I applaud Washington’s legislators for prioritizing mental health this year. Sadly, substance abuse treatment has not enjoyed similar investments.
In Washington state, those persons at risk of harming themselves or others because of mental illness can be involuntarily committed for lifesaving psychiatric treatment. However, for those who pose the same risk of grave harm to themselves or others due to substance abuse, nothing can be done. Even for children as young as 13.
I know this stark reality firsthand. I spent 2011-2012 caring for my best friend Ricky as he battled alcohol and heroin addiction. He suffered multiple overdoses and suicide attempts, resulting in 75 emergency room visits, six psychiatric hospitalizations and three nearly fatal incidents leading to the intensive care unit.
Ricky was dying. And there was nothing I could do to save him.
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On Ricky’s sixth hospitalization, the young psychiatrist told him: “In my few years of practice, I’ve seen three people die of the disease that you have. If we were in California and I could commit you involuntarily to addiction treatment, I would. But my hands are tied in Washington.”
My heart broke that day.
The vast majority of states allow involuntary substance abuse treatment because state law considers addiction a mental illness. Washington state instead created a bifurcated system and discriminated against substance abuse.
Inaction on this matter will prove fatal. The state estimates that more than 5,000 Washingtonians would benefit from involuntary substance abuse treatment annually. Instead, we lose nearly 900 people to drug overdose and 1,000 to suicide each year. One in three Army suicides is substance abuse-related. Without a mental health diagnosis, families cannot intervene.
There is hope, however. House Bill 1713, named Ricky’s law, passed the state House and was funded in the House budget. This legislation would create a unified involuntary commitment system, so that a person can be committed if he or she is at risk of serious harm due to mental illness and/or substance abuse. Ricky’s law is still being worked on during the special session.
While Ricky’s law would cost the state $20 million over the next four years, our state is already paying the costs for untreated addiction. Severely addicted patients repeatedly appear in emergency rooms, psychiatric hospitals, involuntary mental health court, jails and before first responders at extraordinary cost.
A University of Washington study found that a single group of patients treated involuntarily for substance abuse saved the state $18 million over three years. Furthermore, a 2011 report on the involuntary detox pilot project in Pierce and Skagit counties found that the facilities paid for themselves because of the significant health care and court cost savings.
As for Ricky? He finally agreed to get addiction treatment. Today, he is nearly three years clean and sober and is working to save money to finish his university degree.
Recovery is probable as long as there is access to quality treatment. The Legislature should pass and fund Ricky’s law, because every life is worth saving, no matter the diagnosis.
Lauren Davis serves on both the Alcoholism and Substance Abuse Administrative Board and the Mental Health Advisory Board for King County. She works at Forefront, a suicide-prevention nonprofit.