The ethics and effectiveness of coerced treatment of people who use drugs

In the context of international debates about ways to reduce the harms related to

the use of illicit drugs and their control, this article explores the specific issue of

coerced treatment of people who use drugs. It uses established standards of human

rights and medical ethics to judge whether it is ethical to apply either of two types

of coerced treatment (compulsory treatment and quasi-compulsory treatment,

or QCT) to any of three groups of drug users (non-problematic users, dependent

drug users and drug dependent offenders). It argues that compulsory treatment is

not ethical for any group, as it breaches the standard of informed consent. Quasicompulsory

treatment (i.e. treatment that is offered as an alternative to a punishment

that is itself ethically justified) may be ethical (under specified conditions) for drug

dependent offenders who are facing a more restrictive penal sanction, but is not

ethical for other people who use drugs. The article also briefly reviews evidence

which suggests that QCT may be as effective as voluntary treatment.