While laws and regulations differ by jurisdiction, one overarching principle is that individuals have the right to autonomy and self-determination. For example, Florida’s Marchman Act grants state officials authority to initiate involuntary assessment and stabilization programs for people considered dangerous due to substance use disorders (SUDs).
Even in states that provide a path for families and loved ones to help someone struggling with addiction into treatment even if they are against it, there are many legal frameworks, ethical implications, and alternative approaches to supporting individuals suffering from addiction to consider first.
Minors & Rehab
Within the U.S., state laws regarding minors seeking rehab without parental consent vary considerably from state to state.[2-4]
For example, Florida allows minors who meet certain conditions to access substance abuse treatment without parental consent if their health or safety is at stake due to substance use.
These laws usually prioritize the care and safety of the minor above other considerations. Once they reach the age of 18, they are legally able to choose rehab for themselves without the consent of their parents or any legal difficulties.
How Can You Ensure Someone Goes to Rehab?
Guaranteeing someone attend rehabilitation through legal channels can be a complex and delicate process. Unless there are serious, evidence-based risks, the decision will ultimately lie with them alone.
Before attempting to use the legal system to force someone into treatment, you may find that you have an easier time helping them choose the help they need through other methods that may be less damaging to the relationship.
First, try to encourage their participation in treatment voluntarily by using strategies like these:[5-7]
Approach Them With Love & Support
Have an honest dialogue with your loved one regarding their substance abuse issues, conveying your worries while emphasizing the significance of seeking professional assistance. Make it clear that you will support them in their efforts to manage their SUD.
Come From an Educated Point of View
Providing your family members with accurate info regarding addiction, its consequences, and what rehabilitation entails may help them to understand its potential benefits on health, relationships, and overall well-being.
Consult an Interventionist
This professional can help you craft the best approach for your loved one, and this may involve staging a formal intervention. An interventionist can guide the process, ensuring the message conveyed is one of love and concern rather than judgment or shame.
Narrow Treatment Choices
Pinpoint a couple of addiction treatment centers that would be a good fit for your loved one. If you provide some guidance on where they can go to get help, it removes barriers to treatment. An interventionist or addiction treatment professional will also be able to help with this.
Offer Help With Logistics
Your loved one will need help with various aspects of securing treatment, such as assistance in navigating insurance coverage, childcare, or transportation to and from treatment. Be ready to make the process easier for them.
What Is Involuntary Commitment?
In some cases, you may be able to use involuntary commitment to force someone into rehab, but this is tough to do. Involuntary commitment is a legal process by which an individual may be forced to enter treatment for substance misuse or mental health against their will.
The laws on involuntary commitment vary between states, but in general, you must prove that the individual is a danger to themselves or others, they lack the ability to make decisions for themselves (oftentimes because their substance abuse has made them disabled, either physically or mentally), they are unable to fulfill their basic needs, or they have lost control of their life.[9-11]
For involuntary commitment to be approved, a mental health professional or other authority will examine the individual. Based on their findings, they will determine if there is a threat of self-harm or if the person poses a threat to others. A petition and hearing will follow, and a judge will make a decision.[11,12]
What State Laws Exist Regarding Involuntary Commitment?
State laws concerning involuntary rehab vary significantly. Anyone considering the process for their family member must understand the regulations and procedures specific to their state before getting started.
Here are just a few laws that speak to the standards or provisions related to involuntary rehab in different states:
Florida Marchman Act
This law allows for involuntary assessment and stabilization for people who pose risks to themselves or the public due to a substance use disorder.
Massachusetts Section 35
Massachusetts has adopted Chapter 123, Section 35 into their general laws, a policy that permits involuntary commitment of those diagnosed with substance use disorders who present serious risks of harm to themselves or others.
New York Mental Hygiene Law
Under Article 22 Title B of the New York Mental Hygiene Law, some provisions enable courts to order substance abuse treatment for people who are considered dangerous due to their abuse of illicit substances.
California Welfare and Institution Code
Under state law, certain criteria may allow for involuntary commitment of people with mental health disorders, including substance use disorders, when certain criteria are met.
Which States Have Implemented Involuntary Commitment Laws?
All states have implemented involuntary commitment laws, but the specifics of the laws vary greatly between states.[17,18]
Is It Effective to Force Someone Into Rehab?
Experts agree that involuntary addiction treatment can be effective.[19-20] While a person may initially resist treatment, they can still progress in care and come to appreciate that they were forced into treatment to begin with.
Involuntary rehabilitation is controversial. A person’s need for intervention and treatment is weighed against their autonomy to make that decision. The delicacy of this decision is why certain criteria must be met before a person can be forced into treatment, such as the person being a threat to themselves or others.[21-23]
Since involuntary commitment isn’t a simple or quick process, the easier approach is to convince your loved one to seek help. Enlisting the help of interventionists and other addiction treatment professionals can aid this process, helping your loved one to voluntarily get the treatment they need.[24,25]
- Fundamentals of the Marchman Act. Duchene, D. State University Systems of Florida. 2009;6(2).
- What can parents do? A review of state laws regarding decision-making for adolescent drug abuse and mental health treatment. Kerwin ME, Kirby KC, Speziali D, et al. Journal of Child & Adolescent Substance Abuse. 2015;24(3):166-176.
- Parental identification and response to adolescent substance use and substance use disorders. Curtis B, Ashford R, Rosenbach S, Stern M, Kirby K. Drugs: Education, Prevention and Policy. 2017;26(2):175-183.
- Confidentiality and consent in adolescent substance abuse: An update. Weddle M, Kokotailo PK. AMA Journal of Ethics. 2005;7(3):239-243.
- Substance Abuse and Mental Health Services Administration. Early Intervention, Treatment, and Management of Substance Use Disorders. Published November 2019. Accessed October 18, 2023.
- Words matter - Terms to use and avoid when talking about addiction. National Institute on Drug Abuse. Published November 29, 2021. Accessed October 18, 2023.
- Enhancing motivation for change in substance use disorder treatment. Substance Abuse and Mental Health Services Administration. Published 2019. Accessed October 18, 2023.
- Civil commitment in the United States. Testa M, West SG. Psychiatry (Edgmont (Pa : Township)). 2010;7(10):30-40.
- Involuntary commitment. Fariba K, Gupta V. StatPearls. Published 2021. Accessed October 18, 2023.
- Civil commitment for opioid and other substance use disorders: Does it work? Jain A, Christopher P, Appelbaum PS. Psychiatric Services. 2018;69(4):374-376.
- Involuntary commitment and guardianship laws for persons with a substance use disorder. National Judicial Opioid Task Force. Published October 2018. Accessed October 18, 2023.
- Comparing views on civil commitment for drug misuse and for mental illness among persons with opioid use disorder. Christopher PP, Anderson B, Stein MD. Journal of Substance Abuse Treatment. 2020;113:107998.
- Florida Department of Children and Families. Marchman Act. Accessed October 18, 2023.
- The process. Section 35: Commonwealth of Massachusetts. Accessed October 18, 2023.
- Mental hygiene law – admissions process. New York State, Office of Mental Health. Accessed October 18, 2023.
- Codes: Codes Tree - Welfare and Institutions Code - WIC. California Legislative Information. Accessed October 18, 2023.
- Involuntary civil commitment: Fourteenth Amendment due process protections. Congressional Research Service. Published May 24, 2023. Accessed October 18, 2023.
- Involuntary commitment (assisted treatment) standards (50 states). Treatment Advocacy Center Report: Mental Illness Policy. Published 2016. Accessed October 18, 2023.
- Table 4.2, Principles of effective treatment for substance use disorders. Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health. Substance Abuse and Mental Health Services Administration. Published November 1, 2016. Accessed October 18, 2023.
- Readiness to change among involuntarily and voluntarily admitted patients with substance use disorders. Opsal A, Kristensen Ø, Clausen T. Substance Abuse Treatment, Prevention, and Policy. 2019;14(1).
- The effectiveness of compulsory drug treatment: A systematic review. Werb D, Kamarulzaman A, Meacham MC, et al. International Journal of Drug Policy. 2016;28:1-9.
- From coercion to cohesion treating drug dependence through health care, not punishment.; 2010. Accessed October 18, 2021.
- Mandated treatment and its impact on therapeutic process and outcome factors. Hachtel H, Vogel T, Huber CG. Frontiers in Psychiatry. 2019;10(219).
- The community reinforcement approach: An update of the evidence. Meyers RJ, Roozen HG, Smith JE. Alcohol Research & Health: The Journal of the National Institute on Alcohol Abuse and Alcoholism. 2011;33(4):380-388.
- Unpacking involuntary interventions for people who use drugs. Bazazi AR. Commentary on Rafful et al . (2018): Addiction. 2018;113(6):1064-1065.