Coerced Substance Treatment: It May Backfire

Many people are coerced into alcohol treatment. Their family may want them to go to AA. Or to go to a rehab. Sometimes a court gives them an option. They can attend AA or they can go to jail. That’s clearly coerced substance treatment. 

In Sweden, the state can legally force people into treatment. That is, if the state deems them at risk of harming themselves or their families. Or causing “irreparable damage to their futures.”

The Study

Researchers studied 18 years of data on those who finished six months of compulsory substance treatment. Some were not there specifically for alcohol use disorder (AUD). But most were. All had regular discharge. That is, they didn’t die. Nor did they go to a hospital, jail, or prison. There were 7,929 such people.

Researchers studied death rates for two weeks after discharge for “external causes.” Those included suicide and overdose. Death rates were 2.6 times that for their age and sex. They found death rates tapered off as time went by. But they were still high. Many other studies have reported similar findings.coerced substance treatment

People use coerced substance treatment for the best of intentions. But it can clearly be harmful. Especially if the goal is total abstinence.


Here’s an example. A woman sent an email showing the tragic result of unneeded treatment. (See Your Teen Drinks Alcohol or Does Drugs. Now What?)

At age 14 she had drunk alcohol three times and used marijuana twice. As a result, she was sent to several treatment programs. The staff thought that if she denied being an alcoholic, then she must be one. 

One program discharged her because she refused to say she was alcoholic. So they put her into an in-patient rehab. They told her she couldn’t go home until she “admitted” that she was an alcoholic. Also, she had to agree to go to AA meetings.

She was very young and unsure of her identity. So she began to think that perhaps she was wrong. That perhaps she was an alcoholic. AA had taught her about blackouts. Maybe blackouts caused her to forget? 

She attended AA from 14 to age 26. In the meantime, she earned a degree in psychology. And worked in a rehab herself. As she explained, “AA doesn’t tolerate asking questions.” But she studied the criteria and found that she met none of them. Upon doing more research, she left AA.

Think of the mental agony she had by being forced into substance treatment. Fortunately, she didn’t kill herself as many Swedes did after forced treatment.

Coerced Substance Treatment




    • This site gives no advice. Thus, it gives no advice about coerced substance treatment.