Overdosing after treatment is a life-threatening danger that’s well-known to people who work with substance use disorders.
But according to an international literature review, Dr. Susan Collins said that people leaving involuntary treatment are more than 3 times as likely to die right after treatment than those who choose addiction services on their own.
She said that’s a poor return on investment for a treatment option that is very expensive.
Collins said she has experience dealing with substance use addictions, both personally and with family members.
“I understand the desperation that a family can feel," she said. "But that knee jerk response should motivate us to do even more evaluation and more research into what are best practices…versus a knee jerk reaction to force people into treatment.”
She said involuntary treatment should be kept as a last resort, not promoted as a solution for communities reeling from the fentanyl crisis.
"Almost linearly, the more choice a person has when they are struggling with substance use disorder in terms of how they find recovery, the more positive the outcomes are," she said.
Collins pointed out that even mandated treatment seems to have more positive outcomes than involuntary treatment.
Mandated treatment is assigned by a judge, who presents local treatment as an alternative sentence to punishments like incarceration.
Involuntary treatment requires designated crisis responders to meet very strict requirements before locking people into a secure withdrawal management center.
Currently, only three of those centers exist in Washington. They have 45 beds total, and they’re all on the west side of the state.
In 2026, two more secure facilities are set to open, including one in Benton County. It will be the most eastern secure withdrawal management center in the state.
