Saving A life: Involuntary Addiction treatment and the Marchman Act

Joe Considine, Esq

Substance abuse disorders re-wire the brain so that many times no amount of familial, employment, financial or other pressure can interfere with the individual’s demand for more substances. The opponent process theory as outlined by neuroscientist, Dr. Judith Grisel, (2019 NY Times bestseller, Never Enough; The Neuroscience and Experience of Addiction), and others provides an understandable explanation for this phenomenon. Noted New York Times columnist, David Brooks, wrote in an op-ed piece a couple of years ago that the opioid crisis in this country was so severe that a form of benign paternalism was needed to combat it. More than 900,000 Americans have died since the 1990s from substance abuse. Certainly, the number of drug overdose deaths and alcohol-related deaths during the pandemic only reinforces the need for action by all reasonable means necessary.

We simply cannot wait any longer for people to “hit bottom” before they get help.  Involuntary commitment to treatment through the courts provides an effective tool to deliver individuals with substance use disorders to treatment to start the process of re-wiring the brain for recovery. Many individuals must be mandated by the courts to treatment for a long enough period so their brains can cool down and begin to develop the internal motivation necessary for long-term recovery. The violation of a court order for treatment for failure to attend and participate in treatment can result in a finding of contempt and possible incarceration. This often provides the necessary leverage or “skin in the game” to keep a person in treatment long enough to settle the dopaminergic pathways in the brain which are used for chronic substance abuse and begin the process of internally motivated treatment.  There is significant research that confirms that involuntary commitment to treatment is at least as effective, if not more, than voluntary treatment. We will explore these studies and the rationale therein and, as a result, professionals will be more comfortable with the science and the wisdom of using involuntary commitment laws.

Simply put, clinicians and interventionists must become more comfortable with the ways that the legal system can help assist the professionals to get their clients into treatment, whether or not the client initially wants it, for a long enough time for the brain to “cool down” and to begin to develop the internal motivation for recovery.  This presentation will explain how well-accepted principles of treatment are assisted using the legal system. The Florida involuntary commitment model known as the Marchman Act will serve as a guide for the exploration of this process.  Attendees will gain an understanding of how laws requiring treatment attendance through court orders begin to approximate certain features behind the successes of programs such as Impaired Physicians and the FAA/Commercial Airline Pilots programs. One of the goals of this presentation will be to arm professionals with facts to speak with their community leaders about establishing laws in their states similar to Florida, Kentucky, and Connecticut to get court orders for treatment.

Learning Objectives:

1.      Professionals will better understand how the legal system can assist a clinician or interventionist get their clients into treatment, whether or not the client initially wants it, for a long enough time for the brain to “cool down” and begin to develop the internal motivation for recovery. 
2.      Professionals will understand how principles of treatment can be assisted using the legal system.
3.      Attendees will gain an understanding of how laws requiring treatment attendance through court orders begin to approximate certain features connected to the successes of programs such as Impaired Physicians and the FAA/Commercial Airline Pilots programs.
4.      Professionals will become familiar with the results of a number of studies which concluded that involuntary commitment to treatment is at least as effective if not moreso than involuntary treatment.
5.      Professionals will acquire relevant terminology and data with which to speak with their clients, community leaders and others about the efficacy of involuntary commitment. 

2.0 General CEU Hours

Joe Considine, Esq. 

Joe Considine has practiced law, since 1983, focused on using the courts to require substance use treatment through Florida’s involuntary commitment statute.  Joe has handled hundreds of Marchman Act cases getting people into treatment who refused treatment. Joe has presented to state conferences of mental health professionals, the Florida judiciary, and treatment centers about involuntary commitment to treatment using the courts. Mr. Considine works exclusively with families whose loved ones have substance use and co-occurring mental health disorders.  He has authored many articles on the Marchman Act which can be found on his website: joeconsidinelaw.com.

Joe has been a member of the Board of Directors of The Fern House in West Palm Beach, a residential facility for indigent men with substance use disorders, for more than 25 years. Joe also participates with the Max Planck Institute For Neuroscience in Jupiter, Florida as a member of the Brain Trust.

Joe Considine, Esq.  is recognized as an expert on this subject by treatment professionals, clinicians, interventionists and the judiciary throughout Florida and the United States.  He has presented on these issues more than thirty (30) times to groups including the Florida Association of Magistrates and Judicial Hearing Officers (October 2021 and August 2022), Recovery Leadership Institute of the Hanley Foundation (August, 2021), Lake County Florida Opioid Task Force (2019), Delray Beach Florida Drug Task Force (2018),  SUDS Talk National Symposium (2016), Florida Association of Mental Health Counsellors State Conference (2016 and 2017) and more than twenty-five (25) treatment centers (2021-2012).

 Proudly Sponsored by:

John Davis, President