Proposed 72-Hour Detention Has No Basis in Medical Science, Dehumanizes People, and Will Likely Lead to More Overdose Deaths
Policy Responses to Drug Use Must Prioritize Health and Safety of People Who Use Drugs
ALBANY, New York — Medical professionals and advocates are expressing concerns about a provision of the heroin bill package being advanced by Governor Andrew Cuomo and the legislature, which would allow healthcare facilities to detain people who use drugs against their will for up to 3 days.
Central concerns of medical professionals and addiction treatment advocates include:
"We also strongly object to extending the period of involuntary detention from 48 to 72 hours. This additional period increases the likelihood that an individual’s tolerance to opioids drops and is likely to increase the risk of overdose upon resumption of opioids on release,” said Dr. Sharon Stancliff, medical director of the Harm Reduction Coalition.
"Compelling medical treatment and/or taking substances using patients into custody for a period of 72 hours would be both non productive and potentially life threatening," said Dr. Randy Seewald of Briarcliff Manor, New York. "An opioid dependent individual after 72 hours of not using illicit drugs, or prescribed opioid medication will be suffering physical withdrawal symptoms, fatigue, depression, anxiety, and intense craving to use drugs. This will not produce the mental state needed for a patient to be cooperative with treatment and have a successful outcome."
“To address the opioid and heroin epidemic we must use evidence-based strategies. Increasing access to treatments that are known to be effective, like methadone and buprenorphine, should be a top priority,” said Dr. Chinazo Cunningham MD, MS Associate Chief, Division of General Internal Medicine, Albert Einstein College of Medicine, Montefiore Medical Center.
According to a public memo from the Coalition of Medication-Assisted Treatment Providers and Advocates, forced detoxification carries an 80% likelihood of relapse. Since forced abstinence lowers an individual’s tolerance to opiates, many patients will be at a greater risk for overdose upon release from involuntary detoxification than they would be if they had continued to use drugs.
“Instead of listening to the needs of people who use drugs and offering support to match, this proposal perpetuates New York’s shameful history of coercion with regard to drug use,” said Matt Curtis, Policy Director at VOCAL New York. “This bill will undermine our state’s 911 Good Samaritan law and overdose prevention programs and drive people in need away from care.”
In scientific studies directly comparing involuntary and voluntary drug treatment, involuntary treatment does not produce better outcomes in terms of sustained abstinence, and some studies have found negative effects from involuntary treatment. Given the substantial civil liberties issues involved in confining an individual against their will, the legislature and governor have a responsibility to ensure that such action is only taken in exceptional circumstances, with appropriate safeguards, and that there is strong evidence that such action will produce good outcomes. This proposal meets none of those standards.
“We have learned through trial and error – and much unnecessary pain and suffering – that a public health model is the only smart and compassionate approach to addressing substance abuse and addiction,” said Robert Perry, Legislative Director with the NYCLU at a recent press conference. “And yet legislation pending in Albany adopts several misguided compulsory treatment provisions. Let’s not make the same mistakes we made with the War on Drugs – drug policy must be based on upon evidence-based medical science.”
“As we shift toward a public health approach to drug use, we must ensure treatment policies are grounded in scientific evidence,” said Kassandra Frederique, New York State Director of the Drug Policy Alliance. “If the governor’s office wants to effectively address problematic drug use, then it must increase access to evidence-based treatment, rather than allowing for people to be forced into detention by others unqualified to make such a decision. A public health approach to drug use must prioritize the health and safety of people who use drugs.”