A striking phenomenon in many western countries is the increasing use of the criminal justice system as a means of channelling and coercing drug users into treatment. Despite somewhat equivocal research evidence about its effectiveness, this approach has continued to expand, including in Britain. This article takes a step back and explores some of the critical background issues that have been largely overlooked to date. Some conceptual, ethical and criminological aspects of coerced treatment in the criminal justice system are considered. It is argued that coerced treatment is a central issue for both contemporary criminology and criminal justice policy. © 2007 SAGE Publications.