Comparing Outcomes of ‘Voluntary’ and ‘Quasi-Compulsory’ Treatment of Substance Dependence in Europe

Schaub, Michael P; Stevens, Alex; Berto, Daniele; Hunt, Neil; Kerschl, Viktoria; McSweeney, Tim; Oeuvray, Kerrie; Puppo, Irene; María, Alberto Santa; Trinkl, Barbara; Werdenich, Wolfgang; Uchtenhagen, Ambros

doi:10.1159/000265938

Cited by 28 publications

(22 citation statements)

References 74 publications

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“…Services from the United Kingdom, Italy, Austria, Germany, and Switzerland were selected if they treated participants eligible for either QCT or voluntary groups [4,25] . The QCT group was defined as participants receiving treatment on court order (i.e.…”

Section: Services and Participant Selectionmentioning

confidence: 99%

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Predictors of Retention in the ‘Voluntary’ and ‘Quasi-Compulsory’ Treatment of Substance Dependence in Europe

et al. 2011

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Background: Policies and practices related to the quasi-compulsory treatment (QCT) of substance-dependent offenders are currently implemented in many countries, despite the absence of reliable knowledge about significant predictors of treatment retention. This study aimed to identify such predictors in QCT and voluntary treatment. Methods: Participants were treated in one of 65 institutions in 5 European countries. They were interviewed at intake on substance use, crimes committed, perceived pressure for treatment, self-efficacy, stage of change, employment, and health-related variables. Binary logistic regression models were computed to identify predictors of treatment retention at an 18-month follow-up. Moderator analyses were computed to investigate whether these predictors vary by treatment condition (QCT vs. voluntary). Results: A higher number of working days in the previous month was positively associated with treatment retention, while use of heroin, crack, and multiple drugs, psychiatric problems in the previous month, and lifetime depression were negatively associated with treatment retention. Higher perceived medical pressure resulted in higher treatment retention rates only for participants in QCT. Conclusion:Predictors of substance abuse treatment retention are quite similar across both QCT and voluntary treatments. Perceived medical pressure is of higher relevance than the often-believed legal pressure for treatment retention in QCT.

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Section: Services and Participant Selectionmentioning

confidence: 99%

“…In a recent study, we demonstrated that treatment of such offenders reduces substance use and crime and improves health and social integration similarly to voluntary treatment [4] . However, at present only a few substance-dependence treatment programmes for prisoners are available (e.g.…”

Section: Introductionmentioning

confidence: 97%

Predictors of Retention in the ‘Voluntary’ and ‘Quasi-Compulsory’ Treatment of Substance Dependence in Europe

et al. 2011

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“…It also implies that dependent drug users should receive no automatic exemption from punishment for any other crimes that they commit, as they retain responsibility for their actions. If they do commit such crimes, then offering them a treatment alternative to an otherwise justified criminal sanction may offer a way to limit the infliction of penal pain whilst also more effectively protecting potential victims from future offences (Schaub et al, 2010;Stevens, McSweeney, van Ooyen, & Uchtenhagen, 2005).…”

Section: Do 'Addicts' Lose Rights?mentioning

confidence: 99%

Drug policy, harm and human rights: A rationalist approach

Stevens

2011

International Journal of Drug Policy

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Background: It has recently been argued that drug-related harms cannot be compared, so making it impossible to choose rationally between various drug policy options. Attempts to apply international human rights law to this area are valid, but have found it difficult to overcome the problems in applying codified human rights to issues of drug policy. Method: This article applies the rationalist ethical argument of Gewirth (1978) to this issue. It outlines his argument to the 'principle of generic consistency' and the hierarchy of basic, nonsubtractive and additive rights that it entails. It then applies these ideas to drug policy issues, such as whether there is a right to use drugs, whether the rights of drug 'addicts' can be limited, and how different harms can be compared in choosing between policies. Result: There is an additive right to use drugs, but only insofar as this right does not conflict with the basic and nonsubtractive rights of others. People whose freedom to choose whether to use drugs is compromised by compulsion have a right to receive treatment. They retain enforceable duties not to inflict harms on others. Policies which reduce harms to basic and nonsubtractive rights should be pursued, even if they lead to harms to additive rights. Conclusion: There exists a sound, rational, extra-legal basis for the discussion of drug policy and related harms which enables commensurable discussion of drug policy options.

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“…If he or she is not granted the right to withdraw consent, this court order is a form of CCC, but if he or she has the full right to withdraw consent at any time, it is not. The latter situation, when the person has the legal right to withdraw consent and leave treatment, is sometimes called ‘quasi-compulsory treatment’, due to the constrained choice when the only alternative to treatment is prison [14,15]. The orders from drug courts include not only residential treatment, but also placement in outpatient programs.…”

Section: Introductionmentioning

confidence: 99%

Compulsory Commitment to Care of Substance Misusers: International Trends during 25 Years

Israelsson

Gerdner

2012

Eur Addict Res

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Purpose: The study explores international trends in law on compulsory commitment to care of substance misusers (CCC), and two subtypes – civil CCC and CCC within criminal justice legislation – as well as maximum length and amount of applications of such care. Method: The time period covers more than 25 years, and a total of 104 countries and territories. The study is based on available data in three times of observation (1986, 1999 and 2009). Applications of CCC in number of cases are studied on European level for the years 2002–2006. Trends are analyzed using nonparametric tests and general linear models for repeated measures. Findings are discussed from contextual analysis. Result: There is a trend towards decrease in the number of countries worldwide having civil CCC legislation after the millennium, while CCC under criminal law has increased since the mid-1980s, resulting in some total net decrease. The shift results in longer mean duration of CCC and an increase in the number of cases sentenced. Conclusion: There is a risk that the shift from civil CCC to penal CCC implies more focus on young out-acting males in compulsory treatment and that the societal responsibility for more vulnerable persons might be neglected.

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Comparing Outcomes of ‘Voluntary’ and ‘Quasi-Compulsory’ Treatment of Substance Dependence in Europe

Cited by 28 publications

References 74 publications

Predictors of Retention in the ‘Voluntary’ and ‘Quasi-Compulsory’ Treatment of Substance Dependence in Europe

Predictors of Retention in the ‘Voluntary’ and ‘Quasi-Compulsory’ Treatment of Substance Dependence in Europe

Drug policy, harm and human rights: A rationalist approach

Compulsory Commitment to Care of Substance Misusers: International Trends during 25 Years

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