Involuntary Hospital Admission in the Treatment of People With Severe Substance Use Disorder

Objectives: In Canada, substance-related harms and mortality are a significant public health concern. Recently there have been discussions about the utility of involuntary hospital admissions for patients who have severe substance use disorders (SUDs) and may otherwise not receive or remain in treatment. This case report describes 3 patient cases where involuntary hospital admissions were used and resulted in good outcomes. Methods: Patients provided written informed consent to have their deidentified cases shared in this case report, and to review their electronic medical records for this purpose. Results: Patients ranged in age from early 20s to mid-50s. Each patient had a severe SUD and required inpatient hospitalization to stabilize. In each case, patients were admitted involuntarily to hospital for a brief period of time for safety and stabilization, permitting withdrawal management and initiation of medications to treat their SUDs. Although the patients were admitted involuntarily, they remained capable of consenting to treatment. Conclusions: When utilized for the least amount of time under specific circumstances, involuntary hospital admissions for people with severe SUDs may be productive and result in good outcomes for patients. Care should be taken to debrief involuntary admissions with patients to preserve therapeutic rapport. Future research should explore patient perspectives on involuntary hospitalization in the treatment of SUDs.