The Heller School for Social Policy & Management at Brandeis University, Waltham, MA, USA; University of Massachusetts - Boston, Department of Sociology, Boston, MA, USA.
The Heller School for Social Policy & Management at Brandeis University, Waltham, MA, USA; University of Massachusetts - Lowell, School of Criminology and Justice Studies, Lowell, MA, USA.
Drug Alcohol Depend. 2024 Oct 1;263:112391. doi: 10.1016/j.drugalcdep.2024.112391. Epub 2024 Aug 21.
Involuntary civil commitment (ICC) is a court-mandated process to place people who use drugs (PWUD) into substance use treatment. Research on ICC effectiveness is mixed, but suggests that coercive drug treatment like ICC is harmful and can produce a number of adverse outcomes. We qualitatively examined the experiences and outcomes of ICC among PWUD in Massachusetts.
Data for this analysis were collected between 2017 and 2023 as part of a mixed-methods study of Massachusetts residents who disclosed illicit drug use in the past 30-days. We examined the transcripts of 42 participants who completed in-depth interviews and self-reported ICC. Transcripts were coded and thematically analysed using inductive and deductive approaches to understand the diversity of ICC experiences.
Participants were predominantly male (57 %), white (71 %), age 31-40 (50 %), and stably housed (67 %). All participants experienced ICC at least once; half reported multiple ICCs. Participants highlighted perceptions of ICC for substance use treatment in Massachusetts. Themes surrounding ICC experience included: positive and negative treatment experience's, strategies for evading ICC, disrupting access to medications for opioid use disorder (MOUD), and contributing to continued substance use and risk following release.
PWUD experience farther-reaching health and social consequences beyond the immediate outcomes of an ICC. Findings suggest opportunities to amend ICC to facilitate more positive outcomes and experiences, such as providing sufficient access to MOUD and de-criminalizing the ICC processes. Policymakers, public health, and criminal justice professionals should consider possible unintended consequences of ICC on PWUD.
非自愿公民拘留（ICC）是一种法院授权的程序，用于将吸毒者（PWUD）送入药物使用治疗。关于 ICC 有效性的研究结果不一，但表明像 ICC 这样的强制性药物治疗是有害的，并可能产生许多不良后果。我们定性研究了马萨诸塞州 PWUD 中 ICC 的经历和结果。
本分析的数据是在 2017 年至 2023 年期间作为对过去 30 天内披露非法使用毒品的马萨诸塞州居民进行的混合方法研究的一部分收集的。我们检查了 42 名完成深入访谈和自我报告 ICC 的参与者的转录本。使用归纳和演绎方法对转录本进行编码和主题分析，以了解 ICC 经历的多样性。
参与者主要是男性（57%）、白人（71%）、年龄在 31-40 岁之间（50%）和稳定住房（67%）。所有参与者至少经历过一次 ICC；一半人报告了多次 ICC。参与者强调了马萨诸塞州 ICC 用于药物使用治疗的看法。围绕 ICC 体验的主题包括：积极和消极的治疗体验、逃避 ICC 的策略、干扰阿片类药物使用障碍（MOUD）药物的获取，以及在释放后继续使用和增加风险。
PWUD 经历的健康和社会后果远远超出了 ICC 即时结果。研究结果表明，有机会修改 ICC，以促进更积极的结果和体验，例如提供足够的 MOUD 机会和非刑事化 ICC 程序。政策制定者、公共卫生和刑事司法专业人员应考虑 ICC 对 PWUD 可能产生的意外后果。
