In the United States, substance use disorder is grounds for involuntary commitment in more than 30 states. Allowing a nonviolent offender to choose treatment over jail is already a key component of diversion programs here in Los Angeles County. Mandatory treatment is an increasingly popular talking point and a seemingly common-sense approach to the dual crises of opioid overdoses and stimulant abuse. Yet, many experts in the field reject this approach, and it’s not clear if and how it might ultimately make a difference, either for individual drug users or for our city streets. 

Statistically speaking, most efforts at treatment for substance use fail. Half of people who enter treatment don’t last a month before they’re out of rehab and off the wagon. Some are kicked out for breaking program rules. Others are simply disinterested in learning about recovery. Addiction medicine specialists generally agree that entering treatment voluntarily is far more likely to succeed than any form of coercion, but some support for “tough love” approaches can also be found in academic circles.  A 2015 article in the Journal of Substance Abuse Treatment found that among 160 people enrolled in treatment between 2007 and 2010, “those who were mandated” were more likely to finish their programs. 

Yet, the interventions shown to be most effective for helping people with substance use disorders are often not available – including support for stable housing, employment, and medication-assisted treatment. Treatment programs also need to address a person’s environment to assist with long-term recovery.  If you know someone who needs treatment, contact L.A. CADA at (562) 906-2681.

Learn more about: Treatment for Adults in the Criminal System