperactivity Disorder (ADHD). As clinicians, we had some debate about whether Pooh might also demonstrate significant impulsivity, as witnessed, for example, by his poorly thought out attempt to get honey by disguising himself as a rain cloud.”

Piglet: Generalized Anxiety Disorder

Had he been appropriately assessed and his condition diagnosed when he was young, he might have been placed on an anti-panic agent… and been saved from the emotional trauma he experienced while attempting to trap heffalumps.”

Eeyore: Dysthymia – or ‘Persistent Depressive Disorder’

We do not have sufficient history to diagnose this as an inherited, endogenous depression, or to know whether some early trauma contributed to his chronic negativism.”

Tigger: Recurring Pattern of Risk-Taking Behaviours

We acknowledge that Tigger is gregarious and affectionate, but he has a recurrent pattern of risk-taking behaviours. Look, for example, at his impulsive sampling of unknown substances when he first comes to the Hundred Acre Wood. With the mildest of provocation he tries honey, haycorns and even thistles. Tigger has no knowledge of the potential outcome of his experimentation.”

Rabbit: Possible Narcissism

We note his tendency to be extraordinarily self-important and his odd belief system that he has a great many relations and friends. He seems to have an overriding need to organize others, often against their will, into new groupings, with himself always at the top of the reporting structure.”

Do Unto Others… The Stigma of Mental Illness

People living with untreated mental illness are often treated poorly by society. What people can’t understand, often frightens them. Impelling them to treat people in ways that they would never wish to be treated. Perhaps all of us missed the most important aspect of Milne’s stories. That it is O.K. to be different. That things happen in life that are beyond any one person’s control. And rather than ostracize and exile others, compassion and love can be what helps them heal.

Humans have a long history of treating those with mental illness as broken. Moral weakness, and a lack of constitution, drove them to insanity and vice. That has never been the reality, but if people are treated that way they will never find the courage to recover. Recovery is possible, so long is people are given the opportunity to do so—without fear of repercussion.

More than anything, the key to the books are their tone of love and acceptance and unspoken forgiveness in the Hundred Acre Wood,” said Dr. Read. “The stories provide lovely examples of how humans should behave.”

Many of us, upon finding recovery, were unaware that our addiction was inextricably linked to a co-occurring mental health disorder. We found that when our depression or anxiety was treated, achieving lasting addiction recovery was exponentially more likely to come to fruition. If you are a young male battling addiction, please contact PACE Recovery Center. We can help.

You can watch the ‘Goodbye Christopher Robin’ trailer below:


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