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

Abstract

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.

Compulsory detention in addiction treatment

“…Therese Reitan [1] misinterprets us [2] if she thinks we claimed that the Swedish model of compulsory addiction treatment violates human rights in the same way as compulsory detention programmes for addicted individuals in countries such as China and Vietnam. Our editorial said very clearly that what occurs in the latter 'cannot be dignified by the term of "compulsory treatment" '.…”

“…The authors also claim that Russia and Sweden are two of the few developed countries that still detain addicted people compulsorily and that this has been done 'in the absence of rigorous evaluations of the efficacy or safety of this approach'. Israelsson & Gerdner [2] recently published a paper on international trends in compulsory commitment of substance abusers. Based on data from 104 countries and territories, they conclude that the existence of compulsory commitment to care of substance misusers was more common than not at all three times of observation (1986,1999,2009).…”

A Bio-Social and Ethical Framework for Understanding Fetal Alcohol Spectrum Disorders

“…Potter [41] invokes the concept of 'biopower' [42] in arguing that such guidelines and legisliation make pregnant women's bodies the subject of state surveillance. This observation is perhaps most applicable to countries such as the USA and Finland where women can be subject to compulsory commitment and/or incarceration if their drugs or alcohol use is deemed to be potentially harmful to the fetus [3,40,41,43]. Targeted health promotions may exhibit similar characteristics.…”

European laws on compulsory commitment to care of persons suffering from substance use disorders or misuse problems– a comparative review from a human and civil rights perspective

“…Since the millennium there has been a global trend towards the abolition of public (mental health and social) legislation on CCC, while another trend (since the 80ies) has shown an increase in CCC under criminal law [5]. There is no general trend of a decrease in the actual use of CCC per se, but there is an on-going international shift from paternalistic-oriented law towards corrective or protective care of persons with substance misuse problems who are defined to constitute a threat to others or to society [5].…”