Uses of coercion in addiction treatment: Clinical aspects

Maria A. Sullivan, Florian Birkmayer, Beth K. Boyarsky, Richard J. Frances, John A. Fromson, Marc Galanter, Frances R. Levin, Collins Lewis, Edgar P. Nace, Richard T. Suchinsky, John S. Tamerin, Bryan Tolliver, Joseph Westermeyer

Research output: Contribution to journalReview articlepeer-review

61 Scopus citations


Coerced or involuntary treatment comprises an integral, often positive component of treatment for addictive disorders. By the same token, coercion in health care raises numerous ethical, clinical, legal, political, cultural, and philosophical issues. In order to apply coerced care effectively, health care professionals should appreciate the indications, methods, advantages, and liabilities associated with this important clinical modality. An expert panel, consisting of the Addiction Committee of the Group for the Advancement of Psychiatry, listed the issues to be considered by clinicians in considering coerced treatment. In undertaking this task, they searched the literature using Pubmed from 1985 to 2005 using the following search terms: addiction, alcohol, coercion, compulsory, involuntary, substance, and treatment. In addition, they utilized relevant literature from published reports. In the treatment of addictions, coercive techniques can be effective and may be warranted in some circumstances. Various dimensions of coercive treatment are reviewed, including interventions to initiate treatment; contingency contracting and urine testing in the context of psychotherapy; and pharmacological methods of coercion such as disulfiram, naltrexone, and the use of a cocaine vaccine. The philosophical, historical, and societal aspects of coerced treatment are considered.

Original languageEnglish
Pages (from-to)36-47
Number of pages12
JournalAmerican Journal on Addictions
Issue number1
StatePublished - Jan 2008


Dive into the research topics of 'Uses of coercion in addiction treatment: Clinical aspects'. Together they form a unique fingerprint.

Cite this