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Involuntary Rehab: Frequently Asked Questions

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Can I force my loved one to go to rehab?

Yes, but only in certain locations.

There are currently 37 states that allow for involuntary addiction treatment, according to the National Alliance for Model State Drug Laws ((Many states allow involuntary commitment for addiction treatment. (n.d.). Partnership to End Addiction. Retrieved October 12, 2021, from https://drugfree.org/drug-and-alcohol-news/many-states-allow-involuntary-commitment-addiction-treatment/)). That number may change over time, so it’s important to stay up to date with your state’s local regulations.

It’s important to note that your state may or may not make a legal distinction between treating a person for alcohol addiction, drug addiction, and mental health. This distinction is usually intended to protect criminal court proceedings, and to prevent defendants from claiming insanity due to substance use.

Most states have two distinct processes by which a person is evaluated for involuntary care; one that applies to current patients, and another that applies to anyone in the midst of a mental health crisis. In many states, anyone can request that a person in crisis be evaluated by a court to see if they meet the criteria for involuntary mental health and/or addiction treatment ((State Standards for Initiating Involuntary Treatment. (2020). Treatment Advocacy Center. https://www.treatmentadvocacycenter.org/storage/documents/state-standards/state-standards-for-initiating-involuntary-treatment.pdf)). However, this is not always the case. Florida, for example, requires evaluation by an authority, such as a law enforcement officer, clinical social worker, or physician.

Can I send my spouse to rehab?

Yes, but only in certain locations.

In many states, anyone can call for an emergency mental health evaluation of a person experiencing a mental health crisis. This includes crises that are caused by substance use. If your spouse is a habitual substance user, but is not in crisis, you may have fewer available options. Make sure to check the specific regulations in your state ((State Standards for Initiating Involuntary Treatment. (2020). Treatment Advocacy Center. https://www.treatmentadvocacycenter.org/storage/documents/state-standards/state-standards-for-initiating-involuntary-treatment.pdf)) to find out which options are available to you.

If you are in physical danger due to your spouse, get yourself to safety before you help them find medical care. If you need help, you can contact the National Domestic Violence Hotline ((National domestic violence hotline. (n.d.). The Hotline. Retrieved October 12, 2021, from https://www.thehotline.org/)) at 1.800.799.SAFE (7233).

Can I send my teen to rehab?

Possibly, depending on your location and your child’s exact age.

Every U.S. state has slightly different rules governing a minor’s autonomy when it comes to medical care ((Kerwin, M. E., Kirby, K. C., Speziali, D., Duggan, M., Mellitz, C., Versek, B., & McNamara, A. (2015). What can parents do? A review of state laws regarding decision making for adolescent drug abuse and mental health treatment. Journal of Child & Adolescent Substance Abuse, 24(3), 166–176. https://doi.org/10.1080/1067828X.2013.777380)). Some of these laws are vague, and subject to interpretation by local authorities. You may be able to make some decisions on your teen’s behalf, while they have more control over others. For example, in Delaware, parental consent is required for a minor to receive inpatient treatment for substance use, but either a parent or a minor aged 14 and up may legally consent to outpatient treatment.

How does a person qualify for mandatory rehab?

A person must meet certain criteria before they are legally required to attend rehab ((State Standards for Initiating Involuntary Treatment. (2020). Treatment Advocacy Center. https://www.treatmentadvocacycenter.org/storage/documents/state-standards/state-standards-for-initiating-involuntary-treatment.pdf)). These criteria vary based on your location. They may or may not be the same as the criteria for mandated mental health treatment for other conditions.

It’s important to note that there may be different criteria for a person in crisis than for a person with ongoing but less severe symptoms. In a crisis situation, the person may be held briefly before either being released or sent to residential treatment. Often, this means that they will be held for 72 hours in a mental health center, during which time they will be evaluated to see if further treatment is needed.

Is forced rehab effective?

Expert opinions vary. Most seem to believe that successful recovery due to forced rehab is rare, but possible.

A 2016 study found that “mandated treatment of drug dependence conflicts with drug users’ human rights ((Lunze, K., Idrisov, B., Golichenko, M., & Kamarulzaman, A. (2016). Mandatory addiction treatment for people who use drugs: Global health and human rights analysis. BMJ, 353, i2943. https://doi.org/10.1136/bmj.i2943)) and is not effective in treating addiction.” In many cases, mandatory rehab is offered as an alternative to jail. As a result, some rehab centers resemble correctional facilities ((Poser, R. (n.d.). Does forced rehab work? Mother Jones. Retrieved October 12, 2021, from https://www.motherjones.com/politics/2018/06/does-forced-rehab-work/)). If a person decides to go to rehab, on the other hand, they may have more say in choosing their own program.

It’s important to note that a person’s motivation to heal has a great impact on their recovery from substance misuse ((Gideon, L. (2010). Drug offenders’ perceptions of motivation: The role of motivation in rehabilitation and reintegration. International Journal of Offender Therapy and Comparative Criminology, 54(4), 597–610. https://doi.org/10.1177/0306624X09333377)). Certain models of healing, including 12-Step programs like Alcoholics Anonymous ((The Twelve Steps of Alcoholics Anonymous. (n.d.). Alcoholics Anonymous. https://aa.org/assets/en_US/smf-121_en.pdf)), emphasize the value in admitting that you have a problem and deciding to make a change. Forced rehab bypasses this step. If a person hasn’t made an intentional commitment to recovery, rehab can be more difficult and less effective ((Drug addicts and forced rehab? (2018, June 18). Healthline. https://www.healthline.com/health-news/people-with-drug-addictions-forced-into-rehab)).

In some cases, however, people who are forced into rehab ultimately do recover ((In the addiction battle, is forced rehab the solution? (2021, April 23). AP NEWS. https://apnews.com/article/health-quincy-north-america-us-news-ap-top-news-75a4822a714b43a5b6f7b7b988d641f6)), and even express gratitude for their loved one’s decisions. Reporters of these cases emphasize that these stories are the exception, and not the rule.

Some experts disagree with this assessment, even stating that “outcomes for those who are legally pressured to enter treatment are as good as or better than outcomes for those who entered treatment without legal pressure. ((Abuse, N. I. on D. (–). Is legally mandated treatment effective? National Institute on Drug Abuse. https://www.drugabuse.gov/publications/principles-drug-abuse-treatment-criminal-justice-populations-research-based-guide/legally-mandated-treatment-effective))” However, there is little publicly available data to support this claim.

Do interventions work?

Yes, if you get help from a professional interventionist.

To stage an intervention, you’ll start by gathering a group of people who care about someone struggling with substance use. Ultimately, you’ll all sit down with that person face to face, explain how their substance use has affected your lives, and encourage them to get professional help.

Unfortunately, there is little research regarding the effectiveness of interventions. This is likely because many people plan these meetings on their own, without assistance from a professional. Because emotions will be running high at every stage of the process—from the moment you begin planning to the end of the intervention itself—it’s extremely important to have an experienced, impartial perspective to guide you and your loved one toward the goal.

Professional interventionists are often recovered substance users themselves. As a result, these experts are able to see the conversation from both sides, advocating for both your and your loved one’s best interests. They may also be trained in nonviolent communication, connected to local and national resources, and able to answer complex questions about rehab and recovery.

Anecdotal evidence suggests that there may be a high success rate for interventions conducted by professionals ((Marcus, M. B. (2018, May 31). You’ve seen the show “intervention”—But do they actually work? Men’s Health. https://www.menshealth.com/health/a20962345/what-is-intervention-do-they-work/)). The presence of a third party in the room can also defuse potentially volatile situations.

Will my loved one face legal consequences if they go to forced rehab?

It’s possible. However, the answer to this question is rapidly changing.

In many states, court-ordered rehab can be offered as an alternative to jail time ((Many states allow involuntary commitment for addiction treatment. (n.d.). Partnership to End Addiction. Retrieved October 12, 2021, from https://drugfree.org/drug-and-alcohol-news/many-states-allow-involuntary-commitment-addiction-treatment/)). This does not necessarily protect your loved one from accruing a criminal record. It also depends on a substance user’s exact circumstances. Possession of some substances, including dangerous substances, is perfectly legal, and does not represent a risk of legal charges. Possession of other substances may result in criminal charges, but only in certain amounts. And some are highly illegal, and are grounds for felony charges in any amount.

These regulations vary widely from state to state. And as more and more municipalities begin decriminalizing substance use ((Johnson, S. (2021). A shifting regulatory drug regime: What measure 110’s successful campaign teaches us about decriminalizing drugs in the United States. https://dataspace.princeton.edu/handle/88435/dsp010r967683z)), you can expect the rules to change significantly in the near future. If you’re concerned about the legal consequences of forcing your loved one into rehab, it’s best to check with a lawyer or other expert to learn more about your options.

How long does mandatory rehab last?

It depends on your area, and on the results of your loved one’s professional evaluation.

When a person in crisis goes to a mental health facility involuntarily ((Know the laws in your state—Treatment advocacy center. (n.d.). Retrieved October 12, 2021, from https://www.treatmentadvocacycenter.org/component/content/article/183-in-a-crisis/1596-know-the-laws-in-your-state)), they will likely be held for 72 hours. However, this varies based on the laws in your area. During or after that emergency hold, they’ll usually be evaluated to see whether further treatment is required. If it is, they may be held for about two weeks. Following that initial period of treatment, they may be released to an outpatient program, or admitted to a residential facility.

Every person’s experience is different, and options vary based on each patient’s insurance, location, and physical and mental health. If possible, it’s best to stay in close communication with the person’s team of healthcare providers. This allows you to make decisions with or on behalf of your loved one as the situation develops.

What if my loved one won’t go to rehab?

If your loved one won’t go to rehab, you still have options. And you are not alone.

Substance misuse can have a huge impact not only on the person who participates in it, but also on their family and community. It’s important to recognize the effects of their behavior on your own mental health and wellbeing. Thankfully, there are many resources available for people who love someone struggling with addiction.

Al-Anon is a support group for people with a loved one who struggles with substance use ((H, B. (n.d.). What is al-anon and alateen and are they right for me? Al-Anon Family Groups. Retrieved October 12, 2021, from https://al-anon.org/newcomers/what-is-al-anon-and-alateen/)). Alateen is a similar group, specifically for young people and teenagers. CoDA, or Codependents Anonymous ((CoDA.org. (n.d.). CoDA.Org. Retrieved October 12, 2021, from https://coda.org/)), is a support group for people who struggle with codependency, which is often exacerbated by relationships with substance users. All of these are 12-Step groups, modeled after Alcoholics Anonymous, and designed to help you build a healthier, more sustainable life.

If you’re not interested in joining a group, you may consider seeing a therapist who specializes in treating partners of people with substance use disorders. Or you may just pick up a book about this relationship dynamic. Whatever you decide, remember that your mental health is important, too. Whether or not your loved one ultimately gets the help they need, you also deserve to heal.

Reviewed by Rajnandini Rathod

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