Views and experiences of involuntary civil commitment of people who use drugs in Massachusetts (Section 35)

Joseph Silcox; Sabrina S Rapisarda; Jaclyn M W Hughto; Stephanie Vento; Patricia Case; Wilson R Palacios; Sofia Zaragoza; Shikhar Shrestha; Thomas J Stopka; Traci C Green

doi:10.1016/j.drugalcdep.2024.112391

Views and experiences of involuntary civil commitment of people who use drugs in Massachusetts (Section 35)

Drug Alcohol Depend. 2024 Oct 1:263:112391. doi: 10.1016/j.drugalcdep.2024.112391. Epub 2024 Aug 21.

Authors

Affiliations

¹ The Heller School for Social Policy & Management at Brandeis University, Waltham, MA, USA; University of Massachusetts - Boston, Department of Sociology, Boston, MA, USA. Electronic address: joesilcox@brandeis.edu.
² The Heller School for Social Policy & Management at Brandeis University, Waltham, MA, USA; University of Massachusetts - Lowell, School of Criminology and Justice Studies, Lowell, MA, USA.
³ Brown University, Center for Health Promotion and Health Equity, Providence, RI, USA; Brown University School of Public Health, Departments of Behavioral and Social Sciences and Epidemiology, School of Public Health, Providence, RI, USA.
⁴ Brown University, Center for Health Promotion and Health Equity, Providence, RI, USA; The Sutherland School of Law, University College Dublin, Belfield, Dublin, Ireland.
⁵ Northeastern University, Bouvé College of Health Sciences, Boston, MA, USA.
⁶ University of Massachusetts - Lowell, School of Criminology and Justice Studies, Lowell, MA, USA.
⁷ The Heller School for Social Policy & Management at Brandeis University, Waltham, MA, USA.
⁸ Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA.
⁹ The Heller School for Social Policy & Management at Brandeis University, Waltham, MA, USA; Brown University Schools of Medicine and Public Health, Departments of Emergency Medicine and Epidemiology, Providence, RI, USA.

PMID: 39167986
DOI: 10.1016/j.drugalcdep.2024.112391

Abstract

Background: Involuntary civil commitment (ICC) is a court-mandated process to place people who use drugs (PWUD) into substance use treatment. Research on ICC effectiveness is mixed, but suggests that coercive drug treatment like ICC is harmful and can produce a number of adverse outcomes. We qualitatively examined the experiences and outcomes of ICC among PWUD in Massachusetts.

Methods: Data for this analysis were collected between 2017 and 2023 as part of a mixed-methods study of Massachusetts residents who disclosed illicit drug use in the past 30-days. We examined the transcripts of 42 participants who completed in-depth interviews and self-reported ICC. Transcripts were coded and thematically analysed using inductive and deductive approaches to understand the diversity of ICC experiences.

Results: Participants were predominantly male (57 %), white (71 %), age 31-40 (50 %), and stably housed (67 %). All participants experienced ICC at least once; half reported multiple ICCs. Participants highlighted perceptions of ICC for substance use treatment in Massachusetts. Themes surrounding ICC experience included: positive and negative treatment experience's, strategies for evading ICC, disrupting access to medications for opioid use disorder (MOUD), and contributing to continued substance use and risk following release.

Conclusions: PWUD experience farther-reaching health and social consequences beyond the immediate outcomes of an ICC. Findings suggest opportunities to amend ICC to facilitate more positive outcomes and experiences, such as providing sufficient access to MOUD and de-criminalizing the ICC processes. Policymakers, public health, and criminal justice professionals should consider possible unintended consequences of ICC on PWUD.

Keywords: Criminalization; Involuntary Civil Commitment; Opioid Use; Policy; Section 35.

MeSH terms

Adult
Drug Users / psychology
Female
Humans
Involuntary Commitment*
Male
Massachusetts
Middle Aged
Substance-Related Disorders* / psychology
Young Adult