Hard no from me.
Nobody is going to get clean if they don’t genuinely want to.
I'd be interested in looking at what the long-term data on involuntary vs. voluntary hospitalization and residential treatment looks like. I know here in Mass we have a (very imperfect) mechanism for involuntary SUD treatment called Section 35 which relies on the Department of Corrections to civilly detain someone for a period of treatment (typically 30 days, sometimes less) when their use is a threat to safety.
During the institutional era there was a completely different context within which substance use occurred. Successful treatment outcomes were quite poor, so much so that something like AA with its 10-15% success rate for those who chose to engage with it was seen as a revolutionary step. Also, functional yet destructive alcoholism was likely more prevalent in the 30s/40s/50s/60s which was the target demographic to engage with 12-step.
I'd like to believe that we should create programming that people want to engage in - things that provide a solution that someone can buy into instead of being forced into. Right now, treatment programs are designed based on outdated models that can rarely incorporate our understanding of addiction and progress that's been made in that area because they're not well funded, well staffed, or part of the overall health care system (they're silo'd and generally operate as standalone organizations).
If you want someone to get clean, then you treat the root trauma causing them to use. And maybe do some MDMA/psychedelic assisted psychotherapy.
I could see psychedelics having a place in recovery (can speak from personal experience that they were helpful, though not as part of a therapeutic model). I do think that the issue of 'trauma' being a root cause of addiction is a complex one. For some people there isn't always an identifiable trauma that sets them off, so much as the development of an unhealthy dependence on substances to get through the grind of life under an increasingly bleak system. I see this a lot with young people working in jobs that they feel alienated from the end product (eg. data scientists creating algorithms to facilitate financial prediction models for shareholder portfolios) - substance use becomes a way to deal with the grind and ultimately lack of meaning that comes from something that demands so much. Stimulants to stay focused on the pale blue light of their spreadsheets and coding terminals, alcohol and cannabis to soothe at the end of the day, psych meds to sleep. Masturbation and porn addiction is a big thing I encounter in this group, as is gambling due to the widespread integration of app-based gambling as well as crypto. MDMA or psychedelics may help, but traditional therapy, recovery supports, and social engagement are really what's needed.
I am a strong believer that face-to-face social participation is what's most lacking from the lives of people who struggle with problematic substance use. Abstinence is not the opposite of addiction, it's human connection as Hari opined.
Atlantic op-eds do generally make better toilet paper than reading material though.
Respectfully disagree - it's one of the few places that I find thoughtful and critical exploration of these issues taking place regularly, and it has a long history of supporting progressive perspectives on ideas, culture, sciences, politics, and current events. It may not be perfect, but it aspires to explore meaningful topics in a way that I appreciate. That said, if you're looking for a radical publication you probably won't find it there even if it does host some radical perspectives from time to time.
