Paraplegic Drug User Victim of Involuntary Commitment

How a Paraplegic Drug User Became a Victim of Involuntary Commitment by Christopher Moraff – Feb 2019

New laws make it easy for anyone accused of having an addiction problem to be committed if they don’t agree to whatever treatment is recommended for them.

Involuntary commitment for people accused of having an addiction and not actively participating in treatment for it is becoming more common as more laws are being passed to make this legal.

Barely a day passes on my beat without my meeting someone with a harrowing story about the impact of zero-tolerance drug policies on their lives. But few of these stories have impacted me personally as much as that of a young man I’ll call “Jay.”

Jay was severely injured in a motorcycle accident in August 2017. At 23, he’s handsome and healthy-looking, and a father of two children—but the accident left him paralyzed from the chest down.

Jay relies on a catheter, and uses a wheelchair. And the first time I met him, he was several months into daily fentanyl and heroin use.   

Jay suffers from Restless Leg Syndrome as a result of his accident, and experiences deeply unpleasant and painful sensations that make it almost impossible for him to sleep at night.

RLS, or “spasticity” when applied more generally to conditions known to cause muscle spasms, is pretty common in patients with severe spinal cord injuries.

Jay receives a prescription for 10mg oxycodone pills from his doctor. This is the lowest dose available, and has done little to relieve Jay’s physical pain, let alone his emotional anguish (which is often overlooked as a reason people use opioids, despite their extreme, if sometimes temporary, effectiveness in this area).

The dangers of unregulated fentanyl use, with no guarantee of dosage, are clear. But regulated fentanyl is sometimes successfully used to treat spasticity.

It takes an enormous effort for Jay to get himself out of his modified car—behind the wheel of which is the only place I’ve ever seen him—and into his wheelchair.

So he’s forced to rely on the services of other users to obtain his illicit drugs whenever he ventures into North Philly for this purpose.

on February 8, 2019, Jay had that encounter with police.

“I was sitting in my car in the driveway eating some food I just bought and heard a tap on my window and I looked up and saw two police officers there,” he told me. “I thought, what did I do?”

The officers instructed Jay to get out of his vehicle. They then placed him on a stretcher and wheeled him to a waiting ambulance.

Jay was taken to a local hospital, where was initially admitted to the ER due to some wounds on his leg that doctors said needed treatment.

Later he was visited by a psychiatrist, who informed him that his father had filled out paperwork seeking to force him into rehab under Section 302 of Pennsylvania’s code, covering mental health procedures and “involuntary examination.”

Jay had no choice in what was about to happen to him, even though he was being accused of no crime and was sitting in the driveway of his own home, on private property, minding his own business, when he was approached by law enforcement.

The National Rise of Involuntary Commitment

As the overdose crisis intensified, states began quietly revising their laws to allow for longer periods of commitment with fewer legal hurdles for people who use illicit drugs.

by March 2018, 38 states had laws on the books detailing procedures for civilly committing people with substance use disorders.

The researchers identified 16 states with especially invasive provisions, including the authority to legally restrain, medicate or even conduct surgery on a person they deem to be addicted to drugs—all without the individual’s consent.

“The arbitrary legal standards and procedures on these systems leave the door open to abuse, and do not provide patients with evidence-based treatment as a rule, placing patients at higher risk of overdose when they relapse.”

In some states the bar for compelling individuals into treatment against their will is extremely low.

Take Florida, for example, where an individual with substance use problems can be held for up to 90 days against their will with almost no regard for the principles of due process

A petition can be filed by “any adult with direct personal observed knowledge of the respondent’s impairment,” and must only show probable cause that the individual has “lost the power of self-control with respect to substance abuse” and is “incapable of making a rational decision regarding his or her need for care.”

Probable cause is among the lowest evidentiary thresholds in American jurisprudence

Some would see the rise of involuntary commitment as benign paternalism, but there’s nothing benign about it. It takes away basic rights and agency with little realistic legal recourse for the victim.

Even if we set ethics aside, questions of efficacy remain.

once the withdrawal period is over, it’s difficult for authorities to justify keeping a person. In that sense, compelled treatment is sub-par even by treatment standards.

Addiction experts say this could actually increase risk of overdose, as drug users return to the community without the physical tolerance they had only days or weeks earlier

Meanwhile, detaining a person who has committed no crime—based only on what they might do in the future—has potentially severe long-term repercussions.

Involuntary commitment gives someone a lifelong marker that interferes with their ability to get health care coverage or own a firearm, and it could prevent them from getting certain jobs, like federal employment,” Mary Catherine Roper, of the the American Civil Liberties Union of Pennsylvania

Released But Isolated

Jay would find one of these consequences especially problematic. A firearms enthusiast, he would be barred from owning a gun for life under federal law, even if he never used drugs again.

Finally a psychiatrist visited him and told him that there were no grounds to keep him based on the petition that had been filed by his father.

She even listened to him about the beneficial effects fentanyl had on his condition and prescribed him several days’ worth of fentanyl patches.

But there were no refills.

So now a medical doctor knows that Jay needs opioids, gives him a prescription for the next few days, and then just leaves him hanging without any way to continue getting the prescription she agrees is necessary.

I don’t see how that can be viewed as anything other than medical mistreatment.

Jay is now at home, living in the same way except even more isolated.

Before he left, he asked me if he could borrow $40.

“My [oxycodone] script is up in a few days. I have a buyer lined up. I can pay you back then, I swear.”

10 thoughts on “Paraplegic Drug User Victim of Involuntary Commitment

  1. canarensis

    Oh. My. God. There are so many criminal elements (i.e. outrages against ethics & morality & basic human rights) in this story it’s mindboggling.

    With the rise in states establishing “hot lines” for anyone to call about anyone they think (THINK, in their totally ignorant opinion) is taking “too much” of even legal meds prescribed by their doctors, this sort of obscenity will only increase.

    And, much as I hate to sound like a broken record, where the HELL is the ACL-Useless in this insanity?! I know they’ve clearly decided to let CPPs be tortured & denied medical care & civil rights until every one of us is dead, but, but butbutbut….(*insert enraged scream here because words fail me*).

    Utter despair is so hard not to fall into.

    Liked by 2 people

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  2. leejcaroll

    “danger to self or others” seems to have a low threshhold. (as for his getting a script but with no renewals many years ago a doctor seeing me when I was in hospital for testsre my trigeminal neuralgia gave me a script for methadone. told me his teacher, who practiced in NYC where I lived at the time would give me more scripts. Went to see this dr and he told me no way he would give me any scripts for it and didnt even bother to let me know it is terribly addictive. Despite beinbg on low dose for maybe 2 – 3 weeks when I stopped it completely felt the way they describe “junkies” do when they withdraw. nose running headachy, etc On my own decided to halve and halve and halve every few days until I could stop it without feeling sick. Too often it seems the docs dont think of the outcome if they prescribe bi=ut no refils or assume someone else wilkl continue the prescribing.
    I have a feeling these laws really intended *(and we all kow what the road to h*ll is paved with) for those with addiction history and taking the drugs not for medical reasons but then we get apparently are now getting caught up in it. Appalling. Thanks for sharing his story.

    Liked by 1 person

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    1. canarensis

      “…terribly addictive”
      you weren’t addicted*; you developed a rather rapid physiological dependency. The physical symptoms of withdrawal aren’t different, but the behaviors of the taker sure as heck are. The doc certainly should have told you that you could develop physiological dependence.

      *I’m assuming you didn’t run around knocking over liquor stores to get more & just didn’t mention it. If you did, forget what I said about addiction. If the only issue was feeling lousy when you stopped taking it, what I said stands.

      Liked by 2 people

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    2. Zyp Czyk Post author

      You just pointed out what I thought I noticed as well when my doc let me try methadone: it seemed to be horribly dependence-producing.

      I also only took it in very low doses for a few weeks, but I thought I felt a kind of “withdrawal” when I took it just a few hours later than the usual time. Methadone was also the “strongest” pain medication I’d taken, but the idea that I would become so dependent on it scared me so much I went back to oxy . Later, I wondered if I hadn’t just imagined it, but now you describe the same thing.

      I was so lucky to have a doc that let me try out different opioids to see what worked best for me!

      Liked by 1 person

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      1. canarensis

        I find it very interesting how differently different opioids can act on each individual; I got horribly physically dependent upon dilaudid & the fentanyl patches (I didn’t think I’d EVER get off those frigging things), hardly at all dependent on methadone (tho it did squat as far as pain relief), & not at all on hydrocodone. (I was also lucky to have –for a while– a doc that let me try different ones). But most docs I’ve talked to flat refuse to believe that one can have different reactions & effects from different opioids…a stance that makes absolutely no sense whatsoever.

        Liked by 1 person

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        1. Zyp Czyk Post author

          How sad that doctors no longer believe anything their patients say about their pain or response to opioids. This constant suspicion has destroyed any possible rapport between doctors and patients.

          The medical field will never recover from the damage done to the “practice of medicine” with this anti-patient adversarial attitude and unreasonable refusal to treat pain because of opioid prohibition

          Liked by 2 people

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  3. GZB

    About 10 years ago I was taking methadone for pain. There was a delay at the pharmacy. I was first told that they had to order it. Then after the day given to me as being available passed I was told there had been a recall. When I questioned the pharmacy they filled the script.(???). After approximately 5 days without medication I just started taking my prescribed dose. I’ll bet you can guess what happened next. My son found me unresponsive and not breathing. He did cpr and I was airlifted to ER. I spent a month in the hospital due to pneumonia from aspirated vomit after cpr. My son didn’t know about putting someone on their side. I almost died (permanently) from the pneumonia. It was a nightmare for me and my family. After I finally responded to antibiotics my new hurdle was convincing doctors that I had not tried to commit suicide. I honestly had no idea what had happened. The psychiatrist quickly cleared me but my attending physician didn’t believe him. There’s a lot more to this story, but it’s too long. Suffice it to say that they actually had to see my prescriptions (in my home safe which had been in hospital safe since admittance) that had just been filled, before they would let me go. No one ever mentioned that my tolerance to the medication was nil due to time lapse of no medication. Everyone is more than ready to assume the worst.
    I just read a cds update on opioid prescriptions. It’s so full of innuendo about addiction and rhetoric about pain medication. They just keep up the same pretense of prescription drugs causing the opioid epidemic. They do, at the end, say illicit fentanyl is causing overdoses. But they still put the blame on overprescribing.

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    1. canarensis

      omg, what a nightmare! Glad you got through it, but what a dreadful, horrific time.

      And just think how much easier it is for the DEA to go after doc’s offices (they can just use the phone book instead of having to do all that investigating!) & attack pain patients/prescribing…has nothing to do with the actual problem, but after 5+ decades of losing the war on drugs, they finally hit on a way to claim they’re winning. Truth be damned, millions of innocents forced to suffer be damned: they’ve got their winning PR & that’s all that matters!

      Words cannot begin to express how much I hate these people, and the depth of rage I feel at this insanity.

      Liked by 2 people

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