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

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

Affiliations

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

Joseph Silcox et al. Drug Alcohol Depend. .

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.

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Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Findings may not reflect the views of the Massachusetts Department of Public Health (MDPH) and/or the funder.

References

    1. Baigent M, 2012. Managing patients with dual diagnosis in psychiatric practice. Curr. Opin. Psychiatry 25 (3), 201–205. 10.1097/YCO.0b013e3283523d3d. - DOI - PubMed
    1. Benrubi LM, Silcox J, Hughto J, Stopka TJ, Palacios WR, Shrestha S, Case P, Green TC, 2023. Trends and correlates of abscess history among people who inject drugs in Massachusetts: a mixed methods exploration of experiences amidst a rapidly evolving drug supply. Drug Alcohol Depend. Rep. 8, 100176 10.1016/j.dadr.2023.100176. - DOI - PMC - PubMed
    1. Carroll JJ, Cummins ER, Formica SW, Green TC, Bagley SM, Beletsky L, Rosenbloom D, Xuan Z, Walley AY, 2023. The police paradox: a qualitative study of post-overdose outreach program implementation through public health-public safety partnerships in Massachusetts. Int. J. Drug Policy 120, 104160. 10.1016/j.drugpo.2023.104160. - DOI - PubMed
    1. Cascio MA, Lee E, Vaudrin N, Freedman DA, 2019. A team-based approach to open coding: considerations for creating intercoder consensus. Field Methods 31 (2), 116–130. 10.1177/1525822X19838237. - DOI
    1. Charmaz K, 2006. Constructing Grounded Theory: A practical guide through qualitative analysis. Sage.