The executive order Trump issued this summer to “end crime and disorder on America’s streets” directs federal agencies to support enforcement of state civil commitment statutes and deprioritize harm reduction efforts. Two recent articles explored the impact of implementing the federal directives at the state and local levels.

The details:

At least 34 states and DC have laws allowing people with severe substance use disorder (SUD) to be involuntarily committed to treatment, but they are seldom used in many states.
Civil commitment laws are typically invoked by relatives, but police and doctors can also petition judges.
Typically, the petitioner has to prove by “clear and convincing” evidence that the individual presents a continuing risk of harm to themselves or others. Critics say that protections for those who refuse treatment are minimal, with the “risk of harm” standard loosely interpreted.
In some states, judges can mandate a mix of residential and outpatient programs, but in at least 5 states, they can order only inpatient treatment. Length of involuntary commitment can range from 2 weeks to a year, though the most typical is 90 days. Laws do not detail the type, much less the quality, of treatment. Many private-sector programs will not accept a mandated patient because they believe treatment should be voluntary (or prefer not to work with a patient who does not want to be there).
15 states will not civilly commit someone with SUD unless they also have a mental illness.

But:

Civil commitment laws are intended as last-ditch options, and recent research largely suggests that mandated treatment is not effective. Committing someone may help interrupt their substance use, but involuntary treatment is often not designed to adequately treat the chronic disease of addiction and promote long-term recovery.
Obstacles to scaling up implementation of civil commitment laws are considerable. Treatment availability is already limited. Residential treatment is expensive, and to discourage families from using civil commitment as a back door to free treatment, many states say the petitioner or patient must bear the cost. Unless either party has insurance, Medicaid usually pays. Given the pending cuts to Medicaid, the cost for civil commitment placements will be daunting.
Localities are grappling with HIV outbreaks among people who use drugs and are homeless, in part due to the closing of programs that distribute sterile syringes and the clearing of homeless encampments, which upends care for people living there.
The administration says its approach will increase public safety, but research suggests otherwise. Syringe service programs reduce discarded needles in the community and do not increase crime, can significantly reduce new HIV and hepatitis C cases, significantly increase entry into SUD treatment, save taxpayer money, and are leading distributors of overdose reversal medications.
The call to defund harm reduction and force people into treatment has been accompanied by cuts to funding for addiction and HIV-related programs and the federal agencies focused on these issues.

The main point: States/localities are increasingly moving away from harm reduction and toward forced treatment amid backlash as the opioid crisis continues. The executive order will reinforce this shift, despite evidence showing the harm of such approaches.