Massachusetts General Law. Chapter 123, Section 35.
The Law
Section 35 of Chapter 123 of the Massachusetts General Laws offers a framework for a court, physician, police officer, or family member to request for an individual to be obligatorily committed for alcohol or drug abuse treatment ( Klag, O'Callaghan, & Creed, 2015) . In the case the court agrees to the request, the individual is guided to the Men’s Addiction Treatment Center or Women’s Addiction Treatment Center for the full duration of ninety days. In the case that there are no sleeping facilities in the center, the individual is taken to a different care center in a correctional facility (Section 35 (n.d).
Provision of the Law
The law provides that a respondent can be compulsorily put on drug or alcohol use medication for a specified period (90 days). Under the section, ninety days is the maximum time a respondent can be put under involuntary treatment. Often, committed persons are many a time discharged before the lapse of the specified timeframe ( Eisen, 2013) . The law also provides that males committed to such a procedure are put in Massachusetts Alcohol and Substance Abuse Center (located in Bridgewater State Hospital) or the Plymouth House of Correction, or the Men’s Addiction Treatment Center (based in Boston). For the women, they may be committed to Women’s Recovery from Addiction Program (Taunton) or High Point-Shattuck (Jamaica Plain) or the Women’s Addiction Treatment Center (New Bedford) ( Klag et al., 2015) . Teenagers are placed in Clean and Sober Teens Living Empowered (Based in Brockton). Many a time, the center where an individual is placed is dependent on the availability of a bed at the time of the commitment order by the court.
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The law outlines the application process for the petitioner, the handling of the respondent, brought before the court, and determination made on the possibility of commitment in a treatment facility ( Eisen, 2013) . The section also outlines the evidence required, the evaluation aspect, and the state of the respondent at the time of apprehension. After all, factors are put in place; the judge decides whether the respondent can be committed to a treatment center or freed.
As the law focuses mainly on youths or adolescents aged 18 to 25, there is a significant impact on them as a minority group. Massachusetts State is home to over 6.9 million people. Males are approximately 48 percent of the population, while females are 51 percent ( Walton & Hall, 2017) . The people of persons aged 18 to 25 is roughly 12 percent. At only 12 percent, they form a minority group, a straightforward target ( Klag et al., 2015) . With such a small percentage out of over 5 million persons, youths are easily targeted, and the law is having the most significant impact on their lives, especially those using drugs/substances.
In the year 2017, the state had over 130,000 admissions to drug abuse treatment facilities. Out of the 130,000, approximately 4,000 of the cases involved teenagers aged twelve to twenty. Roughly 90 percent of the individuals admitted were whites, and only 12 percent of blacks ( Eisen, 2013) . The National Survey on Drug Use approximately that about 14 percent of Massachusetts locals had at one time involved in alcohol or drug abuse in 2017-2018 periods. The percentage reflected about 31 percent of the adult population aged 18 to 25, pointing to the problem’s concentration level of substance abuse in the state within the bracket range ( Klag et al., 2015) . Within the national context, Massachusetts topped and was among the top ten states having the highest number of substance abuse users in various categories. The groups’ involved illicit substance taken in the past month especially among young adults aged eighteen to twenty-five, depending on the substance in the age of twelve and above, marijuana abuse in the previous month among youths age eighteen to twenty-five, and reliance on illicit substance among teenagers aged eighteen to twenty-five. The states’ rate of substance and drug abuse was higher as compared to the entire US drug use.
Operation of the Law
Klag et al., (2015) argue that c ourts in Massachusetts are out to help parents, guardians, caregivers, brothers, and sisters, the care they require to keep up with the requirements and reality of Section 35. The Section applies somewhat across all boards with no segregation or discrimination ( Walton & Hall, 2017) . Caregivers, parents, brothers, and sisters out to receive the order must write a fact-based concise, and clear letter to the court detailing the particulars of the individuals ( Eisen, 2013) . The letter should have the respondents name, drug use, choice of drug, and the time frame used. The letter should, after that, state the most recent occurrence concerning the respondent’s drug abuse. These can detail the date of use, hospitalization, threats, if any (such as violence, burning down the house or suicidal attempts), a record of any physical abuse or arrest made during the respondent’s engagement in drugs.
The letter should list down all the destructive habits from the latest to the oldest. At the closing of the statement, the petitioner should indicate how the respondent’s behavior is becoming a bother and risk to other lives ( Eisen, 2013) . It can include instances such as a threat to harm life or self. The petitioner should keep in mind that detailing all the respondent’s actions and intentions increases the chances of convincing the court to issue an apprehension order. According to Klag et al., (2015) t he law outlines how to interpret a petitioner’s plea to the court and circumstances under which an apprehension order is given. The court thus decides, depending on the weigh and relevance of the information provided to provide an apprehension order.
The Section does not limit the number of times a petitioner petitions the court on the issue, but it must remain within the requirements and boundaries of the law. After the petition is admitted in court, the court will choose whether to issue summon or an apprehension order. Such an order can only be produced during working hours. After the order is issued, the respondent will be picked by a law enforcement officer, restricted then taken to court. The court will decide, after that review the pieces of evidence produced by the petitioner and will involve examination by a psychologist or psychiatrist ( Klag et al., 2015) . During the hearing, the respondent will have the right to a lawyer. After the review and analysis, the court will issue the order of commitment.
The evidence must detail a medical diagnosis that reveals substance or alcohol abuse, and there is substantial evidence of the probability of harm or risk to others due to the addiction ( Walton & Hall, 2017) . After that, the respondent will be sent to a fitting treatment center. In the treatment facility, the patient will be taken through rehabilitation counseling and detoxification (Section 35 (n.d).
Despite the focus on a specific age group of 18 to 25, the law applies to all within the state with no privileged advantages. However, Klag et al., (2015) maintain that much emphasis is paid on teenagers whose use of drugs and substances is currently high, especially heroin, opioid, alcohol, and cocaine. Over the past decade, alcohol abuse and smoking have often topped the list. Still, their treatment has often been limited within the home setting, with only a few families requesting the courts for apprehension orders.
Treatment Facilities for Women
The law provides for the facilities that offer treatment, and they include Women’s Addiction Treatment Center, New Bedford (WATC). The center is reserved for women who have had a civil commitment and is the main treatment center under the law ( Eisen, 2013) . The services provided include transitional, clinical stabilization, and detoxification. All the services are offered around the clock and in addition to a 12-step education program. All are supplied in transitional stages. Massachusetts Correction Institute (MCI), Framingham: In case WATC has no bed facility, patients are sent to MCI. It is a medium-sized facility and houses the patients are various levels. It offers extensive and diverse treatment services and programs.
For men, the facilities outlined by the law include Men’s Addiction Treatment Center, Brockton (MATC), and Massachusetts Alcohol and Substance Abuse Center (MASAC). Both facilities offer detoxification services, community-based treatment, care management options, education on family matters, and individual discharge initiatives ( Eisen, 2013) . At both facilities, patients committed to change their ways and keep to a drug/substance-free lifestyle
Debate; Intended, Unintended Effects and Efficacy
Walton and Hall (2017) maintain that t he level of efficiency and efficacy of the law changes over time. Evidence across the state shows that once a patient is taken through the program in the treatment facilities, there is often a significant change in their behavior and mannerism. However, common challenges come in getting the apprehension order and committing one for treatment. System based factors do have an impact on the entire process of commitment. According to Eisen (2013) there exists a significant problem in tracking an order, especially for those with limited knowledge of the operation of Section 35. Respondents who have psychiatric comorbidities present daunting challenges, primarily due to a lack of personnel at the center to offer specialized treatment on their psychiatric condition ( Lindahl, 2011) . At the same time, the structure of the legal system has often presented a challenge to those pursuing a committed effort. For example, judges may have a higher threshold for a patient previously committed to the facilities as compared to a new respondent. Timing is also essential as such a petition can only be presented when a court is open. The above challenges have often daunted the efforts of petitioners to follow on the entire process of committing a patient to the facilities.
On the other hand, despite the noble idea behind the law, multiple challenges stand out as obstacles to the attainment of positive results ( Lindahl, 2011) . These include inadequate funding, limited opportunities at the facilities, mismatch in services offered, and poor data collection. These have often daunted efforts of the centers and law in general to produce positive results among the locals. While many support the application of the laws, others view it as a waste of tax payer’s money and poor implementation ( Eisen, 2011) . The poor application arises from the drawbacks realized in applying the stipulated legislation, especially in the treatment facilities that, at times, lack basic requirements and logics for operations.
According to Lindahl (2011), the Bureau of Substance Abuse Services holds it that the law, in general, is playing a critical role in helping people overcome their addictive habits. However, differing schools of thought argue that the intricate procedures involved before getting a patient committed to the facilities deny many the chances to get the treatment services for their loved ones ( Klag et al., 2015) . Despite the difficulty in deciding to commit a loved one to the facilities, most families argue that the centers are offering relevant and helpful services to the population. These services have gone a long way in reforming a large number of locals to adopt new behaviors and habits.
What’s Next? Recommendations, and Implementation
According to Walton and Hall (2017) i t is essential to address the intricate and complicated procedures of getting an apprehension order from the court. At the same time, it is crucial to create awareness among the locals on the relevance and importance of the legislation towards helping drug addicts’, especially among the youth. With a greater focus paid on male drug users, it is crucial too to highlight the need to commit female drug users on the treatment plan. Over the years, the majority of committed patients are mainly male, with only a small portion of females engaged in the program. Eisen (2013) argues that for a productive and positive outcome of the program, the transfer of patients to better optima care centers is recommended to help them get the best of the treatment plans and initiatives.
According to Klag et al., (2015) i n the past decade, over 57,000 persons have been committed to the centers under section 35. The number translates to approximately 5,700 commitments every year. While a small proportion is on self-commitment, a large percentage is due to court orders ( Walton & Hall, 2017) . The number is large, and the facilities are incredibly overused. As the number increases, the facilities are unable to cope in offering an appropriate treatment plan. The Criminal Justice Policy Coalition of Massachusetts is recorded to jail individuals without any criminal record, such only increases the number of persons in the center.
At the current rate, the number of civilly committed individuals is ballooning each day. For the past five years since 2013, the number of civilly committed persons has increased by over 131 percent, putting an enormous strain on the limited resources. The Department of Corrections Testimony argues that civilly committed individuals are not receiving adequate treatment. For example, in MCI, only rehabilitation and detoxification programs are available, limiting the treatment options and services available for the patients.
The inability to understand the religious implications of the long term efficiency of the availed programs is significantly limiting treatment plans raising concern for admittance for abuse substance abuse treatment ( Klag et al., 2015) . The majority of the readmissions are due to the lack of established standards on the effectiveness of the treatment plans and services. There is thus the need to improve on the intervention measures that include ratification of sections of the law to reduce the rate of admission and focus on implementing effective measures of treatment.
Walton and Hall (2017) argue that l ack of transparency, especially of data that is critical for the evaluation of the treatment facilities and section 35, is essential for the enactment of appropriate legislation to provide a legal framework of data management. For example, in the recent past, opiate use and addiction are gradually rising ( Eisen, 2013) . Still, the statistics held in addition to the demographic data on users of Section 35 offers a little framework to evaluate demographic differences. Thus the main issues to address and align Section 35 to the need of the people include data availability and expanded treatment availability ( Lindahl, 2011) . Undertreatment availability, the correction center should look into the issue of civilly committed persons at the centers and misuse of the courts. For data availability, the state, mainly the correction centers and judicial, should establish a comprehensive evaluation and treatment system that is effective, credible, and in line with the rising demands. The state should also have a trustworthy system of the demographics of individuals making use of Section 35 ( Klag et al., 2015) . At the same time, BSAS Community Substance Abuse Services should focus on enacting and applying community-based initiatives in addition to media campaigns directed to young teenagers aiming at the prevention of overdose, alcohol, and substance abuse. These social model programs should be enacted in Section 35 to emphasize on care management, peer counseling, and sober lifestyle.
Conclusion
The primary issues as exposed to Section 35 entail its overuse and the need to go through the intricate court process. The problem is a reflection shortage in alcohol and drug abuse care availability in addition to imperfect information dispensation among the people on how and where to get appropriate treatment care. At the same time, the correction centers and treatment facilities need to enact proper measures to address long term effectiveness of the plans adopted in the facilities. Below are policy suggestions on solving the above-highlighted points for practical use and application of Section 35.
References
Eisen, J. C. (2013). Civil commitment for substance abuse. AMA Journal of Ethics , 15 (10), 844-849. https://journalofethics.ama-assn.org/article/civil-commitment-substance-abuse/2013-10
Klag, S., O'Callaghan, F., & Creed, P. (2015). The use of legal coercion in the treatment of substance abusers: An overview and critical analysis of thirty years of research. Substance use & misuse , 40 (12), 1777-1795. https://www.researchgate.net/profile/Peter_Creed/publication/7352173_The_Use_of_Legal_Coercion_in_the_Treatment_of_Substance_Abusers_An_Overview_and_Critical_Analysis_of_Thirty_Years_of_Research/links/553561bb0cf268fd0015d9c9/The-Use-of-Legal-Coercion-in-the-Treatment-of-Substance-Abusers-An-Overview-and-Critical-Analysis-of-Thirty-Years-of-Research.pdf
Lindahl, M. L. (2011). Patients in Court-Ordered Substance Abuse Treatment. Lund University, Faculty of Medicine Doctoral Dissertation Series , 98. https://www.researchgate.net/profile/Marianne_Larsson_Lindahl/publication/216332475_Patients_in_court-ordered_substance_abuse_treatment_Studies_in_the_involuntary_process_by_interview_assessment_and_randomised_trial/links/00b7d526f6b69081e3000000.pdf
Section 35: Commitment of alcoholics or substance abusers. (n.d.). Retrieved November 19, 2019, from https://malegislature.gov/Laws/GeneralLaws/PartI/TitleXVII/Chapter123/Section35 .
Walton, M. T., & Hall, M. T. (2017). Involuntary civil commitment for substance use disorder: Legal precedents and ethical considerations for social workers. Social work in public health , 32 (6), 382-393.
