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The Conversation
The Conversation
Susan E. Collins, Professor of Psychiatry and Behavioral Sciences, University of Washington

What decades of research reveal about involuntary substance use treatment – and why evidence points elsewhere

Since President Donald Trump issued a July 2025 executive order aimed at “ending crime and disorder on America’s streets,” national attention has increasingly focused on involuntary treatment as a response to visible homelessness and drug use.

A few months later, in September 2025, officials in Utah announced plans for a 16-acre facility on the edge of Salt Lake City that would hold up to 1,300 people experiencing homelessness after they are removed from public spaces and offered a choice: the facility’s abstinence-based shelter or jail time. The facility also plans to include 300 to 400 beds reserved for involuntary treatment, for adults who have psychiatric and substance use disorders.

Supporters of this facility describe it as a humane alternative to the streets, while detractors liken it to prison.

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