‘Last resort’ solution
Civil libertarians are troubled by the idea that addicts who seek treatment at a Massachusetts hospital for an opioid-related overdose could be forced into treatment against their will, under a bill proposed by Gov. Charlie Baker. They cite a 2016 state Department of Public Health study that found those who had previously received involuntary treatment were at greater risk of death from an opioid-related overdose than those who had previously entered treatment voluntarily.
But there are a litany of complex reasons for why an addict who has had to be forced into treatment might be at greater risk than one who volunteers. DPH itself acknowledges the study findings “may not fully reflect the risk of overdose for this population.”
And that same study found that individuals who received involuntary treatment were 1.9 times as likely to die of cause. So if the choice is between death — and 72 hours in rehab, even if not by choice — we can imagine where many families will come down.
State law already permits involuntary treatment for addiction, through the court system. But as Health and Human Services Secretary Marylou Sudders pointed out in her testimony yesterday, “crises of addiction occur 24 hours a day, seven days a week — not only during the hours when a court is open.” Hospitals should be a pathway for treatment, too.
The governor and his team have revised an earlier, more problematic proposal, which would have allowed a person to be held involuntarily in a hospital emergency department. The alternative — up to 72 hours of treatment in a rehab facility — is better, assuming the Baker administration can deliver on its promise to expand treatment
To that end the bill calls for investing $30 million in federal Medicaid funds to expand treatment and recovery services.
It also calls for new licensing standards for clinicians and treatment centers, and new standards for credentialing “recovery coaches.” It would also eliminate paper prescriptions for opioids.
Yes, the best hope for success in beating addiction is voluntary, long-term treatment. But tell that to the doctor who has revived a patient who overdosed, only to see the patient walk out the door a few hours later with no plan for recovery. The “last-resort” provision and others in this bill are a good next step on the path to eradicating this horror.