If someone in your family is experiencing a problem with substance abuse, there are several steps that can be taken to help that person recover. One of them is the involuntary hospitalization of the person by an order called Section 35. 

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What is Massachusetts General Law Chapter 123 Section 35?

Section 35 is a Massachusetts law that allows a qualified person to apply for a court order requiring someone to be civilly liable and involuntarily treated for an alcohol or substance use disorder.

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Is Section 35 a good first treatment option?

No. Involuntary impairment should be the last treatment option. If an individual wishes to initiate treatment voluntarily, there are many private and public programs that can provide treatment. If an individual feels that they participate in the decision to start treatment, they will generally be more receptive to it. Outcomes are generally better if an individual is motivated and willing to engage in treatment in the least restrictive environment. Often, just the threat of being admitted to hospital will influence an individual to voluntarily start treatment.

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What are some other options?

There are many programs that can help family or friends learn more about addiction, the recovery process and how best to intervene. It is helpful for families, friends, and loved ones to learn about addiction and understand the recovery process. Many of the compromised individuals return to the family and continue treatment.

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Can I compromise someone?

Only a qualified petitioner can ask the court to confine someone to treatment under Section 35.

• Police officer

• Doctor

• Spouse

• blood relative

• Guardian

• court official

The petitioner must go to the local courthouse and file a written petition or declaration of an order of engagement. Petitions may be filed in any District or Youth Court, regardless of the residence of the person being petitioned.

 

What happens when a petition is filed with the court?

The court reviews the facts and decides whether to issue a summons or an arrest warrant. If there are reasonable grounds to believe that the person subject to the petition will not voluntarily appear for a hearing, and that further delay would pose an immediate physical danger to the person, a judge may issue a warrant for that person.

In case of summons, the subject of the petition will be ordered to appear in court before a judge. If a warrant is issued, officers will try to locate the person, take them into custody, and hand them over to court for a plea hearing. The order is valid for up to five consecutive days, excluding Saturdays, Sundays and statutory holidays, or until the person appears in court, whichever comes first.

Once a person is in court, he has the right to be represented by a lawyer. If the court decides that the person cannot afford a lawyer, the court will immediately appoint one.

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At the hearing, the court must order an examination by a qualified physician, psychologist or social worker. The person has the right to refuse the examination. The person's attorney may provide independent expert testimony or other testimony from family, friends, employers, and other stakeholders.

The court will hear testimony and evidence from the examination and other evidence related to the case and then decide whether the person meets the criteria for commitment.

After testimony and argument, the judge will decide whether there is clear and convincing evidence that:

• The person has an alcohol or substance use disorder; It is

• There is a likelihood of serious harm to self or others as a result of substance use disorder

If both criteria are met, the person is involuntarily committed. If one (or both) criteria are not met, the person will be released. A judge should order a compromise under Section 35 only when less restrictive alternatives are not available.

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What is the likelihood of serious damage?

The statute defines "probability of serious harm" as:

1. Substantial risk of self-harm, manifested by evidence of suicide threats or attempts or serious bodily harm; OR

2. A substantial risk of physical harm to others, as manifested by evidence of homicidal or other violent behavior, or evidence that others are placed in reasonable fear of violent behavior and serious physical harm to them; OR

3. A very substantial risk of physical impairment or self-injury, as manifested by evidence that that person's judgment is so impaired that he is unable to protect himself in the community and that reasonable provision for his protection is unavailable in the community.

The “probability of serious harm” must be directly related to substance use and must be a current or imminent threat.

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What happens if the court orders the commitment?

If the judge accepts the petition and orders the appointment, the individual will be returned to a holding cell to await transport by the local Sheriff's Department to the internment facility. Transport usually does not occur until the court closes, so the individual may wait several hours depending on the time their hearing is held. 

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Where can a person be civilly committed?

The evaluator will make a recommendation to the judge as to which facility will provide the most appropriate level of services based on individual need and bed availability.

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The following programs are approved to address civil commitments:

For men:

• Centro de Tratamento de Dependência Masculina (MATC)         

• Centro de Abuso de Álcool e Substâncias de Massachusetts (MASAC)  

• Centros de Estabilização e Tratamento de Stonybrook (SSTC)         

For women:

• Women's Addiction Treatment Center (WATC)

• Women's Addiction Recovery Program - Taunton (WRAP)

• And, in some cases, designated public management of 24-hour diversion clearance

 

Will the commitment be 90 days?

The statute establishes that the commitment can be for up to, but not longer than, 90 days. The commitment may be less than 90 days depending on the individual's clinical needs and if the individual fails to meet criteria for the likelihood of serious self harm.

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If an individual no longer meets the commitment criteria, can they remain in the program on a voluntary basis to continue treatment?

Yes. The duration of impairment should not be confused with the duration of the treatment episode, although if the individual does not meet criteria for involuntary impairment, he or she may meet criteria for continuing care. All admissions are encouraged to continue the treatment episode in the appropriate service setting.
 

Can someone be transferred from one facility to another if a bed is opened?

Individuals admitted to a facility will typically complete the commitment at that facility. Under certain circumstances, Section 35 programs may transfer patients to other programs based on their medical or psychiatric needs.

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Can the programs meet all types of medical needs?

No. Some individuals may have complicated medical conditions that cannot be adequately treated in a civilian residential facility. They may require admission to a hospital-based program.

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Can programs address co-occurring mental health issues?

Yes. However, an individual with a psychiatric disorder that requires stabilization and/or management to allow for treatment of the substance use disorder will be referred to a psychiatric hospital or institutionalized in accordance with MGL Chapter 123, Section 12.

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What kind of help will an individual receive?

Once admitted to a facility, an assessment will be completed regarding the person's need for withdrawal management. The length of time in an abstinence management unit varies depending on the substance the individual is using, the amount of use, the time since last use, and their overall health. Once withdrawal is complete, the individual will receive clinical support services and learn more about addiction, sobriety, and how to prevent relapse. Counselors and case managers will work with individuals to help them recognize the consequences of their addiction and hopefully motivate them to accept aftercare plans to continue their treatment.

The aim of the program is for each client to remain in treatment for as long as necessary. The level of care and length of stay are determined by an individual's treatment needs and their progress at each level.

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Will the Section 35 commitment cause the individual to stop using?

Recovery is a process and withdrawal is a start. It is important to understand that addiction is defined as a chronic, recurrent brain disorder characterized by compulsive drug seeking and use despite harmful consequences. For some individuals, a civil commitment to treatment kicks off their recovery. Others see no need or are unwilling to deal with their alcohol or drug related disorders. As with all behavior changes, they cannot be simply asked for, so programs will work to provide substance use disorder education, relapse prevention, and aftercare resources. Hopefully this will motivate the individual to take the next step in recovery.

There are several agencies that help with rehabilitation, entra herefor more information.  

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