New Jersey legislators are considering a proposal to require involuntary commitment for any overdose survivors revived by law enforcement. It seems it might also apply to anyone suspected of overdosing in the past 48 hours, even without medical confirmation.
A6152 was introduced December 4 by Assemblymember Chris Tully (D). Currently, New Jersey requires that someone be deemed an immediate danger to themselves in order to be hospitalized against their will. The state’s definition of “dangerous to self” is specific to mental illness, and situations involving suicidal ideation or inability to care for oneself. Mitigating factors have to be taken into account, such as personal history and whether the person is able to meet their needs with the assistance of others. The proposed addition for substance use is less nuanced:
“An individual who has recently been admitted to a hospital for a substance use overdose or administered an opioid antidote for the emergency treatment of an apparent opioid overdose shall be determined to be dangerous to self.”
Similarly, the state’s definition of someone who is in need of involuntary commitment would be expanded to include anyone recently hospitalized for overdose or administered an overdose antidote.
Law enforcement who respond to an overdose would be directed to take the survivor into custody and transport them directly to a screening for treatment. But the bill also goes further. Someone could be taken into custody even if law enforcement hadn’t treated them for overdose, but a medical professional had reported that they’d overdosed within the past 48 hours. It’s also not just medical practitioners who could make this call; in theory anyone could.
“[A] law enforcement officer [would] take a person into custody … in any case where a health care practitioner, emergency medical responder or private individual has certified, in a form and manner prescribed by the Division of Mental Health and Addiction Services, that the person has overdosed on opioid drugs, and has been revived with an opioid antidote, within the preceding 48-hour period,” the bill states, “thereby necessitating the belief by the health care practitioner, emergency medical responder or private individual that the person is … in need of involuntary commitment to treatment.”
On top of the language being somewhat vague and ominous, it’s a departure from the equivalent proposal for mental health evaluations.
People referred by a medical professional versus a civilian aren’t more likely to benefit from involuntary treatment; no one is. But on top of the “private individual” language being somewhat vague and ominous already, it’s a departure from what the bill proposes for the equivalent subsection on mental health. In the update to the latter, officers would be required to transport people directly to mental health evaluations only if recommended by a “health care practitioner, mental health care practitioner or emergency medical responder.”
Residential or outpatient treatment for reported overdose survivors would be expected to take place at facilities specializing in substance use disorder (SUD) rather than psychiatric facilities. The state would designate at least one such facility per county, or multicounty region, for this purpose. People committed for SUD would receive a review hearing every 30 days, whereas for mental and behavioral health patients the first review isn’t until three months from the beginning of inpatient treatment; for outpatient treatment, it’s six months.
More than half the states have laws authorizing involuntary commitment based on SUD diagnosis. Many require a co-occurring diagnosis of mental illness, and most aren’t hitched to overdose specifically. But it’s not unheard of.
Spokane, Washington, passed a resolution in 2024 wherein “documented administration of [naloxone] constitutes a presumption that an individual has a substance abuse addiction that is a danger to [themselves].” It didn’t become state law, but the Senate is now considering a bill to facilitate involuntary treatment for people who are “gravely disabled,” as defined by having had an overdose antidote administered within the past six months.
In August, New York City Mayor Eric Adams proposed the “Compassionate Interventions Act” to authorize medical holds of people determined to have SUD who don’t enter treatment willingly. The city currently has a law supporting involuntary transport and hospitalization of people who “appear” to be a danger to themselves or others due to mental illness. The Act would expand that to substance use, but the determination still has to be made by a clinician.
Image (cropped) via Washington State Criminal Justice Training Commission
