Annie first suspected her son, Jack, was using methamphetamine in mid-2020. She was getting ready for bed one night when she heard noises downstairs. Jack had just returned from work and Annie believed he was either playing games or fixing his car.

When she went downstairs the next morning, he was there, looking flushed.

"I questioned why he looked so flushed, and if he was on ice. He said, 'Yeah, Mom.' I asked if he was serious about it, and he said he was just kidding. I just knew something was off," Annie said.

Her intuition would unfortunately prove right. Jack has been in conflict with law enforcement on a few occasions. He doesn't speak much to his mother when high, she said, but Jack will confirm when he is. He carries weapons with him, makes threats and becomes vulgar.

"It's as if he fears for his life, like someone's out to get him," Annie said. "He isn't aware that he is having hallucinations."

The transformation was a stark departure from the reserved and hardworking son she had known. But Annie, as his mother, doesn't believe Jack is a bad person. He had known the wrong people at work, she said, and they convinced him to use meth.

Now Annie is desperate to help her son.

"What would it take for my son to get the help he needs? I wouldn't want my son to commit a serious crime, such as rape or murder," she said. "I constantly have been waking up with heart palpitations, and think to myself that I am in a nightmare."

"Annie" and "Jack" are pseudonyms. The Guam Daily Post has agreed to maintain their anonymity.

It's no secret that meth is the greatest contributor to the island's drug epidemic, and Annie has tried getting Jack help. She reached out to police and the treatment centers on Guam. She even sought help from suruhanus and a priest. But these ventures proved unsuccessful. Jack remains on drugs and when she or her husband try to push him to get help, he retaliates and says he doesn't need it, according to Annie.

Treatment is voluntary

Jack is an adult, a young man, and would have to voluntarily commit to treatment. But Annie would like to see legislation that would grant parents authority over their adult children who are under the influence of drugs.

"I would like to be able to put my son under some sort of rehabilitation center without having his consent, especially if it's in his best interest," Annie said.

More than 30 states do have involuntary commitment laws for people suffering from alcoholism or substance abuse, but not Guam.

According to Guam Behavioral Health and Wellness Center Director Theresa Arriola, it is not unusual for parents to petition the court to deem them guardians of adult children who have diminished mental capacity.

"But if it's just, for example, very caring and loving parents of an adult who happens to make the wrong choices and get into drugs, the best thing a parent can do is to continuously talk to their child and convince them to come to Guam Behavioral Health for services," Arriola said. "But at any given time, this adult person could just walk away and say, 'I'm not ready,' and leave."

It is only through a court order that assessment and treatment would be involuntary, meaning the individual would be going through some criminal or legal proceeding.

"A lot of parents of adult children who get picked up for, let's say, driving under the influence ... that is sometimes a blessing in disguise, because they get into the court system and the court system determines they should be assessed, and so it's ordered," Arriola said.

Otherwise, substance abuse and mental health services, which include treatment for depression and suicidal ideation, is voluntary.

Research and future discussions

There are pros and cons to involuntary commitment. Factors include personal rights and the concept that recovery is a personal choice, and that there is a greater chance of maintaining sobriety when a person decides to make the change to stay with treatment, according to Arriola.

A National Judicial Opioid Task Force report on involuntary commitment and guardianship laws notes that professionals generally agree that involuntary commitment can and often does save lives, but a person must receive effective, evidence-based treatment while in confinement.

Sen. Mary Torres once raised the issue of involuntary confinement with Behavioral Health but those discussions were tabled as the agency worked on completing its intense detox unit.

With the unit opening Tuesday, Torres said she hopes to continue discussions and weigh the facility's resources against factors surrounding involuntary confinement.

"Most jurisdictions that have authorized this type of treatment have strict commitment standards, requiring not only proof of substance addiction, but also evidence of potential harm to themselves and others, that the individual lacks the ability to care for themselves, or that there is no suitable adult willing to provide for such needs," Torres said.

As the senator noted, successful treatment also depends on the financial and space capabilities of the provider.

"Because it is involuntary, the facility often needs to be secured to ensure the safety and treatment efficacy of the patients, otherwise people can simply elope from treatment," Torres said. "To balance these restrictions and protect the liberties of the individual, many states have called for stringent procedural and substantive laws pertaining to civil commitment for substance dependence."

But with all that said, Torres acknowledged that involuntary commitment creates a pathway for families who don't want to see their loved ones "hit rock bottom" or face criminal charges.

Arriola said she is available for further discussion with the senator.

But the issue also reaches Arriola on a personal level.

"I have many adult friends who have adult children who find themselves with these difficulties," the director said. "One of the things I tell my friends and family is, 'Continue to be there and support your child.' The best you can do at this point is constantly let your child know they are not alone in having to deal with the ups and downs of life or addiction. That there is a way out."

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