Forcing people into drug treatment can save their lives

Addicts are not the only ones affected by their behaviour, their loved ones suffer too.

- Keith Humphreys

Mayor Eric Adams' recent proposal to force addicted New Yorkers into treatment if they pose a risk to themselves or others is "horrific", one activist said. Another said the plan "sends a chill up my spine".

But mandated treatment, if properly carried out, can help addicted people and the communities where they live.

It is well established that the government can provide care to seriously mentally ill people, even if they refuse. The standards required to do so typically, showing that the individual is gravely disabled or poses a threat to the community can vary, but the underlying principle is the same.

Such civil commitment has existed for a century in the US, and all 50 states have laws governing the practice. But New York is among the minority that does not consider addiction alone a sufficient legal foundation to mandate care.

It should. Because the alternative to mandated treatment in places like New York City is usually not voluntary treatment but no treatment at all life on the street with the most lethal illicit drug supply in US history.

Besides, one of the largest and longest-term studies on this followed 2,095 addicted patients and found that one year after treatment, those whose care was mandated were somewhat more likely to avoid drug use than were those who entered treatment voluntarily. Further, compared with their peers who voluntarily sought treatment within the justice system, the patients whose care was mandated were less likely to be rearrested.

Other studies found that mandated patients do somewhat worse or the same as voluntary patients. A new review of 22 studies found "a lack of high-quality evidence" in favour of or against involuntary treatment for addiction.

But none of those studies compared the results of involuntary treatment with the results of getting no treatment, the most pertinent comparison.

THE BENEFITS OF MANDATING REHABILITATION