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Drug overdose victims could be forced into mental health facilities under Pa. bill

Patriot-News - 4/20/2017

April 20--The Pennsylvania House's Health Committee gave a first approval Wednesday to a bill that would recognize drug overdoses as a cause for involuntary mental health commitments.

At present, such involuntary commitments are tied to apparent mental illness that has led, for example, to a suicide attempt or an attack on others within the past 30 days.

Rep. Matt Baker's bill would expand that definition of "clear and present danger" to include the ingestion of drugs to the point of unconsciousness, or in need of medical treatment to "prevent imminent death or serious bodily harm."

Some experts have endorsed this approach, in keeping with the growing consensus in the substance abuse field that addiction is a type of mental illness.

Baker's bill would force affected addicts into a 72-hour minimum stay where they would be fully evaluated and counseled as to their treatment needs.

Supporters say the benefit is it at least provides an entry point to treatment.

But even some who voted for the bill Wednesday raised questions about whether the right supports are in place for a "committed" addict to get the necessary evaluation and care, should they eventually opt-in for further help.

Baker, a Republican from Bradford County and the committee chair, said he was motivated to draft the bill by stories of families and friends of addicts who saw loved ones receive treatment for an overdose, but were tortured by the knowledge that they had no way to turn that emergency room visit into longer-term treatment for the addiction itself.

As House Bill 713 is written, an overdose patient requiring emergency health care treatment could be held in-hospital or at a treatment facility for at least 72 hours for a further assessment of their problem.

"This would be another option for people who are desperate for intervention," Baker said.

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The bill comes as Pennsylvania, like many other states, is wrestling with a surge in drug-related overdose deaths that jumped to 3,383 in 2015, up 23 percent from 2014.

Some believe the 2016 death toll will only be higher when that count is finalized.

Baker's is not the only anti-addiction bill exploring involuntary treatment.

Senate Minority Leader Jay Costa, D-Allegheny County, introduced a bill in February that would give family members the ability to petition their county court to order -- with a doctor's sign-off -- involuntary commitments of relatives for drug treatment.

Not everyone is completely comfortable with the concept of forced treatment, however.

"One of the things we hear about addiction is that the person who is addicted really needs to want the change," noted Rep. Mary Jo Daley, a Democrat from Montgomery County.

Others have asked what happens if there isn't appropriate bed-space for a patient who agrees to help. Or, what happens to the committed patient who leaves after the first 72 hours?

"My question is, are we moving too fast?" asked Rep. Ed Gainey, a Pittsburgh Democrat, who noted Wednesday that he's heard from several treatment providers who raised questions about imposing new treatment mandates on an already under-funded system.

But some drug treatment advocates have expressed support for Baker's basic concept.

Deb Beck, of the Drug and Alcohol Service Providers Organization of Pennsylvania, noted in an interview with this winter that treatment decision are rarely totally voluntary.

It often takes a hard push, Beck noted, from a boss, a loved one or a doctor for someone with substance abuse problems to enter treatment.

According to the National Alliance for Model State Drug Laws, more than 30 states do have some type of involuntary commitment procedure for substance abuse disorders in place now.

In the end, Baker's bill passed its first test with flying colors. All 26 committee members present voted for it, including Gainey and Daley.

"I guess we need to take every opportunity to try and help these families," Daley said.

Baker said the committee vote was important because the endorsement puts the bill on track for further discussion as the legislature and the Wolf administration prioritize its next moves in the statewide battle against addiction.

It's in those coming discussions, Baker said, that he expects the questions raised Wednesday to be fully explored and answered, at which point lawmakers can decide whether this is a tool they want to add to the fight in Pennsylvania, or not.

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