Critical assessment of the role of compulsory treatment of drug use disorders in Germany

Background
The facilities for complsory treatment of alocohol or opioid or cocaine dependent people (in specially secured psychiatric forensic clinics), who have committed criminal offenses, in Germany are massively overcrowded. Addicted people who comitted criminal offences against the narcotic law or additional criminal offences to their alcohol addiction, are increasingy not being treated in voluntary residential or out-patient treatment, i.e. Opioid Substitution Treatment or drugfree treatment, but are being forced to treatment by court decision based on a psychiatric forensic expert opinion. A law to reform this treatment is ficussed on alleged incorrect placements, but dies not fundamentally question forced treatment.
Methods
The new law will be explained and discussed.
Results
In these specialised forensic clinics there is still hardly any medication-assisted treatment (with Methadone or Buprenorphine or Diamorphine), although the professional standards for the treatment of opioid addiction (based on Opioid Substitution Treatment OST) should be accepted and implemented, according to the guidelines of the medical associations. The responsibility for this implementation in forensic clinics lies within the ministries of health, not the ministries of justice.
Conclusions
In the scientfifc discourse on the enforcementmof measures, the concept of "compulsory crminiality" is questioned, but the effectiveness of this form of treatment is assumed, without questioning the fact that the continued consumption of psychoactive substances (and thus a violation of the narcotic law) is part of the addiction disease. The result of this law reform will lead to more addicted people swithin the prison system with more or less no therapeutic support.