title: Nature and Utilization of Civil Commitment for Substance Abuse in the United States.
abstract: Substance abuse is a leading cause of morbidity and mortality in the United States. Although civil commitment has been used to address substance abuse for more than a century, little is known today about the nature and use of substance-related commitment laws in the United States. We examined statutes between July 2010 and October 2012 from all 50 states and the District of Columbia for provisions authorizing civil commitment of adults for substance abuse and recorded the criteria and evidentiary standard for commitment and the location and the maximum duration of commitment orders. High-level state representatives evaluated these data and provided information on the use of commitment. Thirty-three states have statutory provisions for the civil commitment of persons because of substance abuse. The application of these statutes ranged from a few commitment cases to thousands annually. Although dangerousness was the most common basis for commitment, many states permitted it in other contexts. The maximum duration of treatment ranged from less than 1 month to more than 1 year for both initial and subsequent civil commitment orders. These findings show wide variability in the nature and application of civil commitment statutes for substance abuse in the United States. Such diversity reflects a lack of consensus on the role that civil commitment should play in managing substance abuse and the problems associated with it.
authors.affiliation: Dr. Christopher is Assistant Professor, Department of Psychiatry and Human Behavior, and Taylor Stayton is a medical student, Alpert Medical School, Brown University, Providence, RI. Dr. Pinals is Assistant Commissioner, Forensic Services, and Mr. Blumberg is General Counsel, Massachusetts Department of Mental Health, Boston, MA. Dr. Pinals is also Associate Professor, Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA. Ms. Sanders is a trial attorney, Committee for Public Counsel Services, Greater Boston Area, Boston, MA. Early study results were presented at the 164th Annual Meeting of the American Psychiatric Association in May 2011 and the 43rd Annual Meeting of the American Academy of Psychiatry and the Law in October 2012. Dr. Christopher received funding from NIDA (K23 DA034030).
authors.forename: Paul P
authors.initials: PP
authors.lastname: Christopher
authors.affiliation: Dr. Christopher is Assistant Professor, Department of Psychiatry and Human Behavior, and Taylor Stayton is a medical student, Alpert Medical School, Brown University, Providence, RI. Dr. Pinals is Assistant Commissioner, Forensic Services, and Mr. Blumberg is General Counsel, Massachusetts Department of Mental Health, Boston, MA. Dr. Pinals is also Associate Professor, Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA. Ms. Sanders is a trial attorney, Committee for Public Counsel Services, Greater Boston Area, Boston, MA. Early study results were presented at the 164th Annual Meeting of the American Psychiatric Association in May 2011 and the 43rd Annual Meeting of the American Academy of Psychiatry and the Law in October 2012. Dr. Christopher received funding from NIDA (K23 DA034030). debra.pinals@umassmed.edu.
authors.forename: Debra A
authors.initials: DA
authors.lastname: Pinals
authors.affiliation: Dr. Christopher is Assistant Professor, Department of Psychiatry and Human Behavior, and Taylor Stayton is a medical student, Alpert Medical School, Brown University, Providence, RI. Dr. Pinals is Assistant Commissioner, Forensic Services, and Mr. Blumberg is General Counsel, Massachusetts Department of Mental Health, Boston, MA. Dr. Pinals is also Associate Professor, Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA. Ms. Sanders is a trial attorney, Committee for Public Counsel Services, Greater Boston Area, Boston, MA. Early study results were presented at the 164th Annual Meeting of the American Psychiatric Association in May 2011 and the 43rd Annual Meeting of the American Academy of Psychiatry and the Law in October 2012. Dr. Christopher received funding from NIDA (K23 DA034030).
authors.forename: Taylor
authors.initials: T
authors.lastname: Stayton
authors.affiliation: Dr. Christopher is Assistant Professor, Department of Psychiatry and Human Behavior, and Taylor Stayton is a medical student, Alpert Medical School, Brown University, Providence, RI. Dr. Pinals is Assistant Commissioner, Forensic Services, and Mr. Blumberg is General Counsel, Massachusetts Department of Mental Health, Boston, MA. Dr. Pinals is also Associate Professor, Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA. Ms. Sanders is a trial attorney, Committee for Public Counsel Services, Greater Boston Area, Boston, MA. Early study results were presented at the 164th Annual Meeting of the American Psychiatric Association in May 2011 and the 43rd Annual Meeting of the American Academy of Psychiatry and the Law in October 2012. Dr. Christopher received funding from NIDA (K23 DA034030).
authors.forename: Kellie
authors.initials: K
authors.lastname: Sanders
authors.affiliation: Dr. Christopher is Assistant Professor, Department of Psychiatry and Human Behavior, and Taylor Stayton is a medical student, Alpert Medical School, Brown University, Providence, RI. Dr. Pinals is Assistant Commissioner, Forensic Services, and Mr. Blumberg is General Counsel, Massachusetts Department of Mental Health, Boston, MA. Dr. Pinals is also Associate Professor, Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA. Ms. Sanders is a trial attorney, Committee for Public Counsel Services, Greater Boston Area, Boston, MA. Early study results were presented at the 164th Annual Meeting of the American Psychiatric Association in May 2011 and the 43rd Annual Meeting of the American Academy of Psychiatry and the Law in October 2012. Dr. Christopher received funding from NIDA (K23 DA034030).
authors.forename: Lester
authors.initials: L
authors.lastname: Blumberg
mesh_terms: D003134:Commitment of Persons with Psychiatric Disorders / Q000331:legislation & jurisprudence*; D016208:Databases, Factual; D006801:Humans; D019966:Substance-Related Disorders / Q000534:rehabilitation*; D014481:United States