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Is Addiction a “Brain Disease?”

There are many good reasons to emphasize the biological underpinnings of substance use disorders. Perhaps most important, the biologic basis of this chronic disease is a strong argument for parity: that is, treating (and funding treatment for) addiction on par with other “biologic” diseases.

The stigma and shame of addiction has much to do with the perception that people with substance use disorders are weak, immoral, or simply out for a good time at society’s expense. Understanding that addiction impairs the brain in many important ways may reduce such stigma. What’s more, the specific type of brain dysfunction may help identify a range of effective interventions and preventions. For example, during adolescence, the brain is at its most plastic — and vulnerable. This is a time when caution and intervention may prove most valuable. The earlier the drug exposure or trauma to the brain, the greater the damage.
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INVOLUNTARY TREATMENT FOR SUBSTANCE USE DISORDER: A MISGUIDED RESPONSE TO THE OPIOID CRISIS

Recently, Massachusetts Governor Charlie Baker introduced “An Act Relative to Combatting Addiction, Accessing Treatment, Reducing Prescriptions, and Enhancing Prevention” (CARE Act) as part of a larger legislative package to tackle the state’s opioid crisis. The proposal would expand on the state’s existing involuntary commitment law, building on an already deeply-troubled system. Baker’s proposal is part of a misguided national trend to use involuntary commitment or other coercive treatment mechanisms to address the country’s opioid crisis.

The CARE Act and involuntary hold

Right now, Section 35 of Massachusetts General Law chapter 123 authorizes the state to involuntarily commit someone with an alcohol or substance use disorder for up to 90 days. The legal standards and procedures for commitment are broad; a police officer, physician, or family member of an individual whose substance use presents the “likelihood of serious harm” can petition the court.
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