Clinical Experience with Civil Commitment

Abstract

Unstable motivation has represented a major problem in the treatment of opioid dependence. Early followup studies at the two Public Health Service Hospitals found that legally coerced treatment, especially when combined with compulsory posthospital care, led to better outcomes than did voluntary treatment. During the years 1967–1973, over 10,000 patients were admitted to the two hospitals under the NARA for evaluation of their suitability for treatment under civil commitment. Over one-third were found not suitable. Followup studies suggested that the outcomes of committed patients were somewhat better than those of voluntary patients. While civil commitment may bring some opioid users into treatment who would not voluntarily enter, it cannot overcome deficits in services, and it cannot insure that patients will participate in treatment.