The Ethics Of Coerced Treatment For Drug Use
All drug use is not abuse. Yet, people caught using drugs are often given no choice but to go into "treatment." This is like catching me drinking a glass of wine and forcing me to go to rehab for it.
I do drink wine, but not to excess, because it makes me woozy and sick and I can just take a few curves in my car or take off in a small plane to do that. So why should my mere consumption of wine be a reason to send me to rehab?
Via @ethannadelmann, a paper by Alex Stevens, Ph.D., "The ethics and effectiveness of coerced treatment of people who use drugs," from Human Rights and Drugs. An excerpt:
There are two types of coerced treatment. The first occurs when people who use drugs are ordered into treatment with no opportunity to provide informed consent to such treatment.This will be called compulsory treatment. The second type occurs when drug users are given a choice of going to treatment or facing a penal sanction that is justified on the basis of crimes for which they have been (or may be) convicted. This will be called quasi-compulsory treatment (QCT).
The first of the three types of person who uses drugs includes those who use drugs but who have not committed other crimes, and do not meet diagnostic criteria for drug dependence ('non-problematic drug users'). This group includes the majority of people who use illicit drugs. Most of them will discontinue drug use without any need for treatment. Only a small minority will go on to need treatment to help them give up drugs, or to reduce the harm that their drug use causes.
The conclusion:
This article has argued that it is very unlikely that compulsory treatment can be considered ethical for any category of person who uses drugs, outside of the 'exceptional, crisis' situations allowed for under the UN Office on Drugs and Crime/World Health Organization review.It has been argued that quasi-compulsory treatment may be considered ethical (under some specific conditions) for drug dependent offenders who have committed criminal offences for whom the usual penal sanction would be more restrictive of liberty than the forms of treatment that they are offered as a constrained, quasi-compulsory choice. It has briefly reviewed research that suggests that QCT may be as effective as treatment that is entered into voluntarily. This may help individuals to reduce their drug use and offending and to improve their health, but it is unlikely to have large effects on population levels of drug use and crime.
Nadelman later tweets about the absurd state of things -- the feds deeming total abstinence from drugs a must:
Gil K talking about emphasizing drug prevention, but the feds' approach is all about abstinence only, not reality-based drug education.
Although I don't smoke pot, I know a number of highly successful people who use it -- when they come home from work at 9 p.m. after a 12-hour, highly productive day, to relax and unwind. Are these drug criminals -- or are they just ingesting a different sort of sauvignon blanc than I am?
Finally, let's not forget the cost of "zero tolerance" on adult "offenders," from a NYT piece by Brent Staples:
Millions of people have been arrested under the policy for minor violations, like possession of small amounts of marijuana. And one thing is beyond dispute: this arrest-first policy has filled the courts to bursting with first-time, minor offenders who do not belong there and wreaked havoc with people's lives. Even when cases are dismissed, people can be shadowed for years by error-ridden criminal records....An arrest, even without a conviction, can swiftly unleash disastrous personal consequences. Consider the 2011 case of a 26-year-old single mother from Brooklyn whose lawyers say she was arrested after the police forced her to reveal a small packet of marijuana hidden in her purse. The judge said the charges would be dismissed if she stayed out of trouble for a year. A week later, the woman had been fired from her job as a janitor with the New York City Housing Authority. She has not been rehired.
...Young parents have faced neglect accusations in family court after marijuana arrests, even if they are not ultimately charged with any crime. In a case described in The Times, a woman's son and niece were removed from her home by child welfare workers after police found about a third of an ounce of marijuana -- below the threshold for a misdemeanor -- in a boyfriend's backpack in her Bronx apartment. The district attorney declined to prosecute, but the children spent time in foster care, and her niece was not returned for over a year.
...New York City's overly zealous marijuana arrests, coupled with the unreliability and porousness of record-keeping, damage the lives of tens of thousands of people a year. The Legislature needs to fix this.
I've worked with people who were forced into rehab. It's a total waste of everyone's time. If the person in "treatment" doesn't believe that there is a problem he'll be bored and resentful at best.
Most people will opt for treatment over jail, because jail sucks worse than a rehab clinic, but they'll be cleaning the bong as soon as they get out.
Or so I've heard.
Steve Daniels at May 3, 2012 8:54 AM
The official hypocrisy is astounding.
Pres. Obama frankly admitted that he smoked pot. Former Pres. Bill Clinton smoked but "didn't inhale" (laugh track), and I wouldn't be surprised if the Republican presidents dabbled a bit (or a lot).
They all prosecuted the War on Drugs. Why don't they voluntarily submit to arrest, rehab, and possibly jail? This is what they prescribe for others who were unlucky under their policies.
They may say that punishment is not needed because they reformed in the meantime. If so, why is punishment needed for others who may reform in the meantime?
Andrew_M_Garland at May 3, 2012 12:35 PM
Did you hear about Daniel Chong?
See Google News. He's lucky to be alive. As many are pointing out, this probably wouldn't be getting so much attention if he were black. Who knows how many people in similar cases didn't survive?
Oh, and check this out, from Nancy Pelosi:
http://pelosi.house.gov/news/press-releases/2012/05/pelosi-statement-on-recent-federal-government-actions-threatening-safe-access-to-medicinal-marijuana.shtml
lenona at May 3, 2012 3:42 PM
The whole system for DUI/DWI is setup that their is an industrial feel to it.
I had to do a 72 hour closed, "locked-in" class for my fuck-up DUI. I was stupid and guilty as sin. About five of the 28 in the class were busted for less than .08. They had to pay more than $250 to get their license back. All of us had to pay $325+ per person to go to the class.
Then there was the possible required follow-up "counseling" at the choice of the instructors.
I think it effectively changed about three people.
Anonymous Coward at May 3, 2012 7:23 PM
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