Mayor Adams calls for forced treatment for drug and alcohol addiction in NY

Mayor Eric Adams said Thursday he will push for a change in state law to allow people with substance use disorders to receive treatment, whether they want it or not.

Adams said the mandated treatment, part of an effort to reduce public drug use and intoxication, would empower clinicians to hospitalize people involuntarily if they pose a danger to themselves or others because of their use of drugs or alcohol. Judges would also have the authority to mandate care for individuals who are unwilling to consent to treatment.

Adams said the proposal, which he said he would push in the 2026 legislative session, would bring New York in line with the majority of other states, which already allow some form of involuntary commitment for substance use disorder.

He said the initiative is part of his broader campaign to make city streets more orderly. Adams, who is seeking re-election in November as an independent candidate, announced an effort earlier this year to “clean up” public drug use in the Hub, a shopping district in the South Bronx.

“Today, through our ‘End the Culture of Anything Goes’ campaign, we are putting forward our vision to support those dealing with substance use disorder and address public drug use on our streets and in our subways,” Adams said.

Adams’ new proposal comes after he and Gov. Kathy Hochul successfully advocated for a change in state law this year that expanded the criteria for when someone can be involuntarily transported to the hospital for mental health treatment.

The law now specifies that people can be taken to the hospital against their will if they appear to have a mental illness and are unable to care for themselves — a measure Adams has said is intended to apply to people living on the streets and in the subways.

That proposal faced significant pushback from some mental health and homeless advocates as well as criticism that it was infringing on people’s civil liberties. State lawmakers resisted the measure for years. But Hochul ultimately ushered it through after proposing a central piece of state budget negotiations during this year’s legislative session.

Nicolette Simmonds, a spokesperson Hochul, said she shares the mayor's goal of wanting to connect more New Yorkers with substance abuse disorders to compassionate treatment and will review the proposed bill when it's introduced in the Legislature.

The announcement from the mayor comes after President Donald Trump issued an executive order last month indicating that the federal government will offer grants to help states facilitate compulsory substance use treatment and will pull federal funding for harm reduction programs, such as needle exchanges.

Brian Stettin, the mayor’s senior adviser for severe mental illness, said the proposal around involuntary substance use treatment was developed in collaboration with NYC Health and Hospitals and other city agencies and was not related to the president’s order.

“Sometimes people come to the hospital, they're behaving erratic and they appear to have mental illness,” but it’s actually drug-induced psychosis, Stettin said. “Sometimes, we're letting people walk out of the hospital even though we genuinely know them to be a danger to themselves or others.”

As part of the plan announced Thursday, Adams is also committing $27 million to expand access to drug treatment programs in the city and test out new strategies to keep people engaged in care.

The city will invest in a pilot program called “Track to Treatment,” which will use an evidence-based model to provide patients with small rewards for positive behavior, according to the announcement. To ensure better follow-up, the city will also allocate $2 million to provide cellphones to participants in the Relay program, which seeks to engage people in treatment when they end up in a city hospital after an overdose.

Jasmine Budnella, the director of drug policy at Vocal-NY, a group that organizes around housing and public health issues, said she has mixed feelings about the mayor’s announcement.

“It’s clear he’s listening to public health experts” on the plan to expand and improve addiction treatment, Budnella said.

“Then, there's of course the really awful, ineffective, disproven and potentially deadly involuntary treatment aspect,” she added.

But even as more jurisdictions move toward compulsory drug treatment, there’s limited evidence that it’s effective, particularly when compared with voluntary treatment, said Kristine Torres-Lockhart, chief medical officer for addiction treatment provider Phoenix House New York.

“ Just generally speaking, the data does not support civil commitment for severe substance use disorders,” Torres-Lockhart said, adding that it is “just laden with a lot of ethical and clinical concerns.”

Lockhart said, in some cases, compulsory treatment can even be harmful. She said if someone who’s not interested in treatment goes into rehab and then relapses when they come out, they are likely to have a lower tolerance and be at higher risk for an overdose.

“For too long, politicians have tried to arrest and coerce people out of substance and alcohol use and misuse, and the mayor’s latest proposal is part of the same old, failed playbook,” Donna Lieberman, executive director of the New York Civil Liberties Union, said in a statement.

“There's really no question that voluntary treatment tends to lead to better outcomes” for both mental health and substance use care, Stettin said. “The problem is that we don't always have the option between voluntary and involuntary with someone with either severe mental illness or an addiction issue.  Sometimes the choice is between involuntary treatment and no treatment at all.”

Stettin said the mayor would seek to establish similar criteria for involuntarily taking someone to the hospital for substance use treatment as the state now has for mental health treatment.

This article was updated with additional comment.