This chapter seeks to justify the use of involuntary treatment for a select group of drug dependent individuals to reduce further organ damage while increasing the possibility of achieving a reduction in harmful drug use. The chapter examines the different acceptability of involuntary treatments administered in acute medical, mental health and addiction medicine populations. The brain damage caused by ongoing alcohol consumption and the impact of that damage on rational decision making is proposed as one reason for trialling involuntary treatment units, staffed to assess and manage this more subtle form of brain damage. The lack of data supporting the efficacy of this approach is acknowledged but it is argued this is why core research is needed in this controversial area of medical practice.