If there is an indication that substance abuse is a factor in a case, at the earliest stage and at any stage, the court is encouraged to use tools for prompt screening. Screening is a mechanism for rapid initial determination whether it is appropriate for a person to undergo a substance abuse assessment (as provided in Standard VIII) or to participate in a treatment program. In performing screening, courts should observe applicable constitutional and statutory safeguards, including the right to counsel and the privilege against self-incrimination.
The purpose of screening is to provide the court rapidly with information regarding any drug or alcohol factor in a case. Screening results usually provide a sufficient clinical basis for a court order directing a person to appear for a substance abuse assessment (as provided in Standard VIII) and to undergo treatment, but in some cases the judge may prefer to refer the person for a substance abuse assessment before ordering treatment. The probation department is responsible for conducting screening and recommending whether a substance abuse assessment is appropriate.
Screening is the first stage of the diagnostic process, but an assessment is necessary for full and clear understanding of a party's substance abuse. Screeners look for possible abuse of alcohol or other drug; primary substance used, if any; symptoms of acute mental health problems; signs of acute intoxication or withdrawal; other medical problems, particularly infectious diseases such as HIV/AIDS or tuberculosis; motivation or readiness for treatment; criminal history; prior involvement in treatment; and use of psychotropic medication.
Judges and other court personnel should be aware that a defendant or party who is shaking or suffering from flu-like symptoms may need detoxification, a medical intervention to manage withdrawal symptoms caused by abstinence from alcohol or drugs. Since such withdrawal can cause very serious medical problems, and can be life-threatening in the case of alcohol, the judge should initiate an appropriate response, such as directing the probation department to refer the person to a treatment facility or, if involuntary commitment is necessary, initiating a commitment for detoxification pursuant to G.L. c. 123, §35. If the person is remanded to the House of Correction, the mittimus should make a clear statement concerning the need for detoxification.
Even if a screening cannot be performed, courts should consider the indications of substance abuse to the extent allowed by law.
Francis V. Kenneally, Clerk
Maura S. Doyle, Clerk
Jennifer Donahue, Public Information Officer
1 Pemberton Square, Suite 2500
Boston, MA 02108