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Can We Force the Addict Into Treatment?

Sometimes, I get a call where a family member asks if there is a process of forced medical treatment for someone. Some families ask if there is a way to restrain the addict, throw him in the back of a van, and haul him to the cure. While I do understand the frustrations associated with living with an addict and the endless pleas to help them (which often go unheard), generally speaking, the answer is no. You cannot kidnap an addict and force treatment on him.

The best solution is alcohol or drug intervention. However, any seasoned intervention specialist will tell you that there are no guarantees when it comes to interventions. The addict still has the right to refuse treatment. In most cases, it is still advisable to proceed with the intervention. The family at least has a chance to come together as a team, provide a solution (treatment), and, God willing, if something bad happens to the addict (more health complications, job loss, jail, etc. pa) the family can feel a small level of comfort by knowing that they all came together, did the best job they could and offered the gift of treatment. Additionally, the seed will be planted in the addict’s mind that a solution exists with family waiting in the wings to provide support throughout the recovery process.

Alcohol intervention or drug intervention offers another way to strongly suggest receiving the gift of treatment. To the extent that it is within the framework of family or friends, leverage can be used to persuade the addict to accept help. Addicts often see leverage as a way to force treatment on them, but this is not true. With leverage, the addict has the right to refuse treatment. The result of such rejection, however, has consequences.

For example, an employer may attend an alcohol intervention for an addicted employee. If the employee resists treatment, as a last resort, the employer may set a limit where if the addict continues to resist treatment he will lose his job. Notice that in this example the addict still has a choice. He was resistant to treatment and continued to drink. If he does this, he will have to face the consequences of quitting his job. This type of leverage can be a powerful tool to not only “lure” the addict into treatment, but also to eliminate enablers and, perhaps more importantly, create healthy boundaries for those friends and family members. to the addict.

California allows an involuntary psychiatric evaluation, commonly referred to as a 5150, with an eye toward obtaining some level of short-term medical treatment during mandatory detention. The 5150 process has specific criteria and is not an easy task, especially if you are dealing with a reluctant participant in the treatment process.

California Welfare and Institutions Code (WIC) 5150 is an application for involuntary admission up to 72 hours from the writing of the declaration. The WIC 5150 is not itself a direct admission form and does not by itself authorize involuntary admission; it only brings the individual to the door. Then, as described in WIC 5151: Before admitting a person to the facility, the professional person in charge of the facility or his designee must assess the individual in person to determine the appropriateness of involuntary detention. During the incarceration period, an incarcerated individual is evaluated by a mental health professional to determine if a psychiatric admission is necessary. Detention and evaluation usually occurs at a county mental health hospital or a designated emergency room facility. If the individual is admitted to a psychiatric unit, only a psychiatrist can remove the 5150 and allow the person to stay voluntarily or be discharged.

On or before the end of the 72 hours, the psychiatrist must assess the person to see if they still meet the criteria for hospitalization. If so, the person may be offered voluntary acceptance. If it is refused, then another hold up to 14 days can be applied.

The criteria for a 5150 seizure requires probable cause. This includes danger to oneself, danger to others with some indication, before management, of symptoms of a mental illness, and/or severe disability. The conditions must be in the context of a mental illness and the person must refuse psychiatric treatment.

I can report from experience that the 5150 hold is not an easy process and one that local authorities take very seriously. A family called me to help them facilitate an alcohol intervention. Their loved one, a 50-year-old alcoholic woman, unable to withstand treatment, lives alone in a large house and is a loner. It was clear that his alcoholism had progressed to the point where his family feared that he would die soon (a few days at best) from the disease. Although we tried for several hours to “reach” him through the intervention process, the intervention ended with a phone call to 911 requesting a 5150 based on severe disability.

The police and the fire department arrived and conducted a brief investigation using the criteria mentioned above. After asking him a series of questions to determine his mental state (name, where do you live, what day is it, etc.) and even asking him about suicide and murder, they found out that there was no he meets the criteria for a 5150 hold. Although he was reasonably severely disabled (he was drunk at the time, empty bottles all over the floor, empty food containers strewn about), his condition was not sufficient to satisfy the “severely disabled” provision of the code and the authorities have no alternative. but to leave the house.

While a 5150 grip can be used if appropriate, it is not guaranteed. Specific statutory criteria must be met. In cases where 5150 addiction results are requested, the very serious question of drug/alcohol treatment still remains. At best, the family hopes for three days (and maybe an additional 14 if granted) to plant the seed of treatment to address addiction issues.

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