The New Jersey State Assembly committee has passed a bill allowing judges to order outpatient treatment for addicts who have shown that they are a danger to themselves or others. Similar to California’s 5150 code—which allows a qualified officer or clinician to involuntarily commit a patient to a psychiatric facility—this bill will treat addiction like a mental illness, taking away an adult’s right to chose whether they want to enter treatment or not. According to NJ.com, the bill was strongly advocated by families who have lost their children to drug overdoses.
As someone who is passionate about removing the stigma of alcoholism and addiction and doing what it takes for the general public to have a better, more accurate understanding of the disease, I should be jumping for joy over the passing of this bill. But the truth is, my feelings are mixed. On the one hand, it forces the hand of drug addicts who may appear to be adults capable of making decisions that reflect their best interests but are actually in the grip of their disease and therefore only capable of making choices that serve their addiction. In that regard, addiction behaves a lot like someone in a manic or psychotic episode. The difference is—typically—people who have become a danger to themselves or others due to a mental illness can be mandated to a 72-hour psych hold, given the appropriate medication, and within a few days, become lucid enough to make decisions for themselves. With addicts, their entire thinking and modus operandi is warped, even when they are not high. Addiction is a disease of perception so addicts see the world and themselves in such a way that separates them from reality—and, many times, from hope that a drug-free life would be better or even possible.
So the benefit of this bill is that it could give people who may want help but have been too scared to get it the opportunity to rehabilitate if they are willing to show up and do the work. But anyone who is an addict, treats an addict, or is close to an addict will tell you, recovery from addiction is not something you can force anyone into. There has to be an inkling of desire within the person to want to be clean—and even then, success is far from a guarantee.
Think of how many times you have wanted to stop eating sugar and cut out bread and pasta from your diet while vowing to get on a regular schedule at the gym—then, after a couple of momentous days or weeks, you’ve found yourself slipping or not being able to keep it up. That is how addicts feel about their using. The same way working out or eating right can feel too overwhelming to manage with your day-to-day life, being sober doesn’t fit with the needs of an addict’s everyday life. So in order to stay sober, most addicts require a change in their lives stat. Just as it might seem a bit extreme to get rid of all your friends, change your career and give your kids up for adoption just so you can have the time and space to become disciplined about your new diet and workout regime, expecting an addict to get clean when recovery involves changes just as drastic—sometimes actually having to leave jobs, change residences, leave marriages, hand their children off to someone else as they get their lives together; it’s no small feat. When you don’t have a drug or alcohol problem or struggle with mental illness, I can imagine it’s hard to understand why people who are destroying themselves, their lives and the lives of the people around them can’t just see the error of their ways and carry on with a normal life. But it just doesn’t work that way.
While this bill might seem like a solution for some, family members and the loved ones of addicts should proceed with caution and lower their expectations around the results of an outpatient treatment program. There are many ways outpatient treatment is a good option—it’s more affordable, less disruptive to a person’s daily life, more conducive to family care—but it’s not the best option for many. It’s the difference between relying on self-discipline to get yourself to the gym every day versus going away to a place that will guarantee you are at the gym every day with a trainer.
If someone is an addict to the point where the courts are involved, it’s hard to be optimistic that outpatient treatment will help—unless the person is ready to get sober and willing to do whatever it takes. Of course, residential treatment programs aren’t 100% successful either—far from it—but they do give addicts a head start on clean time and send them off with good habits and a plan; whether they chose to stick to that plan is on them.
Still, the principle behind this New Jersey bill, which is to treat addiction like a mental illness, is a solid step in the right direction in terms of getting people to better understand addiction as a disease. As someone in recovery, I am frequently approached to discuss and answer questions about addiction and it never fails to shock me how under- or misinformed people are about the nature of the disease. Even the Mayo Clinic defines alcoholism as: Problems controlling your drinking, being preoccupied with alcohol, continuing to use alcohol even when it causes problems, having to drink more to get the same effect (physical dependence), or having withdrawal symptoms when you rapidly decrease or stop drinking.
But these are merely symptoms of the disease. These are the signs of trouble that get people into treatment but are just the tip of the iceberg; the real recovery comes when the mental and spiritual aspect of the illness is treated. If you have alcoholism, you may be able to stay “dry” for a period of time—even forever—but you won’t be free of the internal turmoil that led you to the bottle without really doing some work.
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