As of now, the state cannot make anyone get treatment.

LEWISTON – Karen Horton didn’t know what to do when her son stopped going to school and started coming home drunk every afternoon.

She knew he was upset that she had left his father. But he wouldn’t talk about it. She knew he missed his older sister, who was living with friends in Portland. But he wouldn’t talk about it.

He simply drank and got high, then came home and picked fights with her.

Desperate to help her son before he hurt himself or someone else, Horton called every drug and alcohol rehabilitation program in the state.

The response was always the same: Her son must be willing to get help. She couldn’t force him into a program, unless she could get a psychologist to confirm that he was mentally ill and a danger to himself or others.

In Maine, people cannot be involuntarily committed into a treatment program for substance abuse.

The state’s long-standing position has been that forcing people who haven’t committed a crime to be locked up against their will is a violation of their civil rights.

Although most people agree this makes sense when dealing with adults, many have questioned whether an exception should be made for juveniles.

“We don’t want to restrict people’s rights,” said Sen. Peggy Rotundo, D-Lewiston. “But, under the existing law, there is nothing that can be done unless a young person gets in trouble with the law.”

Rotundo began questioning Maine’s law for dealing with young addicts after she got a call from Horton.

After meeting with the distressed mother, Rotundo drafted a bill to allow for the involuntary commitment of people under 18 whose substance abuse problems make them a risk to themselves or others.

The bill never made it to a vote. It did, however, prompt the Maine Legislature to ask for a study on the issue.

Headed by the state’s Office of Substance Abuse, the study took a look at Maine’s services for minors with substance abuse problems compared with services in other states. It also looked at problems associated with court-ordered treatment for substance abuse when criminal charges aren’t involved.

One of the biggest challenges is money.

The Office of Substance Abuse stated in its report to the Legislature that courts would most likely be responsible for deciding whether a person qualifies for involuntary commitment, and the extra time and paperwork could be costly. Involuntary commitment would also create the need for space in treatment wards.

“Placing a child in a locked ward may also have long-term psychological consequences,” the report concluded. “If a young person is ordered to treatment against their will, they must be in a locked facility or face incarceration for violating the order. This places criminal penalties on a person with no criminal charges.”

No consensus

The study revealed that every state handles the matter differently. Some have separate policies for adults and juveniles. Some don’t. Some group the mentally ill with substance abusers.

Some, including Maine, have policies for locking up the mentally ill but do not specifically address substance abuse.

“I thought that there would be at least some direction by looking at the other states, but there wasn’t any consensus,” said Kim Johnson, director of the Office of Substance Abuse.

Johnson believes Maine eventually will come up with a way to lock kids up against their will to get drug and alcohol treatment.

But before that step is taken, she said, more information needs to be gathered about how existing programs could be improved to help kids in need and how many people would benefit from involuntary commitment.

“We’ll have to frame it in a way that doesn’t violate people’s rights,” Johnson said.

“We are all concerned with issues of civil liberties,” Rotundo added. “Involuntary commitment is a serious step to take. Yet, when you hear Karen Horton’s story, it is very compelling.”

‘The best thing’

Horton’s son was 15 when she finally gave up and told him to get out. That night, she kept the doors to her Park Street apartment locked until 11:30 p.m., when she could no longer tolerate the sound of the doorbell as he rang it over and over again.

She let him in and later, as she was sitting on the couch under a blanket, he waved a lighter in her face. Then, with one quick motion, he lit her blanket on fire and sat on top of her as the flames spread to her shirt.

Horton was able to push her son to the side and pat down the flames before they reached her face.

She called police the following morning. Her son was charged with terrorizing and was taken to the former Maine Youth Center, where he underwent drug and alcohol treatment for the first time.

“It was the best thing for him,” Horton said, more than two years later. “But I wish things didn’t have to get so bad first.”

Horton’s son was released from the youth detention center, then sent back later for a charge of possession of drug paraphernalia. He no longer speaks to his mother.

Horton wonders if the situation would be different if her son got help before things got out of hand.

“I know that locking kids down would be controversial,” Horton said. “It wouldn’t be for the kid who smokes a joint for the first time. It would be for the ones with serious problems”

How many?

Johnson, of the Office of Substance Abuse, is trying to find out how many kids need treatment but refuse it, in order to determine whether a system for involuntary commitment is necessary.

The exact number may be impossible to determine, but Johnson has started by asking agencies that deal with homeless teens to start tracking how many of them refuse treatment for substance abuse.

She is also exploring the benefits of training substance abuse counselors on how to better deal with the kids whose parents manage to get them in the door despite their unwillingness to get help.

“We have to take out the easier parts before we tackle what is left,” Johnson said. “But I think we will have something left.”

Johnson plans to submit a more detailed report to the Legislature next fall.

“When I put in the legislation, I was interested in having people re-examine the issue,” Rotundo said. “What the solution is isn’t clear yet. But we are getting closer.”

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