Insanity Defense Includes Meth Psychosis and Other Permanent Disorders Caused by Drug Abuse

 State v. Abion (HSC December 29, 2020)

Background. Ramoncito Abion was charged with assault in the 2d degree. Prior to trial, Abion moved for an examination to determine his fitness to stand trial and his penal responsibility. One of the examiners, Dr. Martin Blinder, concluded that at the time of the assault, Mr. Abion was suffering from a disorder that precluded penal responsibility. Dr. Blinder believed that the disorder was caused by prolonged methamphetamine use. The prosecution moved to preclude Dr. Blinder from testifying at trial on the grounds that his testimony was irrelevant.


The prosecution argued that self-induced intoxication is excluded from the lack-of-penal-responsibility defense and that Dr. Blinder’s testimony would be irrelevant. At the hearing, Dr. Blinder expanded on his opinion. He diagnosed Abion with methamphetamine psychosis. Dr. Blinder explained that methamphetamine can cause “structural changes in the brain” that will render someone “periodically psychotic.” The changes may become permanent even when the drug use ends. Not everyone experiences this psychosis. Dr. Blinder testified that some may have a genetic predisposition for schizophrenia that is latent and will not be triggered without the amphetamine use. Dr. Blinder concluded that Abion would not have had the psychosis had he not used methamphetamine. He also noted that during his interview with Abion, Abion discussed an “auntie” that spent time in a mental hospital and Abion may have that genetic disposition for psychosis.


The circuit court, with the Hon. Judge Richard Bissen presiding, granted the prosecution’s motion and precluded Abion from calling Dr. Blinder as a witness at trial. The circuit court relied on State v. Young, 93 Hawai'i 224, 999 P.2d 230 (2000).


At trial, the prosecution presented evidence that Abion was lying down on the ground near a convenience store and gas station in Waiehu, Maui. The complainant, who worked at the store, was putting kitty litter on a pool of oil near the gas pump and told Abion he had to leave. She observed Abion talking and laughing to himself. She asked Abion to leave, but he did not respond. When she cleaned up the oil spill she turned her back from Abion and started to walk away. Other witnesses saw Abion stand up and hit the woman in the head with a hammer in his backpack. She fell to the ground and Abion walked away.


The police arrested Abion. Abion told the police that the woman swept dust in his face. He appeared cooperative and animated. The officers also did not detect any signs of impairment or intoxication. The officers also noted that Abion displayed bizarre behavior, reported that he heard voices, saw visions, and was unusually suspicious.


The circuit court instructed the jury on the insanity defense. Defense counsel argued that Abion was unable to conform his actions to societal norms. The jury found Abion guilty as charged and the circuit court sentenced him to five years imprisonment. Abion appealed. The ICA affirmed and the HSC accepted his application for writ of certiorari.


The Interplay between the Insanity Defense and the Intoxication Exception. “A person is not responsible . . . for conduct if at the time of the conduct as a result of physical or mental disease, disorder, or defect the person lacks substantial capacity either to appreciate the wrongfulness of the person’s conduct or to conform the person’s conduct to the requirements of the law.” HRS § 704-400(1). Self-induced intoxication, however, “does not, in itself, constitute a physical or mental disease, disorder, or defect within the meaning of section 704-400.” HRS § 702-230(3).


In State v.  Young, 93 Hawai'i 224, 999 P.2d 230 (2000), the HSC rejected the claim that a drug-induced or exacerbated mental illness constitutes a defense. The HSC noted that Young must be construed in light of its circumstances and factual findings. In that case, the defendant was convicted of murder after repeatedly striking a person with a hammer. Id. at 277, 230, 999 P.2d at 233, 236. The trial court found that the psychosis caused by drugs can last for months after the drug use has stopped and specifically found Young drank twelve beers and smoked up to three marijuana joints a day in the weeks leading up to the attack. Id. at 230, 999 P.2d at 236. The HSC noted that Young did not address the issue of whether a defendant suffering from “permanent mental impairment caused by substance abuse but not under the temporary influence of a voluntary ingested substance at the time of the offense” was covered by the insanity defense.


Intoxication Exception Limited to Precluding Temporary Impairment Caused by Self-Induced Ingestion of Intoxicants. Having distinguished Young, the HSC examined the language of the intoxication exception—HRS § 702-230. The HSC interpreted the exception to apply only when “a defendant is under the temporary influence of voluntarily ingested substances at the time of an act.” The HSC’s interpretation is supported by the language of the statute and legislative history, and is consistent with other jurisdictions that recognize that a lack of penal responsibility may be available to defendant suffering from permanent or “settled insanity” as a result of voluntary intoxication. Based on this construction, the HSC held that the circuit court erred in precluding Dr. Blinder from testifying.


The Preclusion of Dr. Blinder Violated Due Process. “Central to the protections of due process is the right to be accorded a meaningful opportunity to present a complete defense.” State v. Matafeo, 71 Haw. 183, 185, 787 P.2d 671, 672 (1990). When “the accused asserts a defense sanctioned by law to justify or excuse the criminal conduct charged, and there is some credible evidence to support it, the issue is one of fact that must be submitted to the jury.” State v. Horn, 58 Haw. 252, 255, 566 P.2d 1378, 1380 (1977). Moreover, the insanity defense has a constitutional dimension in Hawai'i. “A defendant who, due to mental illness, lacks sufficient mental capacity to be held morally responsible for his actions cannot be found guilty of a crime.” State v. Glenn, 148 Hawai'i 112, 116, 468 P.3d 126, 130 (2020) (quoting Kahler v. Kansas, __ U.S. __, 140 S.Ct. 1021, 1039 (2020) (Breyer, J., dissenting)).


The HSC held that although the circuit court instructed the jury about the insanity defense, its preclusion of Dr. Blinder from testifying prevented the defense from presenting “competent evidence” on “a defense sanction by law[.]” Horn, supra. The preclusion of Dr. Blinder violated Abion’s Due Process rights. The HSC vacated judgment and remanded the case for further proceedings.


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