Month: November 2021

What To Do If You Think Someone Has Overdosed

If you are a loved one of someone who is struggling with addiction, the idea that the person you are concerned about may suffer an overdose before you are able to convince them to undergo treatment may be one of your worst nightmares. 

And your fear is in fact a very reasonable one. Drug overdoses are devastatingly common, with yearly overdose deaths having surpassed 100,000 per year in the US, making Americans more likely to die from an overdose than they are from car crashes and gunshot wounds combined. Here are some signs that someone may be experiencing a drug overdose, and some simple instructions that could be life-saving if you do find yourself dealing with someone who you think has OD’d. 

Symptoms of An Overdose

Though symptoms of an overdose can vary depending on what drug has been consumed, the most obvious cause for alarm is if someone appears unresponsive or unconscious, especially if you attempt to wake them and they are unable to be roused. 

Another cause for immediate concern is someone whose breathing has become slow and shallow or stopped altogether, or who has an unusually slow, erratic, or stopped heartbeat. You may also notice choking or gurgling sounds from someone who is choking on their own vomit or on their tongue, or that someone appears to be having seizures. Blue lips or fingernails, pale, clammy skin, and chest pain are other immediate causes for alarm. 

Someone who appears unusually confused, disoriented, anxious, uncoordinated, or agitated may also be experiencing an overdose, or are showing signs that they are in an intoxicated state that may progress towards one. With certain drugs, death may also occur from overheating or dehydration, so keep an eye out for signs of these conditions as well. 

What To Do If Someone Is Experiencing An Overdose

As impossible as it may sound, you should try to stay calm as you work through the situation, and the first thing that you will probably want to do is call 911, and let them know immediately that someone is not breathing if that is the case. 

You should be prepared to tell emergency services your address, or about any landmarks that you are near or your approximate location if you do not know the address that you are at. They may also ask for the person’s age and sex and for any relevant medical information, including what the person has taken, which you should answer as accurately as possible to waste no time in getting them the right treatment. If you have access to any of these drugs,

Then, while you wait for first responders, it may be necessary to perform rescue breathing, if the person has a pulse but is not breathing, or CPR, which involves cycles of rescue breaths and chest compressions, if their heart appears to have stopped as well. 

If the person is unconscious but is still breathing, or if they begin breathing again after you perform rescue breathing, you will want to place them in the recovery position to keep their airway open and reduce the risk that they will choke or their breathing will cease. Turn the person onto their side, bend their upper knee to support their body, and turn their face to the side. Then, tilt their head back and lift their chin to open their airway, and make sure that there is not anything blocking it. 

If you are attempting to revive someone from an opioid overdose, you may also be able to do so with naloxone, which is available as the intranasal spray Narcan as well as in an injectable formulation. If someone you know routinely abuses opioids, you should have naloxone on hand in case of just such an emergency, and know the basics of how to use it. This includes appropriate dosing, since a dose too high may send an opioid user into instant, painful withdrawal, which could prompt them to take more drugs and put themselves at further risk. 

You should also beware that since the effects of naloxone are temporary and it will take the person awhile to clear the opiates from their system, you may need to revive the person with it more than once, even if they do not take any more drugs in the meantime. Other complications of opioid overdose can also occur, so you should still call emergency services so they can monitor and assess the situation rather than attempt to handle it yourself. 

What Not To Do If You Think Someone Has Overdosed

Along with what you should do, you should also be aware of things that you should not do if someone appears to be overdosing. For instance, while it is ok to try to wake someone up and a good idea to try to keep them awake, such as by engaging them in conversation, you should not try to perk them up with coffee or give them anything else to drink. This is unlikely to be helpful but may cause vomiting, which presents the risk of choking. You should also not attempt to induce vomiting for the same reason. 

You should also not try putting the person in a bath to wake them up, as this presents a drowning hazard, or try waking them up with ice, since cooling them down could slow down their system further. Nor should you try injuring them or injecting them with another drug (such as an upper if they have OD’d on downers) or with salt water, as this is unlikely to help matters and is likely to cause further harm. 

You also shouldn’t be afraid to contact emergency services because you fear legal retribution for you or your loved one’s drug use—emergency services will usually not contact the police, and most states have Good Samaritan laws to protect anyone who calls 911 in an emergency even if they have been involved in drug-related criminal activity. 

Finally, do not leave the person alone unless it is absolutely necessary. If another safety issue means that you absolutely must, be sure to put the person in the recovery position before you do so, and to leave the door open so that emergency responders will not have any barriers to reaching the person. And under no circumstances should you let the person resume using the substance they have overdosed on or any other drugs, even if they appear to be “recovered.” 

But the best way of protecting someone from an overdose is preventing it altogether by curtailing a person’s substance abuse. If your loved one has been abusing substances and is uninterested in pursuing treatment on their own, you may be able to have them committed involuntarily using the Marchman Act if certain other conditions are met. To learn more about the Marchman Act or how one of our skilled intervention counselors can help guide you through the Marchman Act process, contact us now at 833.995.1007 or online here.

The Differences Between Residential Treatment And Intensive Outpatient

While addiction treatment can take many forms, perhaps the most meaningful distinction to be found is the distinction between residential and outpatient forms of addiction treatment. If a Marchman Act Petition is successful, a defendant may be court ordered to enroll in either of these treatment formats, depending on such factors as the severity of their illness, the availability of beds, and their family situation. 

Here is a little more information about these different forms of treatment, so that you can assess which one may be right for your loved one and know what to expect depending on which choice you, the courts, or your loved one’s treatment team ultimately end up making. 

What Is Residential Treatment?

Residential or inpatient addiction treatment is probably what most people think of when they imagine “rehab.” These closed facilities require patients to physically live inside the facility, and may be preceded by a period of acute detox (which will typically last for a period of around five to seven days) if it is deemed medically necessary for a physically dependent addict. 

This form of treatment is generally recommended for patients who are suffering from severe substance abuse problems, for whom less intensive forms of treatment have previously been unsuccessful, or who do not have strong support systems or family resources at home, meaning that the risk of relapse is high if they remain in that environment. Residential care may also be recommended for patients who present with violent or suicidal behavior that could constitute a risk if they remained in the community. 

Once a patient moves on from detox to residential treatment proper, they will likely stay for an average of around twenty eight days, with a higher end of sixty to ninety days or even longer for patients who present suffering from severe dependencies. Afterward, the patient may transition into an outpatient program or another less intensive form of treatment before moving on to an aftercare plan, which may still involve regular therapy and regular attendance at support group meetings. 

What Is Intensive Outpatient Treatment?

To be considered an intensive outpatient program, treatment typically involves the patient’s participation in treatment programs for around 8 hours a day on at least 3 days a week, making it an appropriate option for patients who have substance dependencies but who are not at acute physical or psychological risk due to their addiction.

Ideally, these patients should have a strong motivation to get sober and a supportive family environment they can safely reside in while undergoing this treatment. Intensive outpatient is also an attractive option for patients who need to continue to fulfill professional or personal obligations while also receiving intensive treatment for an addiction. 

Does My Loved One Need Residential or Intensive Outpatient Treatment For Their Addiction?

Which form of treatment would be most appropriate for your loved one is dependent on their individual needs, as both options have their own unique pros and cons. For instance, while residential treatment has the benefit of practically eliminating the risk of relapse, it is generally more expensive than outpatient programs, and some patients may find the environment so restrictive that they may forgo treatment entirely rather than endure such restrictive confinement. 

On the other hand, while intensive outpatient allows the patient more opportunity to give in to temptation, it provides the benefit of allowing patients to experience all the tension, responsibilities, and triggers of everyday life while still being supported by the guidance of their treatment program, which is why it is so valuable for patients who are transitioning out of a more restrictive treatment program like residential.

One “middle ground” option that allows many patients to strike a successful balance between freedom and supervision is to enroll in an intensive outpatient program while residing in a sober living residence. This way, they will be subject to more strictures than they would be if they were living on their own or in their family home, but will still be able to attend to obligations in the outside world and adapt to the reality of everyday life without substances. 

Traditional requirements in such sober living homes include the maintenance of a one hundred percent substance free living space, regular drug tests, regular attendance at all treatment program appointments, daily curfews, adherence to household guidelines, and/or daily attendance at the appropriate twelve step meeting (i. e. Alcoholics Anonymous, Narcotics Anonymous, Cocaine Anonymous). 

For more information about the differences between these two forms of substance abuse treatment or how you can use the Marchman Act to help a loved one who is struggling with an addiction, feel free to call our helpline anytime at 833.995.1007 or to contact us online here. Our skilled intervention counselors can guide you through every step of the Marchman Act process, including finding an appropriate inpatient or outpatient facility that is suited to your loved one’s individual needs. 

How Do I Start The Marchman Act Process And What Should I Expect?

While filing the Marchman Act is never an easy thing for a filing family member or their loved one, setting the Marchman Act process into motion is actually fairly simple, only requiring the filing of a Petition for Examination.

The specific procedure for filing this petition varies by county, but to look at Palm Beach County as an example, the petition takes the form of a five page document that requires “specific facts of recent behavior” to support your claim that your loved one is either a danger to themselves or a danger to others or too incapacitated by their substance abuse to recognize their need for care. 

Along with this description sheet, you will also be required you to fill out a date of birth form, notice of related cases, and cover sheet, and will need to get this petition notarized. Then, you will file it to unified family court. Palm Beach County requires no filing fees, but the person you are filing this petition for must be physically located in Palm Beach County at the time of filing. 

Then, in response to this petition, the judge may decide to set a hearing that will take place in the following ten days. Both the petitioner and the respondent are required to be at this hearing, which will determine whether assessment is necessary. The judge may also make an emergency or “exparte” order without hearing, which will take effect immediately. 

Then, law enforcement will be authorized to take the person into custody and to deliver them to the nearest Marchman Act receiving facility. This order will be good for the next seven days, unless the judge specifies that it should last for less. 

Then, the facility will have 72 hours to assess the patient. After that, they will release the patient if they do not meet the criteria for involuntary admission, release them for voluntary inpatient or outpatient treatment if the patient is amenable, or file a petition with the court to request involuntary services.

This petition can only be filed by the facility administrator, not the friend or family member who filed the initial petition for examination, and must include the written opinion of two psychiatrists or clinical psychologists, both of whom must have examined the patient face to face. It is also required that the evaluation prove that no less restrictive treatment option could reasonably be expected to improve the patient’s condition.

Another hearing will be set within five days of the filing of this second Petition for Involuntary Services, and the judge will assign the defendant a public defender unless they have a private attorney. One of the examining psychiatrists must provide testimony, and both sides can call any other witnesses that they wish to. 

Then, if the judge chooses to grant this petition, they will order that the defendant be retained at the facility that assessed them or transferred to a different one that is more appropriate to their needs. They will be ordered to remain in treatment for a period of up to 90 days, and the facility will have the option of filing an additional Petition for Involuntary Services for an extension of the order if they believe the patient requires any additional services. 

The ordered treatment can be inpatient or outpatient, and can only be required based on substance abuse, and not based on another mental health issue (in which case the Baker Act may be more appropriate.) It also cannot interfere with or substitute individual’s existing mental health treatment. 

It’s also worth noting that even inpatient treatment centers are not locked down facilities, so a defendant may choose to leave treatment of their own accord, though they will be risking legal consequences and even jail time if they choose to do so. In this case, a defendant may be ordered back to court for a  hearing that will determine whether they are found in contempt. 

You should also be aware that it will not be the court’s responsibility to find a bed and a receiving facility, or to pay for treatment. A Marchman Act petition also cannot interfere with a criminal case, be used to locate a missing person, or be used solely to make a child obey their parents, though parents can file on a child’s behalf.

For more information about what you can expect and what will be expected of you as you navigate the Marchman Act process, as well as how one of our skilled intervention counselors can guide you through the emotionally fraught proceedings, feel free to contact our helpline anytime at 833-497-3808, or to contact us online anytime here.

Five Signs It Might Be Time To Use The Marchman Act

Someone who finds themselves considering the Marchman Act, the Florida statute that allows for the involuntary commitment of someone who has been abusing substances and meets certain other criteria, is not likely to be taking the matter lightly. Forcing treatment on a loved one is never pleasant for anyone involved, but, in some high-risk situations, it may be the best option to take to ensure their long-term health and safety. The following signs are some serious tip offs that your loved one may be spiraling out of control, and that your intervention may be required.

1. They Are Unable To Manage Their Own Lives

The further one falls into an addiction, the less able they will be to engage in life and attend to even sometimes their most basic responsibilities. Someone who is unable to maintain their professional, personal, or academic obligations due to their substance abuse—i. e., someone who is failing or dropping out of school, quitting or getting fired from a job, or mismanaging significant family responsibilities like childcare, is likely incapacitated enough that the Marchman Act should be seriously considered. 

This also holds true of someone who is only seemingly functional because you or others have been making excuses for them or covering up for their mistakes. The more profound someone’s withdrawal from or inability to cope with life is, the more concerned you should be.

2. Their Physical Health Is Deteriorating

If someone persists in their substance abuse despite the fact that it is causing them serious health consequences, intensive professional treatment is most likely needed. If someone refuses to stop or curtail their use even after showing clear signs of drug-related health issues—for instance, liver problems or cognitive impairment due to alcohol abuse— you absolutely have grounds to step in. 

You may also want to be aware of visual signals of a severe drug problem, such as someone who is seriously underweight. You might notice open sores from untreated wounds, possibly acquired from the injection of IV drugs, or that someone has stopped paying attention to even basic personal hygiene. 

3. They Are Engaging In Increasingly Risky Behavior

Whenever someone uses illicit drugs or abuses legal ones, they are putting themselves at at least some risk, but a pattern of escalating risk-taking demonstrates pretty clearly that that Marchman Act may be warranted. Along with the risks arising from drug use itself, you may notice that someone is engaging in unsafe sex while intoxicated, or engaging in behaviors that come with the risk of legal consequences to be able to abuse or afford drugs, like stealing, intoxicated driving, shoplifting, or even attempting to forge prescriptions. 

Another cause for alarm is escalation in the substance abuse itself: someone switching from snorting or smoking a substance to injecting it, from prescription opioids to a street drug like heroin, or from habitual use to constant intoxication. For certain drugs, and certain drug combinations, overdose is a very real threat that requires the utmost precautions be taken, even if that means involuntary commitment.

4. Their Behavior Or Mental State Has Become Increasingly Volatile

Someone who is out of control due to their addiction may demonstrate increasingly unpredictable behavior. They may appear inordinately depressed or worryingly grandiose or paranoid, going on crying jags or flying into rages at the drop of a hat. They might regularly be so high that they have trouble understanding what is going on or relating to you in any meaningful way, or may even appear be out of touch with reality altogether.

Additionally, you should also be concerned if someone who you believe is suffering from addiction suddenly disappears or becomes uncommunicative. It may be worth tracking them down and attempting to use the Marchman Act in case they have gone off the grid because they are in crisis, in which case you might be able to stop a dangerous spiral. 

5. They Show Signs Of Being A Danger To Themselves Or Others

Patterns of escalating use and increasing emotional instability tie into the most important sign it might be time to use the Marchman Act: if someone is clearly a danger to themselves or others. Danger to others can take the form of abuse or threats of abuse, or another actual or attempted crime, such a threat of harm if someone does not provide them with money for drugs.

It can also involve behaviors like drunk driving, or someone who is engaging in another dangerous activity while intoxicated (e.g. a doctor performing surgery, a pilot flying). Danger to others might also take the form of a parent who is routinely attempting to care for children while also showing signs that they are suffering from a serious substance abuse problem that impairs their judgement. 

As far as danger to oneself, along with neglect of one’s health or escalating drug use, you should beware of potential suicidality. Someone who describes wanting to die or states that they do not care if they do is raising a serious red flag, and in this case, the Baker Act might be an option as well.

As tragic cases like the one behind Casey’s Law indicate, it is far better safe than sorry if you are worried about someone who is exhibiting any of these signs or who is otherwise seriously incapacitated. For guidance on whether the Baker Act or the Marchman Act is more appropriate for your loved one, or for any other questions or inquiries about the Marchman Act and how to begin the process of filing a Marchman Act petition, feel free to call us any time at 833-497-3808, or to contact one of our skilled intervention counselors using this online form