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Table 1 Coercive Treatment vs Involuntary Treatment Characteristics

From: Mandatory treatment for methamphetamine use in Australia

  Coercive Treatment Involuntary Treatment
Definition Treatment provided to individuals as an alternative to a less desirous outcome. Short term civil commitment using specifically drafted legislation to treat people with substance dependence against their will in cases where there is imminent risk as a result of substance use.
Examples Drug Court to avoid incarceration; engagement with AOD services to avoid removal of children by Child Protection Services. Short term, hospital based treatment for people at imminent risk in the short term as a result of their substance use.
Patient’s consent required? Yes, patients must choose to engage in treatment and must have the capacity to do so. No, patients are detained and admitted involuntarily and must be determined to have their capacity to consent undermined by substance use.
Is a substance dependence required? No Yes
Treatment setting Community or residential Inpatient
Program target outcomes Reduced drug related harm to the individual, but also the community, family and/or employer Reduce the immediate harm to the individual, usually by reducing risk of imminent physical risk.
Referring agency Variable: justice, employer or industrial regulatory authorities, child protection, licencing boards Health professionals
Australian States and Territories with current programs All VIC, NSW, TAS
Level of evidence 2Aa 4a
Summary of Evidence available Variable result depending on characteristics of the treatment program, with most evidence coming from programs associated with criminal justice system. Some reduced use and better treatment engagement while in the program. Outcomes best with longer periods of engagement, particularly if combined with social supports. Cost effective interventions [13]. Evidence limited, particularly relating to long term outcomes. Models from Australia and internationally have been unable to show they achieved their aims in reducing long term harm, while being costly to provide [13].
Level of evidence for methamphetamine 3Ba none
  1. aBased on scores using the critical appraisal too from the Centre for Evidence Based Medicine system of grading evidence [15]