People are more likely to stay in a substance abuse treatment program when they are legally advised or ordered to participate, a new U-M study shows.
Deciding to use coercion, however, may affect a person’s recovery from a substance use disorder, says Brian Perron, assistant professor in the School of Social Work and lead author.
Legal coercion often is used to leverage substance abuse treatment among people who otherwise would not voluntarily participate. These individuals are required or recommended by an attorney or someone in the criminal justice system to seek treatment.
The study, which included responses from 2,694 people who abused alcohol or drugs, examines the influence of legal coercion on retention in substance abuse treatment in three different settings: short-term residential, long-term residential and outpatient treatment.
Outpatient treatment had the highest coercion rate (40 percent) compared to short-term residential (31 percent) and long-term residential treatment (26 percent). People in outpatient treatment had the highest dropout rate at nearly 65 percent. Short-term and long-term treatments were 28 percent and 44 percent, respectively.
“These figures reveal a significant loss of the limited dollars that are available in publicly funded treatment,” he says.
Legal coercion appears to have a significant influence, but it also is important to consider the role of matching client problems to specific services, Perron says. “If clients find treatment beneficial to their needs, they are more likely to continue in treatment.”
Coercion of any type removes the decision-making power from clients. “This loss may place clients at risk of receiving substandard care or services of poorer quality services, whereas persons who attend treatment voluntarily are positioned to make more choices on their own behalf,” Perron says.
Perron conducted the study, which appears in a recent issue of Drug & Alcohol Dependence, with Charlotte Bright, a doctoral candidate at Washington University in St. Louis.
