Is Relapse Inevitable With Forced Sobriety?

Fortunately, he didn’t kill anyone.

Wayne’s drugged driving resulted in two wrecked cars, a few broken bones and an arrest. Wayne’s case was turned over to drug court, where he was sentenced to treatment for serious substance abuse problem. Since he didn’t have a choice, Wayne went to the treatment facility. He didn’t think he had a problem, but attended all the required sessions and “graduated” the program a sober man.

Within a week of his release, Wayne was using again.

Wayne is just one example of the many mandated drug rehab cases that occur across the country (and the world). Often, when crimes are committed that involve substance abuse, the offenders are sentenced to rehab. In other cases, family members force their loved ones to enter rehab. But do these tactics work? If the individual isn’t asking for help, will they accept it? If they haven’t admitted they have a problem, is it possible to fix it? A recent study dug into those very questions.

Mandatory Rehab and Relapse

Researchers compared relapse rates for those in mandated opioid addiction treatment to those in voluntary centers. They found that almost 50 percent of the mandated patients relapsed within a month of their release, while only 10 percent of voluntary graduates relapsed.

Based on these results, researchers argue that compulsory treatment has no place in the treatment of opioid-use disorders. They say, if those in mandated rehab are significantly more likely to relapse, what’s the point?

Other research points to the effectiveness of mandated treatment. The National Institute on Drug Abuse (NIDA) conducted a study that showed rehab has positive potential for success, whether the individual enters treatment voluntarily or is forced. The NIDA study showed that those who volunteered for treatment and those we were mandated to attend had similar success rates after five years. At the five-year follow-up point, both groups had high-sustained abstinence rates.

Other studies indicate that most mandated-rehab participants experience outcomes equal to or even better than those who enter voluntarily. However, at least 90 days of treatment is needed to achieve the best outcomes. Those who spend at least this much time in therapy experience “significantly reduced rates of drug abuse and criminal behavior.”

Who’s Right and What’s True?

Arguments persist on both sides of this debate. On the one hand, you can’t force someone to get clean if they don’t want to. Every legally-mandated rehab runs the risk of hitting this barrier to recovery. On the other hand, forced treatment may result in the individual realizing they have a problem. During the course of rehab, they may admit they have an addiction and accept the help they need. One could argue that they didn’t have the desire to change beforehand, but the mandated treatment provided this desire.

It’s a tough line to walk. All we can do is hope that forced rehab helps, since hundreds of mandated programs operate across the U.S. and around the world.