Mandated Drug Treatment: A Controversial Yet Potentially Life-Saving Approach

Recent proposals to require treatment for New Yorkers struggling with addiction who pose risks to themselves or others have sparked strong reactions from activists, with some describing the plan as deeply troubling.

However, when implemented with care and appropriate safeguards, compulsory treatment can offer significant benefits to individuals battling addiction and to the wider communities they inhabit.

It is a well-accepted legal practice in the United States to provide care to individuals with severe mental illnesses even against their will, particularly when they are gravely disabled or present a danger to society. While the criteria for such interventions differ across states, the foundational principle remains consistent.

This form of civil commitment has been part of U.S. law for over a century, with all states having regulations governing the process. Yet, New York is among the few that do not recognize addiction alone as a valid reason to mandate treatment.

Advocates for reform argue that this should change, noting that without mandated treatment, many addicted individuals in cities like New York face a grim reality—continuing life on the streets amid the deadliest illicit drug supply ever seen in the country.

Research examining over 2,000 addicted patients found that, one year after treatment, those compelled to undergo care were slightly more likely to remain drug-free compared to those entering treatment voluntarily. Additionally, mandated patients had lower rates of rearrest than their voluntary counterparts within the justice system. While some studies suggest mandated treatment outcomes are comparable or slightly worse than voluntary treatment, a recent review of 22 studies highlights a lack of definitive high-quality evidence either supporting or opposing involuntary addiction treatment.