An involuntary addiction treatment law on the books for 50 years in Massachusetts has in recent years become part of the Falmouth Police Department’s go-to tools. It is used to combat the opioid crisis when urging people to get help does not work.
The number of addicts committed to treatment facilities against their will has grown this year as opioid use and overdoses increased in town.
“I think it’s fair to say that 50 to 75 percent of what we do is related to drugs, alcohol and mental health issues, which often go hand-in-hand,” said Sergeant Michael Simoneau, one of the Falmouth police officers who works with Gosnold Treatment Center in trying to coax addicts into treatment.
Falmouth police petitioned the court 74 times in 2020 under the Massachusetts Section 35 law to have a person with a drug or alcohol abuse issue committed to a locked treatment center.
“We typically get pushback from the person involved,” Sgt. Simoneau said. “And the majority of the time, the family is at their wits’ end and they have run out of options to help their loved one.”
Section 35 is meant to save those on the verge of death from addiction. It is considered a last resort.
“It is intervention. The issue is the addiction is so bad that the person has become a physical danger to himself or in some cases, their loved ones,” Falmouth Clerk Magistrate Edward B. Teague said.
The law allows immediate family members—including spouses, relatives and guardians, police officers, court officers and physicians—to petition courts to force someone into substance abuse treatment for up to 90 days, usually against their will.
The judge decides whether to “section” a person based on evidence presented in court by family, friends, employers or others, and after being evaluated by a licensed social worker, physician or physiologist, Mr. Teague said. Most are resistant to the forced treatment and are entitled to a defense attorney.
“The judge must find that the person has an addiction issue and is in imminent danger to himself or others…that they have lost control over the ability to make a decision when it comes to the substance,” Mr. Teague said.
“They are being civilly committed. They are handcuffed, put in a police car, transported to the courthouse and put in lockup,” Mr. Teague said.
At Falmouth District Court, he said, more often than not it is a concerned family member who petitions for committal, but increasingly it is police or emergency room physicians who are making the referrals.
“Police are making observations of people who need help every day out in the field,” he said. He said the same of doctors. “After the person is medically stable, physicians will write a lengthy notice to court, based on observations and how frequently the person is in the ER. It’s a good demonstration of concern for people in their care,” he said.
Although the law allows for up to 90 days of inpatient treatment, typically the sentence is two to three weeks, Mr. Teague said.
“It’s for detox and some education,” he said.
Judges granted more than 80 percent of the Section 35 requests they heard in Fiscal Year 2018, sending more than 6,000 people into forced treatment, according to the state Department of Mental Health.
There were 170 mental health requests processed through Falmouth District Court last year, about 90 percent of which are Section 35s. The remaining 10 percent are Section 12s, which are requests for involuntary committals for mental health treatment.
Sgt. Simoneau said the department is using the law more than it did even a decade ago. In 2014, the department made 26 referrals to a judge for committal. That number spiked to 118 referrals in 2016, while 2017 saw 94 referrals. There were 76 in 2018, 55 in 2019 and 74 this year.
The number of people “sectioned” has grown alongside the state’s opioid epidemic, increasing by more than 47 percent in the last eight years. There were 136 overdoses in Falmouth in 2020, including four over the Christmas holiday weekend. There were 123 in 2019 and 28 in 2014.
While alcohol addiction is a concern, Sgt. Simoneau said, the “overwhelming majority” of Section 35s are due to drugs. The Falmouth police force continues to battle the heroin epidemic in town that began in earnest in 2014, when a stream of prescription pills from Florida began to slow to a trickle and the federal government began to crack down on them, the sergeant said.
“Once it dried up, heroin came in to take the place of pills. It’s way cheaper to buy, and the pills were no longer readily available,” Sgt. Simoneau said. “Currently, most of the overdoses are caused by fentanyl, a high-risk potent synthetic opioid, or by taking counterfeit pills or buying a white powder that is being sold as cocaine and is actually fentanyl.
“This stuff is so dangerous, and it’s still coming in. It’s frustrating.”
Falmouth police do not wait until a repeat overdose to intervene.
In 2015 the department partnered with Gosnold Treatment Center in Falmouth to conduct home visits to offer all recent overdose victims services.
“Whenever there is an overdose, we, along with a Gosnold counselor, conduct a home visit and attempt to connect the victim or the family to services,” he said.
Not everyone is ready or willing to accept the help, and in many cases they will overdose again. A person with the victim will call for help and police or fire personnel will arrive and revive the person with naloxone.
Repeat drug overdoses will trigger officers to start the Section 35 process.
“Repeat overdoses in a short period of time will do it. We notice and track the overdoses,” he said. “The family is at the end of the rope. A lot of times, the addict has burned bridges, stolen and hurt people, and that is when we step in,” Sgt. Simoneau said.
For alcohol, officers will apply for involuntary treatment if they recognize a person with alcohol-related police incidences and the family is not intervening.
“We will go ahead and apply ourselves. If a person is in protective custody with us repeatedly and the family is not stepping up, we do it,” Sgt. Simoneau said.
When he started with the department 20 years ago, he and his co-workers encountered heroin occasionally.
“It was primarily alcohol. And it’s frustrating. When we take someone into protective custody for alcohol, often they want to get treatment, but there’s often not a bed for them at Gosnold. So we’ll keep them and keep trying for a bed for them,” Sgt. Simoneau said.
Protective custody allows an officer to hold a person for 12 hours if police deem that person is a danger to himself or others. In that instance, police try to contact a sober friend or family member who will come get the person from the police station.
While pivoting job duties to include responding to the spike in substance abuse and mental health issues is challenging, the department has risen to meet it. “We have to. Take a look at the police logs and you’ll see 99 percent of incidents are drug-, alcohol- or mental illness-related,” Sgt. Simoneau said.
“We’re dealing with it head-on. We’re out there every day wearing many hats in more traditional police roles and now as counselors.”
Many officers are trained to cope with mental health issues and mental health first-aid. They also tap into Falmouth Human Services for counseling assistance and offer services to people they have noticed have repeat or chronic mental health issues. Police Chief Edward A. Dunne plans to create a community action team where more officers will be trained in crisis intervention and the department will hire a full-time counselor.
“Often it’s a dual diagnosis—people are masking mental illness with alcohol and drugs for temporary relief,” Chief Dunne said.
Sgt. Simoneau said involuntary treatment is not a magic bullet for the overdose problem.
“It might take multiple trips to stay sober. Their wiring is screwed up from the drugs and/or alcohol and not thinking correctly,” he said. “It’s frustrating but, then again, they are not thinking like you or I. Their brain is technically broken.”
Once someone leaves treatment, recovery is a full-time proposition.
“If you want to get better, you have to drop everything and totally immerse yourself in sobriety, whether inpatient or outpatient,” Sgt. Simoneau said, acknowledging it is nearly impossible for most who have jobs and families.
Mr. Teague calls the law a first step in the recovery process, adding it is rare to see a person “sectioned” more than once.
“This is step one. It is not long-term care, and they are usually in for two weeks and are directed to outpatient services. But without it, the person could keep doing what they’re doing and it could end badly,” he said.