This document discusses laws enacted as a result of parental advocacy around substance abuse issues. It summarizes Casey's Law, a law passed in Kentucky that allows involuntary substance abuse treatment. It was inspired by the death of Matthew Casey Wethington from a heroin overdose at age 23. The law allows parents, relatives or friends to petition the court to require someone to undergo treatment if they are unable to recognize their need for treatment due to impairment. It outlines the petition process, required evidence, evaluations, hearings, and possible outcomes including court-ordered treatment. The presenters aim to help advocates identify laws in their states, explain their components, and apply successful models elsewhere.

1. Education & Advocacy Track:
Parent Advocates
Moving Legislation
Presenters:
• Karen H. Perry, Co-Founder and Executive Director, Narcotics
Overdose Prevention and Education (NOPE) Task Force, and
Member, Rx Summit National Advisory Board
• Gary R. Martin, EdD, Dean of Students, Lynn University, and
Vice President, NOPE Task Force
• Charlotte Wethington, MA, Recovery Advocate, Transitions, Inc.
Moderator: Michael C. Barnes, JD, Executive Director, Center for
Lawful Access and Abuse Deterrence (CLAAD), and Member, Rx
Summit National Advisory Board

2. Disclosures
• Karen H. Perry; Gary R. Martin, EdD; Charlotte Wethington;
and Michael C. Barnes, JD, have disclosed no relevant, real,
or apparent personal or professional financial relationships
with proprietary entities that produce healthcare goods and
services.

3. Disclosures
• All planners/managers hereby state that they or their
spouse/life partner do not have any financial
relationships or relationships to products or devices
with any commercial interest related to the content of
this activity of any amount during the past 12 months.
• The following planners/managers have the following to
disclose:
– Kelly Clark – Employment: Publicis Touchpoint Solutions;
Consultant: Grunenthal US
– Robert DuPont – Employment: Bensinger, DuPont &
Associates-Prescription Drug Research Center
– Carla Saunders – Speaker’s bureau: Abbott Nutrition

4. Learning Objectives
1. Identify state laws enacted as the result of
parental advocacy.
2. Explain the purpose and components of the
Overdose Prevention Act.
3. Describe Casey’s Law for involuntary
treatment, as well as its passage, impact and
applicability to other states.

5. Parent Advocates Moving
Legislation
Karen H. Perry
Co-Founder, Executive Director
NOPE Task Force
Gary R. Martin, Ed.D
Dean of Students, Lynn University

6. Disclosure Statement
Karen Perry and Gary Martin
have no financial relationships with
proprietary entities that produce
health care goods and services

7. Learning Objectives
1. Identify state laws enacted as the result of
parental advocacy.
2. Explain the purpose and components of the
Overdose Death Prevention Act- “Richie’s
Law”
3. Describe Casey’s Law for involuntary
treatment, as well as its passage, impact and
applicability to other states.

8. Richard Perry
Age 21

9. FloridaHospitalConsenttoTreatment

10. Hospital Release Orders

11. Facts
• In 2013, there were 35,663 unintentional
drug overdose deaths in the United
States.
(Source: Center for Disease Control)
• 2.5 million emergency department visits
are attributed to drug misuse or
overdose.
(Source: Drug Abuse Warning Network (DAWN), 2011 National ED
Estimates)
• 26.8% of the people who died from a
drug overdose had experienced a prior
drug overdose with a hospital visit. (Source:
Palm Beach County Sheriff’s Office Overdose Suppression Project 2013)
• 82.3 % of the decedents had a known
substance abuse history
(Source: Palm Beach County Sheriff’s Office Overdose Suppression Project
2013)
• 51.3 % of the decedents were under the
care of a physician
(Source: Palm Beach County Sheriff’s Office Overdose Suppression Project
2013)

12. Heart Attack Victim Care
The first 24 hours following a heart attack are usually spent in
a coronary care unit (CCU) or an intensive care unit(ICU).
Where skilled staff will:
•Continuously monitor your heart rhythm
•Administer a series of test and blood work
•Administer medication as needed
•Review patient’s history
•Contact primary care and/or cardiac care physicians

13. Cardiac Care Day Two
If you remain stable after 24 hours
You may be transferred to the
"telemetry" floor of the hospital
• Continue to receive care by a
cardiac care team.
• Depending upon the severity of
the heart attack and how quickly
you received treatment, you may
be able to go home within two to
four days.

14. Overdose Patient
Treat and Street

15. Intervention Point

16. Overdose Death Prevention Act
(ODPA)
A bill that requires specific
rules that would apply to
an emergency care
practitioner when the
patient suffers a non-fatal
unintentional overdose.

17. ODPA Rules and Procedures
• Proper medical
stabilization (detox)
• Substance Abuse
Screening Brief
Intervention and
Referral to Treatment
(SBIRT)

18. ODPA Rules and Procedures
• Notify patient’s
primary care physician.
• Notify all patient’s
prescribing doctors
within last 12 months.

19. ODPA Rules and Procedures
• Notify the patient’s
emergency contact or next
of kin.
• Provide materials on
addiction treatment,
treatment facilities and
practitioners.
• Provide local involuntary
treatment laws.

20. HIPAA
The HIPAA law currently indicates that emergency room
physicians may notify next of kin if they feel it important
or necessary for survival of the patient.
This linked-document (authored by the U.S. Department of Health and
Human Services) provides a summary of the HIPAA Privacy
Rule. http://www.hhs.gov/ocr/privacy/hipaa/understanding/summary/in
dex.html

21. HIPAA
Federal Register-Volume 65. No. 250 (12-28-2000) Section
164.502(g) – Personal Representatives
“We continue to allow covered entities to use their discretion
to disclose certain protected health care information to
family members, relatives, close friends, and other persons
assisting in the care of an individual, in accordance with
164.510(b). We recognize that many health care decisions
take place on an informal basis, and we permit disclosures in
certain circumstance to permit this practice to continue.
Health care providers may continue to use their discretion to
address these informal situations” (p. 82501).

22. Readmissions
Because Centers for Medicare
& Medicaid Services will
penalize hospitals that see
too many patients return
within a month, now is the
time to create strategies to
avoid readmissions.

23. Local Overdose Death Data
247 drug overdose
deaths in Palm Beach
County in the year 2012
• More than Suicides
• More than Homicides
• More than Fatal Car
Accidents

24. Combining and Mixing Drugs
• Multiple contributable
drugs found in majority
of overdose fatalities
• Average of 2.7 drugs
found in overdose cases

25. 81
66
41
231
54
84
11
0
50
100
150
200
250
Cocaine Alcohol OTC Prescription Drugs
Only
Illicit Drugs Only Prescription and
Illicit Drugs
Not Toxicology
NumberofDecedentswithDruginToxicology
Toxicology Findings
Compiled from 304 Closed Overdose Death Investigations

26. 2
9
78
51
78
69
11
1
3
0
2
0
10
20
30
40
50
60
70
80
90
0-10 11-20 21-30 31-40 41-50 51-60 61-70 71-80 81-90 90-100 Unknown
NumberofDecedents
Years of Age
Decedent's Age
Data Compiled from 304 Closed Overdose Death Investigations

27. 82.57%
43.09%
36.18%
22.04%
26.64%
20.72% 18.75%
51.32%
15.79%
33.22%
0.00%
10.00%
20.00%
30.00%
40.00%
50.00%
60.00%
70.00%
80.00%
90.00%
100.00%
Substance
Abuse
History
Substance
Abuse
Treatment
Drug Related
Arrest
Suicide
Attempt
Non-Fatal
Overdose
Marchman
Baker Act
Bipolar
Diagnosis
Receiving
Medical
Treatment
Pain
Management
Patient
Employed at
Time of
Death
Decedent's History
Data Compiled from 304 Closed Death Investigations

28. 40.13%
32.57%
67.76%
38.16%
59.87%
48.68%
35.20%
17.43%
0.00%
10.00%
20.00%
30.00%
40.00%
50.00%
60.00%
70.00%
80.00%
Died in
Municipality
Taken to Hospital Died at Home Discovered by
Family
Died While Others
Present
Others Aware of
Fatal Drug Use
Others Recognized
Victim's Distress
Unusual Snoring
Heard
Circumstantial Variables
Data Compiled from 304 Closed Overdose Death Investigations

29. Education and Advocacy
 Be informed of local
issues
 Build relationships
 Educate Legislators and
community partners
 Create tool kit for
community partners
 Attend and provide
testimonials at
important legislative
meetings

30. Contact Information
Karen H. Perry
NOPE Task Force
561-478-1055 x201
kperry@nopetaskforce.org
Gary Martin, Ed.D.
Lynn University
561-237-7157
gmartin@lynn.edu

31. Parent Advocates
Moving Legislation
Charlotte Wethington, MA
Recovery Advocate
Transitions, Inc.

32. Disclosures
• Charlotte Wethington, MA, has disclosed no relevant, real, or
apparent personal or professional financial relationships with
proprietary entities that produce healthcare goods and
services.

34. Casey’s Story
Passion

38. Purpose

39. Matthew Casey Wethington Act
for Substance Abuse Intervention

40. What is Casey’s Law?
• An involuntary
treatment act in
Kentucky for those
who suffer from the
disease of addiction

41. History of the Act
• Became a law on April 9, 2004
• Became effective July 13, 2004 in
Kentucky
• Inspired by the death of Matthew Casey
Wethington, who died of a heroin
overdose at the age of 23

42. What does this
law provide?
Who can use the
law?
• A means of
intervening with
someone who is
unable to recognize
his or her need for
treatment due to their
impairment
• Parents, relatives
and/or friends can
petition the court for
treatment on behalf of
the person who is
impaired

43. First Step
• Obtain the petition
from:
– Your local Circuit
Court Clerk’s Office –
ask for Ask for the
Verified Petition for
Involuntary Treatment
(Alcohol/Drug Abuse)
otherwise known as
form AOC 700A
– www.caseyslaw.org

44. Definitions for Completing the
Petition
Respondent Petitioner
• The person needing
substance abuse
intervention
• The person seeking
to involuntarily
commit someone
else into treatment

45. Steps for Completing the Petition
• Step One: Enter the Respondent’s name,
address and physical residence
• Step Two: Enter Petitioner’s name,
address and physical residence
• Check box that corresponds with
Petitioner's relationship to the Respondent
• Step Three: Check box that corresponds
with Petitioner's relationship to the
Respondent

46. Steps for Completing the Petition
• Step Four: List the name, address and
residence of persons related to the
Respondent
• Step Five: Provide all evidence Petitioner
has that Respondent has an alcohol/drug
abuse issue
• Step Six: Attach additional sheets of
paper if needed

47. Evidence for Alcohol/Drug Abuse
• Witnessing
intoxication
• Witnessing drug use
• Behavioral changes
• Failing drug screens
• Criminal substance
abuse charges
• Theft
• Track marks
• Loss of interest
• Occupational, social
issues
• Admitting
alcohol/drug issue
• Changes in physical
appearance

48. Steps for Completing the Petition
• Step Seven: Provide all evidence to
support why Petitioner believes the
Respondent is a danger or threat of
danger to self, family or others
• Attach additional sheets of paper if needed

49. Evidence of Threat
• Respondent has threatened or talked of
suicide
• Respondent has threatened or talked of
harming others (homicide)
• Respondent is unable to provide basic
survival needs (homeless, unemployed)
• History of driving while intoxicated
• Theft (breaking into homes, stealing from
others…)
• History of Overdose

50. Steps for Completing the Petition
• Indicate what length of treatment the Petitioner is
seeking
• Involuntary treatment for:
– 60 consecutive days or less
– 360 consecutive days or less
• Sign and date the petition
• Swear before the Court Clerk (staff) that all in the petition
is true
• Petition is then presented to a District Court Judge
• The District Court Judge will then decide if there is just
cause to continue with the petition

51. The Final Step in Filing
• By signing the petition, the petitioner
guarantees payment for ALL COSTS
incurred on behalf of the respondent
• This includes but is not limited to the initial
evaluations, transportation and placement
in a treatment program

52. What Now?
• If the Judge agrees that there is just cause
he/she will:
• Set a hearing date
• Order the Respondent to be examined by
both a Licensed Physician and a Qualified
Health Professional (Psychiatrist, CADC,
LCSW, LRN)
** (Most counties require the names of the
two evaluators upon filing the petition) **

53. The Hearing
• The hearing must be conducted within 14
days of the Petition being signed by the
Judge
• The Judge can chose to set the date sooner
if the examinations can be completed
• Or the Judge can extend the hearing date if a
problem with the evaluations arise
• The Respondent will be represented by legal
counsel on the day of the hearing

54. Summons of Involuntary Treatment
• The Respondent is then notified to attend
both examinations and to appear at the
scheduled hearing
• The Respondent can request that a Qualified
Health Professional (at the Respondents
expense) be permitted to witness and
participate in their examinations
• The Respondent is also notified that failure to
comply with this summons may result in
being held in contempt of court

55. Appointment of Counsel
• A public defender is appointed to
represent the Respondent and is obligated
to represent the desires of the Respondent

56. Examinations
• The Petitioner is responsible for the cost
and the selection of the two evaluators,
one of which must be a physician
• Have the examination appointments set
when filing the petition
• If the Respondent does not keep the
scheduled appointments he/she can be
held in contempt of court

57. Examinations
• The Judge may order that the Respondent
be held on a 72 hour hold if he/she feels
the Respondent is in imminent danger
• The Petitioner is responsible for all fees
associated with the cost of evaluations

58. Certification of Qualified Health
Professional
• This form is completed by the professional
completing each examination
• It is then sent to the court no longer than
twenty-four (24) hours prior to the hearing
• This also provides the professional’s
recommendations for treatment

59. At the Hearing
• The Judge will examine all evidence
including but not limited to:
– Respondent’s testimony
– Petitioner’s testimony
– Examination reports

60. Judgment and Order for Involuntary
Treatment
The Court will be looking for three things:
1. Does the Respondent suffer from
alcohol and/or other drug abuse; and
2. Does the Respondent present an
imminent threat of danger to self, family or
others as a result of alcohol and other
drug abuse; and
3. Can the Respondent reasonably
benefit from treatment?

61. Judgment and Order for Involuntary
Treatment
• If the Judge feels that all three criteria are
met, then the Judge will order treatment
• Since the Petitioner is responsible for
payment of any ordered treatment, the
Petitioner also chooses where the
Respondent will complete treatment

62. Judgment and Order for Involuntary
Treatment
• The Judge determines who will be
responsible for transportation of the
Respondent to the treatment program
• If the Judge orders the Sheriff’s office to
transport, then the Petitioner may be
responsible for reimbursement to the
Sheriff’s office for the cost of transportation

63. Noncompliance
• So what happens if the Respondent fails
to complete anyone of these steps?
• The respondent may be held in Contempt
of Court
• Contempt of Court is punishable in jail by
any length of time the Judge sets each
time the Respondent does not complete
the Judge’s orders

64. Passion + Purpose + Persistence= Power

65. 7
BE
PERSISTENT
5
CREATE
A
PLAN4
IDENTIFY
YOUR
MISSION
3
FIND
ALLIES
2
DEFINE
YOUR
PURPOSE
1
HONOR
YOUR
PASSION
THE SKY’STHELIMIT
6
TAKE
ACTION

66. Charlotte Wethington, M.A.
Recovery Advocate
Transitions Inc.
cwethington@transitionsky.org
http://caseyslaw.org/
https://www.facebook.com/caseywethingtonact