If there is danger right now
If the person may be overdosing, is threatening to harm themselves or someone else, or is in a medical emergency, call 911. For a suicidal or mental health crisis, you can also call or text 988, including to get advice as a worried family member.
Emergency services can respond to the immediate situation. What happens afterward depends on the person's condition and the laws where you live.
Why adults usually decide for themselves
State rules generally protect an adult's right to accept or refuse treatment; Texas's client bill of rights for treatment facilities, for example, includes the right to refuse it. Laws that allow involuntary treatment are exceptions with specific conditions, court oversight and legal protections for the person. They are designed for serious situations, not for disagreements about whether someone should get help.
That can be very hard to accept when you can see the harm. It helps to know what the law in your state actually allows before you plan around it.
Rules vary by state
The examples below come from official pages in four states. They show how different the rules can be. They are not legal advice, and the details and procedures change. If you are considering a court process, speak to a lawyer or the local court or county office that handles these cases.
In Texas, Health and Safety Code chapter 462 allows a county or district attorney or another adult to file a sworn application for court-ordered treatment of a person with chemical dependency. Except when filed by a county or district attorney, the application must be accompanied by a certificate of medical examination. The application must state that the person is likely to cause serious harm to themselves or others, or will continue to deteriorate and cannot make a rational and informed choice about treatment. The court appoints a lawyer for the person if they do not have one, and the criteria must be proved by clear and convincing evidence. If the court orders treatment, the order is for at least 30 and not more than 90 days.
In California, a state law known as SB 43 changed the definition of “gravely disabled” in the state's involuntary treatment law. DHCS's FAQ on SB 43 says the definition now includes people who, because of a severe substance use disorder, are unable to provide for their basic needs for food, clothing, shelter, personal safety or necessary medical care. The same law's processes include a 72-hour hold and, in some cases, longer periods of treatment or conservatorship. The FAQ notes counties could delay implementing the change until January 1, 2026.
In Pennsylvania, the state's Mental Health Procedures Act says that people who are alcohol or drug dependent receive mental health treatment under that act only if they are also diagnosed with a mental illness, and that dependence alone is not considered mental illness. The act also states that voluntary treatment is preferred to involuntary treatment.
In Arizona, the state Medicaid program's page on court-ordered evaluation and treatment says that process applies to people with a mental disorder who meet certain criteria, and that people with substance use disorders are not eligible unless their behavior results from a different mental disorder.
What NIDA says about pressure and treatment
NIDA's Principles of Drug Addiction Treatment says treatment does not need to be voluntary to be effective. It says pressure from family, employers or the criminal justice system can increase how many people enter treatment, how long they stay and how well they do, and that people who enter treatment under legal pressure can do as well as those who enter voluntarily.
That finding is about outcomes, not a recommendation to use any particular kind of pressure. Pressure from family can mean a clear, honest conversation about what you have seen and what you will and will not keep doing. It does not have to mean threats, surprise confrontations or ultimatums you cannot keep.
What you can do without a court
You can tell the person, calmly and specifically, what worries you and what help you are willing to offer. The guide on starting a conversation about substance use covers how.
You can find out what treatment would involve so that, if they become open to it, you are ready. The guide on contacting treatment services for someone else explains what a program can and cannot discuss with you.
You can decide which of your own limits you will hold, such as not lending money, not covering for missed work or not providing a place to stay if there is drinking or drug use there. If they refuse, the guide on when someone does not want the help you are offering covers what you can still do.
If the person is already involved with a court, probation or a drug court, those bodies may be able to require treatment as part of their process. That is between the person, their lawyer and the court.
Get support for yourself
Watching someone refuse help is exhausting and frightening. Support groups for family members, and counselors who work with families, can help you think through your options and look after your own health, whatever the person decides.
Activities from this guide
Your checklist
Read the steps now. A free account lets you save your own checklist.
- 1. Know when to call 911 or 988
- 2. Find out what your state's law allows
- 3. Decide which of your own limits you will hold
About this guide
AI-generated editorial image; it does not depict a real person or event discussed in this guide.
Examples in this guide are illustrative, not reported experiences.
SoberSphere provides independent general information, not individual medical, legal or financial advice. No provider referral, affiliate arrangement or specialist review is claimed.