On August 14, 2025, New York City Mayor Eric Adams unveiled a sweeping new proposal, the Compassionate Interventions Act, that would allow authorities to involuntarily commit individuals deemed to pose a danger to themselves or others due to substance use disorder (SUD). The plan, which Adams announced as part of his “End the Culture of Anything Goes” campaign, aims to address what he describes as a crisis of addiction and disorder in the city’s streets. But the move has ignited a fierce debate among advocates, experts, and the public, raising thorny questions about civil liberties, public health, and the limits of government intervention.
According to the mayor’s office, the Compassionate Interventions Act would codify the authority for police and other officials to hospitalize people who appear to be a danger because of substance use. Judges could mandate treatment for those who do not attend voluntarily. Adams’ plan closely mirrors recent expansions of New York State’s involuntary commitment law for mental health, and, as Filter notes, is expected to disproportionately impact unhoused people—those already among the city’s most vulnerable.
“In the name of public safety, public health, and the public interest, we must rally to help those in crisis because ‘anything goes’ is worse than nothing at all,” Adams said during remarks to the conservative Manhattan Institute. The mayor positioned the legislation as a necessary step to restore order and compassion to city streets, contending that, “We need humane places that give people dignity. Staff who care. That’s really important.”
The proposal comes with a $27 million investment focused on improving access to substance use treatment. Initiatives include connecting emergency room patients with long-term care, expanding peer support for those who have survived nonfatal overdoses, and launching New York’s first pilot program of “contingency management”—offering small financial incentives to encourage people to quit using drugs. According to the mayor’s office, these strategies represent a multi-pronged approach to a persistent and complex problem.
Yet, as The New York Times and Filter have reported, the specifics of how involuntary commitment would be implemented remain murky. The act does not clarify how authorities would assess whether someone is a danger due to SUD, or how the rights of drug users and unhoused people would be protected in a system that, critics say, has a history of trampling those very rights. The lack of detail has only fueled skepticism among civil liberties groups and harm reduction advocates.
Donna Lieberman, executive director of the New York Civil Liberties Union (NYCLU), issued a stark warning: “Forcing people struggling with substance use into treatment will not deliver recovery to the person or real community safety. Forced treatment can greatly increase the risk of a fatal overdose, raise serious due process and civil liberties concerns, and contribute to harmful stereotypes about people with substance use disorders.” Her concerns echo those of many in the harm reduction community, who argue that coerced or involuntary treatment undermines dignity and autonomy, and may ultimately do more harm than good.
James (a pseudonym), an unhoused New York City resident and blogger, voiced fears that the policy could lead to misjudgments and abuses. “For example, sleep deprivation has very similar symptoms” to intoxication, he told Filter. James predicted that authorities might use excessive force in arrests and that facilities would be plagued by poor conditions, lack of medication, and retaliation against complaints. “Mayor Adams isn’t saying where he would commit people who use drugs, or what would be done to them there,” James said. “But we can guess based on similar initiatives and related facilities,” which, he added, are rife with violence and abuse.
Despite these concerns, some experts argue that compulsory treatment can be justified in certain circumstances—if, and only if, it is implemented with care and high-quality resources. Keith Humphreys, professor of psychiatry and behavioral sciences at Stanford University, told Filter, “If someone steps out of a bar smoking cannabis and is taken away, that’s crazy. But if someone is doing fentanyl 50 times a day and they might die … you can make a case for it.” Humphreys emphasized the importance of offering the full range of evidence-based medications and ensuring that treatment settings are humane and respectful, not punitive or neglectful.
The debate over Adams’ proposal has also drawn in national context. The plan echoes similar laws in other states, as well as a July 2025 executive order from President Donald Trump that called for expanded use of involuntary commitment for substance use disorders. Portrayals of urban disorder have fueled right-leaning political agendas across the country, and Adams’ move is seen by some as aligning with that trend—especially as he faces a tough reelection campaign and is trailing in the polls, according to Filter.
But does compulsory treatment actually work? That question has been at the heart of the public response since Adams’ announcement. As The New York Times reported, critics argue that forcing people into treatment is “often ineffective,” and Anne Marie Foster, CEO of a city addiction treatment facility, told NY1, “Forcing people into hospitalization does not work.” These objections, as summarized by Filter and The New York Times, are rooted in concerns about individual autonomy, the effectiveness of treatment, and civil liberties.
The research on compulsory treatment is, in a word, mixed. A widely cited systematic review found limited evidence of benefits and some potential harms, concluding that the damage to liberty may outweigh the gains. Another, more recent review in the Canadian Journal of Addiction reported a “lack of high-quality evidence to support or refute involuntary treatment” for substance use disorders. Many studies suffer from selection bias, making it difficult to determine whether compulsory treatment itself is responsible for any observed benefits or harms.
Yet, as highlighted in a Manhattan Institute analysis, some studies suggest that involuntary treatment performs at least as well as voluntary treatment. For example, research has found no significant difference between veterans ordered by a court into alcohol treatment and those who entered voluntarily, or between Chinese heroin users in mandatory versus voluntary detox. Some studies even show retention benefits, particularly in specific populations like pregnant women and older adults, when using methods like propensity score matching to control for differences between groups.
The strongest evidence comes from randomized or quasi-randomized studies. In California’s 1960s-era civil commitment program, those who remained in compulsory inpatient treatment relapsed and returned to crime at half the rate of those released early. Another randomized study found that alcoholics assigned to compulsory inpatient treatment were less likely to be drinking or using drugs at follow-up than those assigned to compulsory participation in Alcoholics Anonymous.
Perhaps most relevant to Adams’ plan are drug courts, which mandate treatment instead of incarceration. These programs have been shown to reduce recidivism by 9 to 24 percent and lower drug use, with the Honest Opportunity Probation with Enforcement (HOPE) program demonstrating significant benefits compared to control groups.
Still, the evidence is far from perfect. The Canadian Journal of Addiction authors caution that much of the literature is contaminated by poor study design and selection bias, and the best research—often focused on drug courts—may not be generalizable to other forms of compulsory treatment. Nonetheless, the balance of research, as summarized by the Manhattan Institute, suggests that compelled treatment can help some individuals more than leaving them untreated, especially those most resistant to voluntary engagement.
As New York City weighs the Compassionate Interventions Act, the debate is sure to intensify. The city stands at a crossroads, grappling with how best to balance compassion, public safety, and the rights of some of its most marginalized residents. The outcome may well shape not only the future of addiction policy in New York, but also the broader national conversation about how far society should go in the name of saving lives.
