this post was submitted on 24 Dec 2025
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It seems nobody has a good solution, just disjointed efforts. The only hope I see for changing the creation of people that end up homeless Is early support for abused people, and mental health care for free, so that future generations have better chances of avoiding drugs as a coping mechanism for their demons.
To the articles: There seems to be a point where the drugs in society have become so addictive that it ~100% removes the persons ability to make healthy choices for themselves, and removes joy from life- other than the drug.
It seems to make logical sense to move the people suffering to involuntary care. We bring physically injured people to hospital and perform life saving surgeries on those that are too injured to refuse treatment choices.
As compassionate humans we take injured wild animals against their will and force them into treatment so they can live a proper life, so we try to do the same with our fellow humans.
Maybe its the wrong approach, but the other non barrier methods don't appear to be working.
I think you're making a false equivalence. If you're brought unconscious to emergency after a motor vehicle collision, the docs can legally presume you'd consent to life-saving interventions and give you them before you're conscious. Once you're awake, you're free to decline treatment and leave the hospital. That could be within 24 hours.
Involuntary treatment for substance use probably means 1 to 3 months of involuntary care: not being able to leave a hospital unit, and having most 'resistance' to medical treatment or the hospitalization interpreted as hostility and/or inability to care for oneself (in some eye's justifying ongoing involuntary detention).
Hospitalization is pretty indignifying. If you're on board with the treatment plan, you accept it. If you're there against your will, it feels less like healthcare and more like prison (including for the healthcare staff). From my experience of caring for people involuntarily admitted to hospital for mental health reasons - the experience is more traumatizing for them than it is a foundation to improve their lives. Addiction is a social problem; it needs a social fix: Housing, counseling, employment opportunities are far more needed than medical care.
I also don't believe any drug is 100% addictive. The more stress and trauma and fewer resources and alternative sources of relaxation a person has access to - the more susceptible they are to addiction. These underlying factors are what we need to treat. The only reason involuntary care is popular amongst some politician-types isn't because it's effective, it's because it aligns with their neoliberal values and they don't care about effectiveness. Money for involuntary care would be better spent treating (eg, Housing First) and preventing homelessness
They have proved that meth destroys the dopamine system so the only way you feel pleasure in life is meth.
Recovered people have suggested it takes years for the brains reward syatem to reset. A meth addict is not able to make proper choices for their future quality of life. Oxy seems similar, and add deadly drugs cut into that you have immenent death waiting.
I'm not saying involuntary care is the answer, I'm saying it seems like the answer when you follow logic reasoning, thus why people are for it.
I have lots of compassion for people without a roof over their heads, and I agree there's no one-size-fits-all solution, and we shouldn't just use this program to move people into a prison or cattle pen away from public view.
And while I support and advocate for tackling the precursors to both addiction and homelessness (affordable homes, secure food supply, safe drug supply, proper care, up-skilling), there's a certain level where those things won't work well anymore and you have to move to treat before things get even worse for them. How can one navigate living on their own if they are on the street bent over from the fent? A program shouldn't treat every homeless person in the same way as an addict, but an individual in the bent over situation needs treatment that they cannot easily obtain on their own, and would make sense to put them in involuntary treatment until they can make their own decisions uninfluenced by drugs.
I believe the evidence is pretty clear that the best method of getting people to achieve long-term self-driven improvements around these issues is offering them health and social care (e.g., wounds, food, shelter, employment info) where they are (eg, using in a safe consumption site, on the street, admitted to emergency or hospital) and building relationships with them, as opposed to temporarily taking away all their decision-making capacity and incarcerating them. Medicalizing the problem is to treat it very superficially and has a revolving door effect on patients, which is costly and associated with worse outcomes. I appreciate the discussion. It's making me realize that I may want to do more work in this area.