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Related Experiment Videos

Clinical experience with civil commitment.

J F Maddux1

  • 1Department of Psychiatry, University of Texas Health Science Center, San Antonio 78284-7792.

NIDA Research Monograph
|January 1, 1988
PubMed
Summary
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Legal coercion, like civil commitment, can increase opioid dependence treatment entry but has limitations. While short-term outcomes may improve, it doesn't guarantee long-term abstinence or overcome service deficits.

Area of Science:

  • Addiction Medicine
  • Public Health Policy
  • Legal Medicine

Background:

  • Unstable motivation is a significant barrier in treating opioid dependence.
  • Voluntary treatment retention rates in hospitals are historically low, even post-withdrawal.
  • Existing research suggests limited, though potentially positive, short-term outcomes for coerced treatment.

Purpose of the Study:

  • To evaluate the effectiveness of civil commitment as a form of legal coercion in treating opioid dependence.
  • To compare outcomes of voluntary versus legally coerced treatment for opioid addiction.
  • To identify limitations and challenges associated with civil commitment for addiction treatment.

Main Methods:

  • Analysis of patient data from two Public Health Service (PHS) hospitals.

Related Experiment Videos

  • Comparison of treatment outcomes between voluntary patients and those under civil commitment.
  • Follow-up studies assessing short-term and long-term treatment engagement and abstinence.

    • Main Results:

    • Civil commitment, particularly with post-hospital care, showed slightly better outcomes than voluntary treatment but not markedly.
    • A significant proportion (one-third to one-half) of civil commitment candidates were unsuitable for treatment due to behavior.
    • High attrition rates were observed during civil commitment treatment, with only about one-third proceeding to aftercare.
    • Short-term outcomes for civil commitment patients were somewhat better than voluntary patients, but long-term data remain inconclusive.

    Conclusions:

    • Civil commitment can facilitate entry into treatment for some opioid users who would not voluntarily seek it.
    • Limitations include inability to overcome treatment service deficits and ensure patient participation.
    • Constitutional individual liberty guarantees restrict the scope and effectiveness of civil commitment as a coercive measure.