(Photo Wikimedia commons)
Civil rights and public order – the right of the people as a whole to be safe from harm and the right of the individual to be free from intrusive government – are often in conflict.
Take the homeless. Some proportion of them are mentally ill, in need of anti-psychotic medications, but unless they are doing harm to others, they are permitted to not take their medications, and to live on the streets, not even availing themselves of public homeless shelters if they do not wish. This has sometimes led to harm to others or harm to the individual.
Then take substance use disorder. If someone is abusing alcohol, illegal drugs, prescription drugs, other substances, should they be forced into substance use disorder treatment? If they have committed an illegal act – drunken driving, purchasing illegal drugs or prescription drugs illegally – they are sometimes offered a reduced sentence or clemency if they complete a course of drug or alcohol rehab.
Dr. Mark Willenbring, who runs an addiction specialty clinic, said locking up addicts who refuse treatment is as ridiculous as “incarcerating people with heart disease who continue to smoke or people with diabetes who don’t manage their diet.”
If they don’t really want to stop their substance use disorder, this can lead to worse outcomes. One is that they may resume their substance use disorder without realizing their tolerance has decreased, and a much smaller drug dosage could lead to overdose and death.
In the case of pregnant addicts who don’t stop using their drugs while pregnant, sometimes the mother is arrested, incarcerated and forced into drug and alcohol detox and rehab until at least the baby is born. Even if you don’t consider a fetus a human being, what’s the harm in that?
Well, one unintended consequence is that in states where that is the law, pregnant addicts may not go to prenatal care at all. It’s bad for a child to be born to a substance abusing mother for a plethora of reasons, but to be born to such a mother without prenatal care, maybe without even a doctor, is much worse.
Substance abuse is a real problem, but forcing incarceration or treatment is a feel-good political or law-enforcement idea, not an evidence-based solution.
