The effectiveness of compulsory drug treatment: A systematic review
Open accessAbstract
Background Despite widespread implementation of compulsory treatment modalities for drug dependence, there has been no systematic evaluation of the scientific evidence on the effectiveness of compulsory drug treatment.Methods We conducted a systematic review of studies assessing the outcomes of compulsory treatment. We conducted a search in duplicate of all relevant peer-reviewed scientific literature evaluating compulsory treatment modalities. The following academic databases were searched: PubMed, PAIS International, Proquest, PsycINFO, Web of Science, Soc Abstracts, JSTOR, EBSCO/Academic Search Complete, REDALYC, SciELO Brazil. We also searched the Internet, and article reference lists, from database inception to July 15th, 2015. Eligibility criteria are as follows: peer-reviewed scientific studies presenting original data. Primary outcome of interest was post-treatment drug use. Secondary outcome of interest was post-treatment criminal recidivism.Results Of an initial 430 potential studies identified, nine quantitative studies met the inclusion criteria. Studies evaluated compulsory treatment options including drug detention facilities, short (i.e., 21-day) and long-term (i.e., 6 months) inpatient treatment, community-based treatment, group-based outpatient treatment, and prison-based treatment. Three studies (33%) reported no significant impacts of compulsory treatment compared with control interventions. Two studies (22%) found equivocal results but did not compare against a control condition. Two studies (22%) observed negative impacts of compulsory treatment on criminal recidivism. Two studies (22%) observed positive impacts of compulsory inpatient treatment on criminal recidivism and drug use.Conclusion There is limited scientific literature evaluating compulsory drug treatment. Evidence does not, on the whole, suggest improved outcomes related to compulsory treatment approaches, with some studies suggesting potential harms. Given the potential for human rights abuses within compulsory treatment settings, non-compulsory treatment modalities should be prioritized by policymakers seeking to reduce drug-related harms.
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Decades of research have failed to provide conclusive and consistent evidence supporting the effectiveness of involuntary treatments for substance use issues.
“This occurs despite the fact that decades of research have failed to provide conclusive and consistent evidence supporting the effectiveness of involuntary treatments for substance use issues [16,17].”
From “Backed into a Corner”: Lived experiences of receiving and providing involuntary psychiatric treatment under British Columbia’s Mental Health Act (2026) · cites this paper as [17]
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Snow, M. E., Salmon, A., Banjo, J., Morrow, M., & Varcoe, C. (2026) · PLOS One · doi:10.1371/journal.pone.0329049
- Authors
- Werb, D., Kamarulzaman, A., Meacham, M. C., Rafful, C., Fischer, B., Strathdee, S. A., & Wood, E.
- Affiliations
- St. Michael's Hospital (CA)
- University of Malaya (MY)
- University of California San Diego (US)
- Centre for Addiction and Mental Health (CA)
- Corresponding author
- Werb, D.
- Venue
- International Journal of Drug Policy
- Publisher
- Elsevier BV
- Published
- 2016-02
- Volume
- 28
- Pages
- 1-9
- ISSN
- 0955-3959 (ISSN-L)
- PMC
- PMC4752879
- OpenAlex
- W2211276749
- Cited by
- 260
- References
- 68
- Citations by year
- 2026: 30 · 2025: 28 · 2024: 41 · 2023: 19 · 2022: 22 · 2021: 32 · 2020: 27 · 2019: 26 · 2018: 23 · 2017: 6 · 2016: 6
- FWCI
- 1.50
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- International Journal of Drug Policy (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institute for Health and Care Research
- National Institutes of Health (1dp2da040256-01)
- Canadian Institutes of Health Research ((OP 79297)
- National Institute on Drug Abuse (DP2-DA040256, DP2 DA040256-01, R37DA019829, T32DA023356)
- Fogarty International Center (D43TW008633)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Social Sciences › Sociology and Political Science › Criminal Justice and Corrections Analysis
- Keywords
- drug addiction, recidivism, inpatient care, community-based treatment, prison-based treatment, human rights violations, harm reduction, treatment effectiveness
- MeSH terms
- Humans, Program Evaluation, Treatment Outcome, Substance-Related Disorders, Mandatory Programs
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