[Is involuntary commitment to treatment applicable in case of an addictive disorder in the French context? A critical review of available evidence]

Abstract

Objective: The objective of this work was to determine whether compulsory psychiatric treatment is applicable in France to patients with an addiction. To this end, several questions were formulated, at the legislative level and in terms of professional recommendations. Our secondary objective was to analyse those practices epidemiologically and in terms of evaluating their impact.

Methods: Using the PRISMA method for systematic research, documents were selected from the following databases: regulatory (Legifrance), scientific societies [High Authority for Health (HAS), French Society of Emergency Medicine (SFMU), French Society of Alcohology (SFA)]; concerning our secondary objective (epidemiological and evaluative) documents from several data bases [Public Health Database (BDSP), Psy Health Foundation, EM-Premium, Pubmed] were reviewed.

Results: The search retrieved 163 documents, of which 13 were included based on examination. Legislative texts and professional recommendations do not exclude involuntary commitment to treatment in case of an addictive disorder. Epidemiological data describe use disorder as one of the most mentioned disorders in cases of involuntary commitment to treatment, with clinical improvement as long as treatment lasts.

Conclusion: French law does not prohibit compulsory addiction treatment in psychiatry. Compulsory addiction treatment could be an access to health care for some patients and an emergency measure to limit at one point the accumulation of damage or in view of a life-threatening situation.

Keywords: Addiction; Civil commitment; Compulsory treatment; Hospitalisation sous contrainte; Soins sans consentement; Substance use disorder; Trouble de l’usage.