History of Civil Commitment and Required Treatment

The use of civil commitment procedures has a long history in the United States. Since at least the adoption of the Harrison Act in 1914, civil commitment has been used to confine individuals and to get them into treatment. While civil commitment continues to be regularly used for psychiatric treatment for people deemed to be a danger to themselves or others (including the mentally ill, violent, and sexual offenders), beginning in the 1970s jurisdictions began to less frequently use formal civil commitment procedures for AOD abusers and make more use of community-based treatment as an alternative to incarceration or as a condition of probation or parole.

However, about 30 states currently have statutes specifically allowing involuntary commitment for treatment of AOD abusers. (39)
The use of civil commitment and involuntary or mandatory treatment in this country is based on the police power of the state to protect society from what it considers to be dangerous people (social control through criminal incarceration or supervision) and the parens patriae doctrine of guardianship or protection of those unable or unwilling to care for themselves.

The states have a multiplicity of overlapping statutory provisions and practices for involuntary commitment and required treatment that have been refined by case law, administrative regulations, and institutional practices. The provisions vary according to the type of condition, legal status and age of the person, purpose of commitment, primary authority for initiating commitment, degree or type of state coercion, and location and type of treatment. (2)

Legally in the United States, being addicted to AOD was considered a crime until the 1962 United States Supreme Court case of Robinson v California (370 U.S. 660, 664-665, 1962) when the Court declared it was unconstitutional to prosecute a person for being addicted to AOD. The Court distinguished the status of AOD addiction from AOD related criminal conduct such as possession or sale of drugs, driving while under the influence, and criminal behavior accompanying AOD use for which an individual can still be prosecuted. The Court’s decision did not specifically address the constitutionality of required treatment, but the Court declared (in a dictum) that a state might establish a program of compulsory treatment and penal sanctions might be imposed for failure to comply with treatment procedures.

Subsequent cases have emphasized that the power to require treatment is a highly limited one that could be exercised only on a showing of a specific danger to the individual or to the public. A series of legal decisions have reinforced the importance of due process rights procedures as a way to protect both the civil rights of individuals and as a means of ensuring that the state does not wrongly detain people. (4)

However, the use of law and legal sanctions to get people into treatment has generated a significant amount of controversy. The issue has generated a new field of study called therapeutic jurisprudence which is the study of the extent to which rules and laws, legal procedures, and the role of lawyers and judges produce therapeutic or anti-therapeutic consequences for individuals involved in the legal process.

The debate centers on the desire to strike a balance between the need for legal safeguards against improper commitment and treatment and the desire to help get individuals in treatment and allow organizations, treatment personnel, and court officials sufficient discretion in making decisions that could be in the best interests of individuals and society. (42)

Review Questions for Section III

Is it true that many states still have the right to involuntarily commit DOA abusers?

Is it still a crime in the United States to be addicted to drugs or alcohol?

What is therapeutic jurisprudence and what is its significance for mandated DOA treatment?