Abolition and Addiction Treatment: From Moral Injury to Moral Rebellion

Mandated addiction treatment is a punitive and carceral practice fed by the prison system, child protective services, and other state authorities. Though billed as a support service and an alternative to punishment, it relies on criminalization of people who use substances and serves to monitor and control them rather than addressing their needs or wishes. In an abolitionist perspective, substance use should be decriminalized and all services strictly voluntary. Drawing from the author’s experience as a clinical counselor in mandated treatment, this article examines worker distress in the industry as a form of moral injury. Turnover and short-staffing in addiction services are often blamed on “burnout,” but this article suggests a deeper cause: that mandated treatment violates the morality of those providing it. Moral injury offers a conceptual framework with which to articulate and consolidate dissent among clinicians and others in direct service who hold abolitionist ideals of autonomy, justice, and care without conditions. Considering findings on “moral rebels” in the workplace, as well as the author’s first-hand learning challenging treatment organizations and the state treatment apparatus, the article presents possibilities for refusing coercion and abuse in substance use services.