Voluntary vs Involuntary rehab
Rishab and Ayush were at the same rehabilitation centre for their drug addiction issues. They were offered standardized treatment for addiction along with personal counselling sessions. At the end of 6 months, both were released from care, however, while Rishab continued to stay clean even months after release, Ayush had a non-fatal overdose within weeks of release. While there are many reasons to relapse, it is important to note that Rishab’s was a voluntary admission to rehab, whereas Ayush’s was involuntary admission to rehab, forced by his parents.
The Mental Health Care Act (MHCA) was published in the Gazette of India by the Ministry of Health and Family Welfare in April 2017 and the rules were notified on May 29, 2018. The Mental health care act 2017 has undergone important changes and added new dimensions to the 3-decade-old Mental Health Act. One such new addition is the inclusion of the “mental conditions associated with abuse of alcohol and drugs” under the new Act. Another important mandate of the MHCA is that informed consent must be obtained from all individuals with substance use disorders (SUDs) for any treatment. However, there are a significant number of cases where people with SUDs are forced into rehabilitation centres through various forms of coercion.
Voluntary vs Involuntary rehab: difference in the outcome
Although there isn’t much research done on this particular subject, some studies have shown that when a person with SUDs seeks voluntary admission to rehabilitation, the outcome tends to be more positive. The reason being the person is actively seeking help and is willing to go through all the steps of rehabilitation which can be quite tough on the mind and the body, especially the process of detoxification. The person has also accepted that their drug addiction is harming their life as well the lives of their loved ones. This realization gives the person the mental and the physical strength to continue with their sobriety post-rehabilitation as well.
On the other hand, when a person with SUDs is coerced into rehabilitation the outcome is usually not the same. While many countries around the world force people with SUDs to undergo rehabilitation as an alternative to jail, the outcome is not usually as expected. More often than not the forced periods of abstinence causes the individual to seek drugs with renewed vigour and cases of overdose are not uncommon.
There have been cases where such “rehabilitation centres” can more appropriately be described as “compulsory drug detention centres”, where there is a lack of evidence-based treatment, and sometimes there is even a violation of human rights where detainees are forced to undergo forced labour. It is important to note that even when there is no maltreatment and all the said standardized treatments are offered, involuntary admission/interventions lack the efficacy of voluntary treatment.
A 2016 study published in the International Journal of Drug Policy found little evidence that mandatory drug treatment helps people abstain from drugs. According to study author Dan Werb, PhD, “There appears to be as much evidence that [compulsory treatment] is ineffective, or in fact harmful, as there is evidence that it is effective,”. A majority of the studies reviewed by Web and his colleagues examined involuntary drug treatment centres outside the United States, many of which were rife with human rights violations.
How to convince a loved one to go into rehab voluntarily?
As you are now aware, involuntary admission is not legal in India nor is it an effective method of treatment. However, that doesn’t mean you give up hope and not seek treatment for your loved one. The most important thing you can do is help them realize that they need help for their drug addiction issues and that they need to voluntarily seek help. Here’s what you should and shouldn’t do when trying to get your loved one to a rehabilitation centre.
| Dos | Don’ts |
| Listen to them and build trust | Threaten them with dire consequences if they don’t stop using |
| Be truthful and open about how their addiction is affecting your life and your personal relationship with them. | Criticize them and shame them for their behavior or make them feel like a disappointment. |
| Respect their privacy | Tell everyone about their drug addiction |
| Share articles and pamphlets with them about rehab centres | Stop them from going out and meeting friends |
| Continue being supportive till they are ready to seek help | Keep barraging them with threats both verbal and physically till they go for treatment |
A very popular method of getting someone to see reason is to hold an intervention. An intervention is a carefully planned meeting of friends and family, which could also have a professional such as a licensed alcohol and drug counsellor involved. During the intervention, friends and family will confront the loved one in a kind manner about the consequences of addiction and request him or her to accept treatment. It is important to note that a carelessly planned intervention can worsen a situation where the person with SUDs may feel ambushed or attacked.
Signs that you may need rehab treatment
If you have addiction issues, then chances are that your friends or your loved ones may have pointed it out to you. However, if that is not the case or that you are not convinced by them then here are some of the signs that may indicate that it is time to admit yourself into a rehab program.
You are having financial troubles – Your drug use is so out of hand that your savings have dwindled to the extent that you are financially broke.
You have run into trouble at work – Your drug use has led to a drop in productivity at work or at the worse loss of job.
Your personal and social life is in shambles – Your family and friends are now beginning to avoid you due to your unpredictable nature when you are “high” on drugs.
You have started doing drugs alone – From doing drugs for recreational purposes at parties you have now progressed to doing drugs all by yourself at any time of the day or night.
You no longer have control over your drug use – Your tolerance has increased and you need more drugs to get high and you would go to any extent to obtain drugs.
In closing, addiction to drugs is not a lack of willpower or morals, it is a mental condition that needs to be treated with evidence-based treatment, medication and therapy. Coercing or forcing someone with an addiction to a rehab centre can prove detrimental and is also looked down upon by the law. If you know someone that needs rehab treatment then try holding an intervention for them and help them understand why they need to admit themselves to a rehabilitation centre. One can always hope for a long-term positive outcome when the person needing the treatment admits themselves voluntarily to a rehab centre. Ultimately, healing begins with self-acceptance.
Sources:
Sarkar. S., Ghosh. A. (2018, Sep) Current legislation governing the care of individuals with substance use disorders in India: Rationale and implications. Indian Journal of Social Psychiatry.
Bazazi. A. (2018, June) Unpacking involuntary interventions for people who use drugs.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7006027/
Werbab. D., Kamarulzaman. A., Meacham. M.C., Rafful. C., Fischer. B., Strathdee. S.A., E.Wood. (2016, Feb) The effectiveness of compulsory drug treatment: A systematic review. International Journal of Drug Policy.
https://www.sciencedirect.com/science/article/abs/pii/S0955395915003588
Radcliffe. S. (2018, June) Should People with Drug Addictions Be Forced into Rehab? www.healthline.com
https://www.healthline.com/health-news/people-with-drug-addictions-forced-into-rehab
Umhau. J., Hartney. E. (2022, Feb) How to Help an Addict: Resources and Treatment. www.verywellmind.com
https://www.verywellmind.com/how-to-help-addicts-22238
(2017, July) Intervention: Help a loved one overcome addiction.
https://www.mayoclinic.org/diseases-conditions/mental-illness/in-depth/intervention/art-20047451
Reviewed by
Rajnandini Rathod
M.Sc. Psychology,Research Associate at RehabPath
Rajnandini is a psychologist, keen on bringing awareness and uplifting the stigma attached to mental health in India. She completed her Master’s in Psychology with considerable experience with people with addiction problems. She co-initiated an online counseling platform during the pandemic to assist people with their rising mental health concerns. She is also working on various research projects and likes to spend her spare time making illustrations.
