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Tijdschrift voor Psychiatrie 55 (2013) 4, 269 - 277

Essay

Compulsory hospitalisation of patients suffering from severe drug or alcohol addiction

P.E. Höppener, J.A. Godschalx-Dekker, B.J.M. van de Wetering

 summary
background Psychiatrists treating patients with drug and alcohol addiction currently consider these afflicions to be mental disorders. If patients are so mentally disturbed that they are a danger to themselves or others, then compulsory hospitalisation seems to be an acceptable treatment option. However, it would seem that at present this solution is not normal practice in addiction care.
aim To describe the indications for compulsory hospitalisation when mental disorders associated with addiction and withdrawal cause risks and dangers.
method Discussion of the indications for compulsory enforced hospitalisation supported by literature.
results Compulsory hospitalisation is based on the acceptance of the principle that addiction and substance abuse are mental disorders. Indications for emergency hospitalisation include intoxications, acute withdrawal symptoms and other disorders associated with substance use. Indications for longer-term measures are (self)-protection, societal isolation and the need to protect other people from danger. Factors influencing the decision-making process regarding emergency hospitalisation are motivation and treatment perspectives, mental incompetence, contraindications and conflicts between criminal law and patients’ rights.
results Compulsory hospitalisation deserves serious consideration as the ultimate step in treatment of intoxication, drug and alcohol dependence and withdrawal symptoms. In addition, emergency hospitalisation can be a way of averting danger, facilitating diagnosis and motivating abstinence or at least a reduction in substance use.

keywords addiction, compulsory hospitalisation, substance abuse