Coerced treatment for drub abuse occurs when a person is forced involuntarily into rehabilitation for addiction. They may be ordered to rehab by the court due to criminal charges or at the request of their family or pressured into rehab after an intervention by family and friends.
It’s unclear whether people forced into treatment experience the same treatment outcomes as people who voluntarily enter care. You may want your loved one to enter rehabilitation and takes steps like an intervention or getting a court order, but if they aren’t dedicated to getting sober, will treatment be less effective?
When Coercion Works
Some researchers have argued that coercion works because many people with substance abuse disorder won’t seek help on their own. Sometimes loved ones, or even the court, must step in to help them fight addiction. Furthermore, the court should order people into rehabilitation as betters the community and may lead to a better future for the addict than time in prison.
In a review of 11 different studies of coercive treatment, five studies found that coercion resulted in positive outcomes, some even more positive than people who entered treatment voluntarily. People who were ordered into rehabilitation due to criminal activity were more likely to enter rehabilitation earlier in their addiction, which is linked to better outcomes and a greater chance for long-term sobriety.
People who are given the choice of completing treatment or going to prison also tend to have better outcomes. They are more likely to complete treatment, perhaps motivated by the desire to avoid jail time. Another study of people who had received DUIs and were mandated to treatment were more likely to attend each treatment than patients who were not mandated to care.
Another four studies found there was no difference in outcomes between people who were forced into treatment and those who entered treatment voluntarily. These studies measured treatment completion, criminal involvement, social functioning and other criteria. They suggest that at the very least coercion may not harm patient outcomes, but simply provide the same outcomes as they would have experienced if they had entered care on their own.
Around 40 to 50 percent of all people who enter rehab do so because of a court order. There is some evidence that, in certain circumstances, the justice system is right to send people to rehabilitation as it benefits both them and their community.
When Coercion Doesn’t Work
Still, of those 11 studies, two did find that coercion led to more negative outcomes than voluntary treatment. In these studies, people on probation were less likely to complete treatment and organizations with greater than 75 percent of patients from court-ordered mandates saw more patients fail to comply with treatment than organizations with fewer court-ordered patients.
It’s possible that coercion may be less effective because those entering treatment are not motivated to change. They require internal motivation to change, not just external pressure from the courts. One study found that people ordered into treatment had less internal motivation, which may affect their ability to stay sober long term.
Still, many patients, even though they are ordered by the court to enter treatment, are very willing to go to rehab. They feel they are ready to change and their motivation may make them more likely to succeed, whether or not they were ordered there. It’s possible that their court order or criminal activity helps them realize they need to change, causing internal motivation.
While early treatment typically corresponds with good outcomes in patients who enter treatment voluntarily, the opposite may be true for coerced treatment. Younger patients or those who have only recently started abusing substances may not feel the heavy consequences of their use yet. If they feel their substance abuse has few consequences, they may lack the internal motivation to stop using. On the other hand, people who have gone to jail, lost a job, or lost their home due to substance abuse may feel more motivation to become abstinent.
Coercion also has ethical ambiguities. Though treatment may benefit a patient and their community, it may not be right to force them into care they don’t want to receive. Some medical professionals question if patients should be committed to addiction treatment involuntarily.
Whether or not a patient is ordered into treatment, it’s clear that internal motivation is the key factor in determining their success. This motivation also helps overcome any moral problems posed by involuntary care. Treatment may not be effective, or right, if a person is going through the motions in order to fulfill legal requirements, but has no real desire to change. It’s vital that you carefully weight the possible benefits and drawbacks of coerced treatment before seeking a court order for your loved one’s care.
At Harmony Place, we strive to help our patients discover their internal motivation for getting and staying sober with comprehensive therapy. In our supportive, compassionate environment, we can help you or your loved one make positive changes in their life and achieve long-term sobriety.
If you or a loved one require addiction treatment, we can help. Contact us at 1-888-789-4330 at any time day or night for assistance.