Governor Kathy Hochul, Mayor Eric Adams, and MTA Chair & CEO Janno Lieber announce a Subway Safety Plan at Fulton Transit Center on Fri., February 18, 2022...(Marc A. Hermann / MTA)
On August 14, New York City Mayor Eric Adams announced the “Compassionate Interventions Act.” The proposed legislation, which the Adams administration intends to pursue in the upcoming state legislative session, is part of the mayor’s “End the Culture of Anything Goes” campaign. It would codify involuntary commitment, allowing authorities to hospitalize anyone “who appears to pose a danger to themselves or others due to substance use disorder,” and judges to mandate treatment for those who don’t attend voluntarily.
Like New York State’s involuntary commitment law for people deemed at risk from mental health conditions, which lawmakers recently expanded, Adams’ proposal would be expected to disproportionately impact unhoused people.
“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 in remarks to the conservative Manhattan Institute.
“Forced treatment can greatly increase the risk of a fatal overdose, raise serious due process and civil liberties concerns, and contribute to harmful stereotypes.”
His plan separately includes “a $27 million investment focused on improving access to substance use disorder treatment through outreach and enhanced treatment strategies,” according to the mayor’s office. Initiatives mentioned include connecting emergency room patients with long-term treatment, more peer support for people who’ve experienced nonfatal overdoses, and the city’s “first-ever” pilot program using contingency management—a model that gives participants small financial incentives to quit using drugs.
Adams’ proposal for involuntary commitment and forced substance use disorder treatment echoes those in many other states, as well as a July executive order from President Donald Trump.
There are few details so far about what kind of treatment programs would be mandated. Nor does the proposal explain how SUD and the appearance of posing a danger could be assessed upon brief observation. Nor how the rights of people who use drugs and unhoused people will be protected in a system that regularly tramples on those rights.
Many experts condemn forced or coerced treatment as unethical, ineffective and often harmful. The NYCLU is among advocates speaking out against Adams’ plan.
“Forcing people struggling with substance use into treatment will not deliver recovery to the person or real community safety,” Executive Director Donna Lieberman said in a statement. “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.”
James, an unhoused New York City resident, hopes the proposal is merely a “desperate publicity stunt.”
James*, an unhoused New York City resident and blogger, shares these and other fears. He told Filter that with Adams badly trailing Zohran Mamdani and others in his reelection bid, he hopes that the proposal is merely a “desperate publicity stunt.”
He worries that authorities might misjudge who is under the influence—”For example, sleep deprivation has very similar symptoms”—and predicts arrests with excessive force.
“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 said, are rife with violence and abuse. He expects a lack of medication, poor conditions and “complaints ignored, then answered with retaliation.”
Keith Humphreys, professor of psychiatry and behavioral sciences at Stanford University, is prominent among those who believe coerced treatment can be justified in certain circumstances, depending on how it’s implemented. “If someone steps out of a bar smoking cannabis and is taken away, that’s crazy,” he told Filter. “But if someone is doing fentanyl 50 times a day and they might die … you can make a case for it.”
He emphasized the need for “good quality treatment programs” if treatment is to be “helpful” rather than “destructive.” To this point, he wondered if people would be offered the full range of evidence-based medications under Adams’ plan, or forced to suffer painful withdrawal, with lowered tolerance increasing subsequent risk of overdose.
“We need humane places that give people dignity. Staff who care. That’s really important,” Humphreys said.
Many in the harm reduction space, however, assert that dignity is incompatible with the loss of agency coerced or forced treatment entails.
Portrayals of urban disorder have fueled right-wing politics nationwide, and are a lynchpin of the Trump administration’s agenda—weaponized to wage war against everyone from immigrants to student protestors. Mayor Adams’ plan could be seen as following that lead.
* Name changed to protect source.
Photograph of Adams in 2022 by Metropolitan Transportation Authority of the State of New York via Wikimedia Commons/Creative Commons 2.0
