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I think you bring up a good point. So what if the consequence for these crimes (any crimes?) was compulsory treatment? That needn't include being imprisoned except for where it's absolutely warranted.


My former coworker was a recovering addict who was also a addiction counselor. He perspective was that the addict has to want to be there for anything to happen.

If you cigarettes from a smoker or booze from a drunk and the outcome isn’t walking away from the addiction.


In contrast I've heard several counselors and specialists interviewed on the radio who say compulsory treatment is a useful and necessary tool. Some of them even lament the latest round of decriminalization measures in cities like SF because it leaves no recourse whatsoever for compulsory treatment. (And, yes, some of these people are counselors in SF. And, yes, some sort of civil commitment would be better than abusing criminal law, but civil commitment is a less politically likely option.) Before full, de facto decriminalization of drug use, SF already had shifted most cases to specialized drug courts which couldn't send anyone to jail, but could only force people into treatment--and AFAIU only did so if advised by addiction counselors.

Moreover, because SF and similar cities have so fully decriminalized drug usage, and done so asymmetrically to surrounding jurisdictions, they attract addicts to the city (it's not just the weather or social services). Whether or not you think compulsory treatment is ever effective or morally justified, surely one must admit that the last thing any addict or at-risk person needs is such a permissive environment, where they can surround themselves with others suffering from the same affliction and who will give them license to let go, hit rock bottom, and stay there indefinitely. SF has such a concentrated drug problem partly because it's like some platonic ideal of an enabling environment for codependent, drug-centered relationships.

My family has a long history of alcoholism, including both my parents. My grandfather was a regional AA president or some such, though long after he had destroyed his family. I've seen addiction up close and personal. I've been in foster homes and met kids from families destroyed by drug addiction, or who turned to drugs themselves. I've seen how enablement works, how my mother's alcoholism, while never going away, ebbed and flowed, yet at least for her was invariably precipitated by her alcoholic "friends" coming over or inviting her to drink with them. In the aftermath of a long binge we'd be lucky if she only lost her job; on more than one occasion we ended up on the street, though thankfully we never had to sleep on the street.

Over the years I've also met several very intelligent and otherwise perfectly functional alcoholics who chose to give themselves over to alcoholism. (At least one walked away from his life as a well-paid chemical engineer.) It's what they wanted and they literally said as much. They were perfectly capable of scraping together a lawful subsistence, and did so, though in one case that didn't always include regular electricity and running water, which they were fine with. I'm not sure what it means for an alcoholic to "choose" to live like that, but from my perspective if "choice" has any meaning it applies to those particular people just as much as it applies to me or anyone else. But the contrast between people like that, and people like my mother (or especially like my next door neighbors' daughter, someone whose drug addiction is so thorough she has given herself over to the streets and her codependent addicts and won't even entertain offers of help from family or the city) tells me that there's plenty of legitimate need for various forms of compulsory interventions, including short- and long-term treatment. My mom was forced into compulsory treatment once for 3 months. She lapsed a year or so later but if you ask her I'm sure she'll tell you that that experience was important to hastening the day she had her last drink, even though her darkest days were after that stint in the hospital.

There's a dangerous narrative in our culture that beating addiction is about hitting rock bottom so you can come to the realization about your problem and then seek treatment. I have no doubt that such is the experience of many addicts, but it's hardly universal. Other not uncommon experiences are repeatedly cycling through rock bottom for much of, most of, or all of your life, never once seeking treatment; or hitting rock bottom and staying ay rock bottom until you die. There are people who manage to sustain a heavy substance abuse habit but otherwise seem to live a normal, functional, middle-class lifestyle; maybe perfectly contented or maybe hating themselves and wishing someone would discover their secret and force a reconciliation, through legal compulsion or otherwise. Compulsory interventions don't have to cure people to be effective. They can be effective just by breaking whatever cycle they're stuck in. And no intervention need be used as matter of course.

There are countless dimensions at play when it comes to addiction and addictive behaviors. Everybody has their own stories and their own opinions, both addicts and those around them. There aren't many clear answers to even the simpler aspects, but in my experience and opinion categorically excluding options like compulsory treatment is one of the few wrong answers. It's premised on a similarly flawed and overly simplistic concept of volition as that behind excessively punitive responses. Certainly compulsory treatment can be done wrong, and perhaps in many contexts (e.g. many U.S. jurisdictions) the capacity to do it effectively and judiciously doesn't exist. But that's a different kind of argument.




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