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Court-Ordered Rehab

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Every year, people enter involuntary rehab under legal obligation or pressure from the court system and tend to remain in treatment longer and have higher attendance rates than those who enter voluntarily.1 Consequently, involuntary rehab programs lead to better treatment outcomes.1

There is a correlation between crime and substance use. Studies show that over 50% of offenders incarcerated within U.S. jails and prisons have a substance use disorder and that almost two-thirds are re-arrested within 36 months of their release.2 Some are in prison on drug-related offenses, such as theft, possession, or distribution.

Completing a drug or alcohol rehabilitation program as opposed to jail or prison time can be a more supportive, favorable option, since incarceration does not treat substance use disorders. Rehab is an effective way to treat the addiction and prevent future relapse and imprisonment.


What Is Court-Ordered Rehab?

Court-ordered rehab has been around for years. In 2011, the National Institute of Justice (NIJ) and the Bureau of Justice (BJA) collaborated to identify the evidence-based aspects of successful drug court programming so that various stakeholders could create more effective programs.3 Court-ordered drug rehab can be beneficial to those with substance use disorders since behavioral therapy, such as cognitive behavioral therapy (CBT), can be tailored to their specific motivations, learning styles, and other cognitive attributes.3

Receiving treatment involving cognitive behavioral therapy through court-ordered rehab can serve as early intervention and possibly prevent future crimes. Studies detail that punishment alone is not an effective public health and safety intervention for offenders who commit drug-related crimes.4

Drug courts serve as alternatives to regular courts and pair evidence-based treatment with support services and judicial supervision.5 Since 65% of all inmates meet the criteria for a substance use disorder and only 11% receive addiction treatment, drug courts can order drug rehabilitation, as well as community support to help after treatment ends.5

There are different types of drug courts: adult drug treatment court, DWI courts, family dependency treatment court, juvenile drug treatment court, and tribal healing to wellness court.6 Aspects of court-ordered rehab can include accelerated pre-trial rehab, educational rehab, group counseling, residential rehab, detox, and inpatient hospitalization. Offenders who are currently using drugs and/or alcohol might require medical detoxification in a supervised setting as the first step to recovery.


What Are the Benefits of Court-Ordered Rehab?

Court-ordered rehab emphasizes the importance of treatment and can help remove you from your environment and circumstances. The criminal justice system recognizes that drug addiction is a neurological disease which has behavioral, cognitive, and physiological attributes. These contribute to a cycle of use despite dangerous consequences.7 Recovering from addiction involves treatment and aftercare management, and it is often recommended that treatment lasts for at least three months in order to be most effective.7 The first step in getting help is to undergo an assessment and evaluation; then, the individual can begin treatment that caters to their specific needs.

Treatment should focus on the factors linked to criminal behavior.7 By targeting these factors, individuals can be trained to recognize flawed ways of thinking and correct them using new CBT skills. This can help people stay sober and deal with co-occurring disorders or dual diagnoses (the existence of both a mental health condition and a substance use disorder).


Eligibility: How to Get Court-Ordered Addiction Treatment

There are a few ways to receive court-ordered addiction treatment. It can be issued as part of a court or judge’s ruling, and it can be for inpatient or outpatient therapy (e.g. the Florida senate ruled that the courts can order 6 months of involuntary outpatient treatment in lieu of inpatient rehab if a person has twice been ordered to inpatient treatment during the previous 36 months and meets the criteria for placement in involuntary rehab).8

To qualify for involuntary outpatient placement, a person must be 18 years of age or older, have a mental illness, be unlikely to safely survive in the community without supervision, and have a history of non-compliance with mental health treatment. The individual must have been involuntarily admitted to rehab or a correctional or forensic facility twice within the past 36 months or have engaged in at least one violent act toward themselves or someone else, be unlikely to voluntarily seek the recommended help, need outpatient services to prevent a relapse that would result in harm to oneself or someone else, and be likely to benefit from outpatient placement.8 Additionally, any less restrictive alternative must be deemed unavailable or inappropriate for the person.8

An administrator of a treatment facility can petition for involuntary outpatient placement if they detail the criteria for this. They must also provide a certificate of recommendation for involuntary outpatient placement and a recommended treatment plan from a qualified professional.8 The court has 5 business days to hold a hearing once the petition is filed.8 A public defender will be appointed by the court unless the person chooses their own counsel.8

As for involuntary inpatient placement, a person must be deemed mentally ill and have refused voluntary treatment, be incapable of surviving alone or with family or friends, be likely to neglect self-care without treatment—which could lead to harm of their well-being—and be likely to inflict harm on themselves or someone else.8 And, as is the case with involuntary outpatient treatment, there must be proof that less restrictive alternatives would not be appropriate for the individual.8

During the 1970s, the federal government enacted laws that created formula grants for states to generate care continuums for individuals and families impacted by substance use.8 This led to separate funding channels and requirements for drug and alcohol use and, in response, Florida enacted the Marchman Act, which encourages people to voluntarily seek treatment.8 The Marchman Act also creates a variety of ways to assess, stabilize, and treat substance use on an involuntary basis. A person must clearly show impairment and loss of self-control regarding their substance use. They must also need the services because they are unable to understand and appreciate their need for help or are likely end up engaging in self-harm or harm of another if they don’t get help.8

Non-court-involved involuntary admissions can be made, and there are three types provided under the Marchman Act: protective custody, involuntary assessment for minors, and emergency admission.8 When someone is impaired by a substance, a law enforcement officer can use protective custody procedures to get the person into a safe environment.8


What Are Involuntary Commitment Laws for Drug and Alcohol Rehab?

In most states, the courts can use involuntary commitment laws to get a person into treatment for substance use. By applying legal pressure, the criminal justice system can mandate or encourage treatment, or they can issue it as a condition of parole, probation, or a pretrial release.1 These laws vary from state to state. For example, in California, there can be a multidisciplinary evaluation or court-ordered evaluation to determine treatment placement.9 Professionals can provide intensive treatment, and a referral provides for the person’s continuity of care.9 A 72-hour hold can be placed if a person is deemed a danger to themselves or others or is gravely disabled.9 That person has the right to be informed of what is going to happen during those 72 hours and what will happen following the court proceeding.


Who Pays for Court-Ordered Drug and Alcohol Treatment?

In most cases, the individual must pay for court-ordered rehab, but they can choose the treatment center that meets their budget and specific treatment needs. Treatment approaches can differ, but many start with detoxification and medically managed withdrawal, which is the initial stage of treatment.9 Cost factors include the cost per treatment episode, the length of a stay in rehab, the level of care, whether the facility is for-profit or non-profit, and where the rehab facility is located.10

Does Health Insurance Cover Court-Ordered Rehab?

Involuntary drug rehab can be paid for using health insurance. Depending on the plan you have, you may be responsible for certain copays, deductibles, and coinsurance rates. With a copayment, you have a fixed amount that you pay for a covered healthcare service after you’ve paid your deductible.11 A plan with a lower monthly premium will likely have a higher copayment; a plan with a higher monthly premium will probably have a lower copayment.12

A deductible is an amount you pay for a covered service before your insurance plan begins to pay.13 Once you’ve paid your deductible, you only pay coinsurance or copayment while your insurance provider covers the rest.13 Coinsurance is the percentage of costs of a covered service you pay after you’ve paid your deductible.14

The Affordable Care Act (ACA) of 2010 deems substance use treatment an essential health benefits requirement, which means that any health plan must make provisions for it.15 Any plan purchased through a health insurance provider, via the Marketplace, or through Medicaid or Medicare must make this provision, but coverage amounts are going to vary by plan. It is always a good idea to verify your insurance before deciding on a rehab facility or program.

If you don’t currently have health insurance, you can investigate the different providers that are out there. United Insurance, Aetna, Blue Cross and Blue Shield, Cigna, Humana Health, and Kaiser Permanente offer various plans that cover court-ordered alcohol rehab.

Other Payment Methods

If you do not have a health insurance plan, there are other ways to pay for rehab. Medicaid and Medicare can provide coverage. Some facilities offer sliding scale payment plans and other types of financial assistance, such as scholarships. Loans can also help cover the cost.


How Long Does Court-Ordered Rehab Last?

You might see programs that last 30 days, 60 days, or 90 days days while researching rehab options. However, the length of your stay in rehab will vary depending on factors like disease severity, your mental and physical health, and any prior treatment you’ve undergone. Studies show that better outcomes are associated with treatment programs lasting 90 days or longer and that legal pressure can assist in improving retention rates.16

Early treatment stages aid in stopping substance use and implementing therapeutic changes, while later phases teach coping skills for self-managing a SUD.16 Detoxification is usually the first step and is followed by a formal assessment and recommended treatment plan.10 Detox is medically assisted since withdrawals can range from unpleasant to dangerous, and medications can help reduce the severity of these symptoms.10 Going through the detoxification process under medical guidance is the safest method for getting started, and there are programs out there that can cater to your specific needs.


Find a Rehab Center

If you or someone you know has been struggling with a substance use disorder, American Addiction Centers can help you find the treatment you need. Call for free at . Our admissions navigators are available 24/7 to discuss your drug and alcohol addiction treatment options and help you start on the path to recovery.

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Senior Web Content Editor
Jennifer Fifield is a Senior Web Content Editor at American Addiction Centers and an addiction content expert for drugabuse.com and recovery.org. She holds a bachelor's degree in Broadcast Journalism and a master’s degree in Health Promotion Management. Jennifer has served as a content editor on numerous articles, web pages, and blog posts within the medical, dental, and vision industry. She has 15+ years of experience in higher education including writing/editing, administrative, and teaching positions within the health/wellness, accreditation, and health communications areas.
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