Responses help 2!

“The oldest and strongest emotion of mankind is fear, and the oldest and strongest kind of fear is fear of the unknown” (H.P. Lovecraft). Often times, we fear things we do not understand ourselves. This has no exception when it comes to dealing with addicts. The reason why it is so hard to help those with addictions is because we do not comprehend what they are going through, or how to effectively help them. Many loved ones surrounding these addicts eventually, after many failures, use “tough love” to promote treatment and recovery, while insisting they stay drug free. The main question comes down to, should addicts be forced into treatment? *Thesis*

“Ninety-five percent of people suffering from substance use disorders to not think they have a problem or need treatment” (DuPont, Robert L). Few addicts enter treatment by themselves and often require coercion from families or the criminal justice system. This does not mean that everyone addicted should be committed to treatment, however, some should be forced into treatment against their will depending on the severity (DuPont, Robert L). Two examples of programs that deal with addiction and recovery are HOPE probation, and Physician Health Programs (PHP). These programs have a lot of similarity, though, the consequences of not completing each program is very different. For HOPE probation, the risk of failing out of the program is prison. These individuals attending (change word) this program are already convicted felons on probation, but are given the chance for a recovery program instead of prison time. The PHP program results in a loss of medical license if the program does not get completed. Both of these programs are voluntary in the sense that individuals can choose not to abide by the program requirements, but the consequences are severe (DuPont, Robert L). Programs such as PHP and HOPE probation are effective because they are enforced by intensive random monitoring (change wording?). Many fear joining these programs, and it often times takes a significant measure of coercion not only to get addicts into treatment, but also to keep them there and to prevent relapse upon discharge (DuPont, Robert L). After much time, however, there is a transition from near-universal denial of problems and rejection of treatment to gratitude for and acceptance of the coercion that got them on that path (DuPont, Robert L).

Another idea brought up by Howard Jospher is to make addiction treatment better and more available. As a former drug addict, he mentioned that he was constantly pushing the limits, subconsciously seeking an outside force or authority to draw the line and stop him (Jospher, Howard). For many addicts, testing the boundaries is a cry for help, and the only way to save them is by coerced treatment. However, forced treatment needs to be applied selectively, and there needs to be a distinction between the types of drugs that are being used and the actions that need to take place. In order to make addiction treatment better and more available we need to “decriminalize possession of drugs for personal use; determine a hierarchy of need among persons being considered for coerced treatment (pot smokers being at the bottom of this list); and create alternative ‘harm reduction’ treatment program in addition to the abstinence, one-size-fits-all, model that makes up the overwhelming majority of treatment programs in the United States” (Josepher, Howard). By doing this we are allowing those that require immediate attention the help that they need. The Substance Abuse and Mental Health Services Administration claims that about 20 million problematic drug users in need of treatment do not have access to helpful resources that can get them back on the right path. Instead of faulting those for their reluctance, we need to look at approaches that have been successful in engaging drug users through attraction rather than coercion, and making drug treatment better and more accessible and appealing to those who need it most (Jospher, Howard).

A similar idea to Jospher’s is Maia Szalavitz, who is a former cocaine and heroin addict. Szalavitz agrees that in order to help the most amount of people, treatment should attract patients, not force them into it. Also, she claims that treatment designed to be “tough love” is not only likely to be painful, but ineffective. In order to attract patients to addiction treatment, therapies must be kind, welcoming and supportive, not harsh or confrontational. Seeing force as the only way to motivate addicted users has created a largely inhospitable system that views harsh and disrespectful treatment as not only acceptable, but also necessary to get patients to realize that they have hit “rock bottom” (Szalavitz, Maia). Often times, incompletion of a program results in punishment. This punishment further stigmatizes addiction by implying that punishment in necessary in treatment, unlike any other disorder (Szalavitz, Maia). If harm reduction programs focused on attracting people into recovery, the results would be astounding (reword?).

Last but not least, Sally Satel argues that individuals should be mandated to monitored quality treatment. Many of times, addicts are forced into treatment programs by the justice system. While civil commitment saves lives of those that are severely addicted by interrupting cycles of extreme self-destruction, it is not enough to lead a life of recovery (Satel, Sally). While voluntary treatment is the most preferred, the rate of drop-out after several weeks is a common problem. Drop out often leads to relapse, and while civil commitment is not always ideal, it provides the leverage for patients to remain in care (Satel, Sally). The main goal for those in treatment is retention-because it often leads to recovery. The longer one stays in treatment, the more time spent toward managing cravings and other negative views (reword). Not only does this help one achieve their goal of preventing relapse, but it also helps repair family relationships, start new, healthier networks; find new modes of fulfillment, and develop realistic future plans (Satel, Sally). Another way for treatment plans to be effective is that after initial stabilization and detox, care should include structured supervision not institutional surroundings (Satel, Sally)-reword. Examples of this structured supervision should be incentives for drug tests, and immediate consequences following. In order to attract those to get help, coercion should be an option of last resort. If this help is still refused and the individual is therefore mandated to monitored quality treatment, over time he or she often becomes open to change (Satel, Sally).

**maybe insert research from library database**

All in all, there is no perfect way to help those suffering from addiction, although, some ways have proven to be more effective than others. The most important thing to promote recovery is to understand that every person handles things differently, and every road to recovery starts on a different path. For some, testing boundaries and pushing limits is a cry for help, in which coerced treatment might be the best. For others, recovery programs such as PHP and HOPE probation might benefit those by implementing consequences, although abiding is voluntary (reword). Similar options would be monitored quality treatment, whether it be civil commitment or being forced into treatment. In order to help those to stay in programs, they must provide a welcoming and supportive atmosphere. This not only attracts patients into treatment, but also helps with retention, which is a determining factor on whether or not a person will relapse.

Citation Page

DuPont, Robert L. "Drug Addiction Recovery Often Starts with Coercion." Room for Debate. New York Times, 12 Feb. 2016. Web. 18 Feb. 2016.

Josepher, Howard. "Make Addiction Treatment Better and More Available." Room for Debate. New York Times, 11 Feb. 2015. Web. 18 Feb. 2016.

Satel, Sally. "Compelled Drug Addiction Treatment Works Because of Retention." Room for Debate. New York Times, 11 Nov. 2015. Web. 18 Feb. 2016.

Szalavitz, Maia. "Attact Patients to Addiction Treatment, Don't Force Them Into It." Room for Debate. New York Times, 11 Nov. 2015. Web. 18 Feb. 2016.