Standards on Substance Abuse: Standard VII. Screening

Standard VII

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.

Commentary

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.