By Dr David Laing Dawson

What would that actually look like? In a few words, to start: Something like the infirmary of a prison.

Involuntary treatment for addiction would entail:

1. Police apprehension on some legal basis: (?Family to JP, ?police judgement of risk )

2. Escort to a medical facility for examination to be certain the addict is sufficiently healthy (no communicable diseases, not in organ failure, does not have head injury, pneumonia) to undergo the second phase.

3. The enactment of a second phase of legal incarceration for the purpose of withdrawal. (?involuntary commitment after examination by two doctors, special tribunal?)

4. This second phase is forced withdrawal. This requires a special locked facility with adequate monitoring of the consequences of withdrawal, plus available medical and emergency services for the sometimes severe consequences of withdrawal.

5. The administration of drugs and supplements that alleviate the worst symptoms of withdrawal. The length of time required differs depending on the particular drug and severity of addiction. Usually day four is the worst but the withdrawal symptoms can last for weeks and months.

6. A period of time still in lock-up for physical recovery: nutrition, medication, sleep, exercise, abstinence. Length of stay? Two weeks or more.

Now What? Discharge at this point would ensure over 90% relapse. So:

7. A comprehensive assessment to ascertain the factors in this particular addict’s life, beyond biological craving for relief, bliss and ecstasy, that contribute to his or her addiction.

The possibilities range from mental illness, trauma, loss, personality disorder, ADHD, intellectual disability, to lack of housing, lack of regular income, family support, social connections, skills, friends who are not addicts, life skills, belief systems (meaning), lack of membership (belonging), lack of primary relationship, lack of meaningful activities, job….

8. Address the above, with our now voluntary addict-in-recovery, within well funded comprehensive programs, over an extended period of time, some of which must be residential, or removed from the addict’s addicted friends and sources.

9. Plan on large numbers relapsing and requiring a second intervention or moving to an addiction maintenance program.

The above would be very expensive, fraught with legal and civil rights questions; and partial implementation would not be effective.

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