Substance Abuse and Addiction

Addiction, substance abuse and substance use disorders are an epidemic in the United States. In 2016 MA had one of the top ten highest rates of opioid-related overdose deaths in the United States. Substance use disorders, including alcohol and opioid abuse, can devastate almost every facet of a person’s life. These problems are only made more complex by mental illness.

A loved one with a diagnosed mental illness is at greater risk of developing a substance use disorder. Clinicians use the terms dual diagnosis, co-occurring disorders, or comorbidity to describe individuals with both a mental illness and a substance use disorder. Recovery for a loved one with a dual diagnosis is difficult. Clinicians and treaters have made significant strides in understanding these issues and attempting to treat these individuals.

A person with an untreated dual diagnosis is likely to be unable to make informed medical decisions that are necessary in order to secure effective treatment. The MA legislature has provided some ability for family members and other loved ones to intervene and affect treatment through the Courts.

One option is to seek a guardianship through the MA Probate Courts. Under the MA Uniform Probate Code (MUPC) a family member, friend, or other concerned person can petition the Court to help someone who is unable to make informed medical decisions due to their lack of capacity. Under G.L. c. 190B § 5 a Court will determine a person’s capacity by examining four factors, 1) a clinically diagnosed condition, 2) that results in an inability to receive and evaluate information or make and communicate decisions, 3) to such an extent that the person lacks the ability to meet essential requirements for physical health, safety, or self-care, 4) even with appropriate technological assistance. As part of this evaluation the severity of the substance use and addiction are considered as well as the impact of any mental illness. If the Court finds this standard is met they may appoint a guardian.

Another, and frankly less favored option is to file a Petition and seek to admit a loved one for substance abuse treatment under G.L. c. 123 § 35. Under Section 35 a family member, guardian, police officer, or treating physician goes before a MA District Court and asks the Judge to order an examination of a person with substance use disorder. If the person is not already in Court that day, that Judge can issue an order for them to be brought for an examination with the Court clinician. After the examination the Court will hear the clinician’s report and make a decision, based on the likelihood of serious harm caused by the substance abuse, as to whether or not to order inpatient treatment for up to 6 months. While Section 35 is an option we caution clients on its use.

These cases are difficult, and the court processes involved can be complex. Please Contact Us to discuss what options are available to for you your family’s circumstances. We are here to help.

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