Compulsory Drug Treatment

As I have noted before on this blog (see, e.g., this post) a major part of the homelessness problem is addiction. Charles Lehman has an article at City Journal titled Compulsory Drug Treatment Works: Activists who say otherwise hide their views behind a cloak of scientific objectivity.

The actual state of the research is not as definitive as that title implies. A big part of the difficulty in evaluating efficacy is the lack of a good comparison group, and there is disagreement as to what comparison is appropriate. Do people compelled to accept treatment do as well as those who seek it out? A “no” answer to that question would prove nothing, as the seekers had a better attitude out of the gate. The actual evidence is mixed.

Is compulsory treatment better than no treatment at all? Lehman cites a couple of studies that find an improvement while conceding that there is a selection bias problem in these studies as well. Random and quasi-random assignment studies are better, and they provide some evidence of a benefit.

One of the many side-effects of California’s disastrous Proposition 47 of 2014 was that it effectively killed off drug courts. Prosecution for drug possession was the stick that moved people toward the carrot of getting clean. The people of California voted to reverse that unfortunate error in Proposition 36 of 2024, but the “progressive” Legislature has crippled the effort through its control of the purse strings.

Leaving people to live on the street, locked in the prison of addiction, is not “progress” in my view, but the “progressive” movement and actual progress parted company long ago.

Personal autonomy is an important value in our society, but when the very condition that requires treatment also deprives the patient of the capacity to make a genuine choice, society has to make hard choices. Involuntary treatment is sometimes necessary.