Abstract Background and aims Mandating people charged with drug‐related criminal offenses to participate in substance use disorder (SUD) treatment as an alternative to jail time is a policy with widespread political and public support in the United States; however, mandated treatment programs present a tension between competing ethical values (e.g. autonomy versus protection from harm). To help ground the ethical discussion, this paper examined qualitative literature on mandated treatment programs that explores these ethical tensions from the perspective of program participants. Methods We undertook a review of studies reporting views of individual participants on their experiences in a mandated treatment program. Scope of search was limited to the United States, and only literature pertaining to substance use treatment mandated by the criminal legal system was considered. In total, 39 studies were included in the review. Results Participants' perspectives reported in the literature attest to the existence of the following five tension points: (1) choice about whether to participate in a program, (2) choice about what services are provided during mandated treatment, (3) perceived conflicts of interest among treatment providers, (4) involvement of judges or other criminal legal officials in treatment decisions, and (5) targeting of people who are not in need of treatment. People subjected to mandates often experience these same tensions, but their overall appraisal of their experience often depends on unique contextual factors that vary substantially based on the implementation of programs in real world conditions. Many participants felt that programs such as drug court provide a necessary nudge without overly restricting their autonomy, but others revealed more ambivalent or negative attitudes. Conclusions The widely varying experiences of people in the United States participating in mandated substance use disorder treatment programs underscore the difficulty of rendering sweeping conclusions about the benefits and harms of mandated treatment and highlight the need to calibrate programs and policies to meet the specific needs and interests of different groups facing mandates.
Taylor et al. (Sun,) studied this question.