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One state forces opioid abusers to get help. Will others follow?

Christine Vestal, on

Published in News & Features

In Kentucky, Moser said the state plans to use federal and state grants to create secure triage centers in rural areas where there are no hospitals or addiction treatment centers within 50 miles.

And in Massachusetts, at legislative hearings on Baker's emergency commitment proposal, physician groups and hospitals argued that in many parts of the state there would not be enough room at local hospitals and treatment facilities.

Here in Tampa there's little mystery why the Marchman Act is more widely used than anywhere else in Florida. A circuit judge here, infamous among some drug users who weren't quite ready to quit, has dedicated his career to helping people with addictions find treatment and turn their lives around, whether they want to or not.

When he's not hearing Marchman cases, Judge Jack Espinosa Jr. is presiding over drug courts, family courts and juvenile cases. And he does everything in his power, addiction professionals say, to ensure that people who are ordered into treatment stay there.

Marchman Act orders are civil proceedings. Police don't arrest the people they pick up under the law's emergency powers. Instead, they bring them to health care professionals who stabilize and assess them to determine the nature and severity of their addiction.

Once a health care professional has recommended a treatment plan -- which can range from six months of outpatient counseling with medication to three days of detox and 30 days of residential treatment at an average cost of $5,500 to $7,000 -- Espinosa is then asked to order the person to complete it.

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If a patient doesn't show up for treatment on any given day, a sheriff's deputy is sent to pick the person up. "I use the common law powers of contempt of court to enforce the order," Espinosa explained.

"We have better outcomes with our Marchman Act patients than with any of our other patients," said Linda Mann, an addiction specialist at DACCO. "They know Espinosa will send the sheriff around. That gives us leverage we don't have with our other patients."


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