In the addiction battle, is forced rehab the solution?

QUINCY, Mass. — The last thing Lizabeth Loud wanted, a month from giving birth, was to be forced into treatment for her heroin and prescription painkiller addiction.

But her mother saw no other choice, and sought a judge’s order to have her committed against her will. Three years later, Loud said her month in state prison, where Massachusetts sent civilly committed women until recent reforms, was the wake-up call she needed.

“I was really miserable when I was there,” the 32-year-old Boston-area resident said. “That was one bottom I wasn’t willing to revisit again.”

In many places, lawmakers are trying to create or strengthen laws allowing authorities to force people into treatment.

But critics, including many doctors, law enforcement officials and civil rights ad- vocates, caution that success stories like Loud’s are an exception. Research suggests involuntary commitment largely doesn’t work and could raise the danger of overdose for those who relapse after treatment.

And expanding civil commitment laws, critics argue, could also violate due process rights, overwhelm emergency rooms and confine people in prisonlike environments, where treatment sometimes amounts to little more than forced detox without medications to help mitigate withdrawal symptoms.

At least 35 states currently have provisions that allow families or medical professionals to petition a judge, who can then order an individual into treatment if they deem the person a threat to themselves or others. But the laws haven’t always been fre- quently used.

Wisconsin Gov. Scott Walker signed a law last year allowing police officers to civilly commit a person into treatment for up to three days. In Washington state, legislation that took effect April 1 grants mental health professionals similar short-term emergency powers. In both states, a judge’s order would still be required to extend the treatment.

Related bills have also been proposed this year in states including Pennsylvania, New Jersey and Massachusetts, where involuntary commitment has emerged as one of the more controversial parts of Republican Gov. Charlie Baker’s wide-ranging bill dealing with the opioid crisis.

Massachusetts already allows for judges to order people to undergo up to three months of involuntary treatment, but lawmakers are considering giving some medical professionals emergency authority to commit people for up to three days without a judge’s order.

The proposal is a critical stopgap for weekends and nights, when courts are closed, said Patrick Cronin, a director at the Northeast Ad- dictions Treatment Center in Quincy, who credits his sobriety to his parents’ decision to have him involuntarily committed for heroin use almost 15 years ago.

But giving doctors the ability to hold people in need of treatment against their will, as Massachusetts lawmakers propose, will burden emergency rooms, which already detain people with psychiatric problems until they can be taken to a mental health center, said Dr. Melisa Lai-Becker, president of the Massachusetts College of Emergency Physicians, an advocacy group.

“We’ve got a crowded plane, and you’re asking the pilots to fly for days waiting for an open landing strip while also making sure they’re taking care of the passengers and forcibly restraining the rowdy ones,” Lai-Becker said.

Baker’s administration stressed the proposal wouldn’t take effect until 2020, providing time to work out concerns.

Even without the state legislative efforts, use of involuntary commitment for drug addiction is rising, according to information the AP obtained from states that have historically used it the most.