When New York Mayor Eric Adams proposed forcing addicted individuals into treatment if they posed risks to themselves or others, the backlash was immediate. One activist called the plan “horrific.” Another said it “sends a chill up my spine.” Yet this visceral opposition may overlook a crucial reality: mandated drug treatment, when properly executed, can transform lives and restore communities.
The debate over compulsory care has intensified as cities grapple with unprecedented drug crises. With the most lethal illicit drug supply in American history flooding streets, the question is no longer whether intervention is necessary, but what form it should take.
The debate over compulsory care has intensified as cities grapple with unprecedented drug crises. With the most lethal illicit drug supply in American history flooding streets, the question is no longer whether intervention is necessary, but what form it should take.
The Legal Framework for Mandated Drug Treatment
Civil commitment for mental health treatment has existed for a century in the United States. All 50 states have laws governing the practice, typically requiring evidence that individuals are gravely disabled or pose threats to their communities. The underlying principle remains consistent: governments can provide care to seriously ill people even against their wishes.
However, New York is amongst the minority of states that do not consider addiction alone sufficient legal foundation to mandate care. This distinction matters because the alternative to mandated drug treatment in cities like New York often isn’t voluntary treatment, but no treatment at all. For many, it means life on the street with fentanyl and other deadly substances.
What Research Reveals About Compulsory Treatment
One of the largest long-term studies examining mandated drug treatment followed 2,095 addicted patients. The findings challenge common assumptions: one year after treatment, patients who received mandated care are slightly more likely to avoid drug use than those who entered treatment voluntarily. Moreover, mandated patients are less likely to face rearrest than peers who voluntarily sought treatment within the justice system.
Other studies have produced mixed results, with some finding mandated patients do somewhat worse or the same as voluntary patients. A recent review of 22 studies found “a lack of high-quality evidence” either supporting or opposing involuntary treatment for addiction.
Yet these studies share a critical limitation: none compared involuntary treatment results with receiving no treatment whatsoever, the most relevant comparison for policy decisions. (Complete article WRD News)
