• Clients may mistrust someone who is allied with law enforcement and may not confide important clinical information for fear it will be used against them.
• Treating sick people like criminals may breed countertherapeutic feelings of resentment, hostility, or hopelessness.
• Forcing clients to spend time in criminal justice settings may have the unintended consequence of socializing them into a milieu of antisocial behavior.
• Criminal justice supervision is expensive and time-consuming. Judges, bailiffs, and probation and parole officers cost money that would then not be available for formal drug abuse treatment.

Proponents of a public safety perspective contend instead that:

• Drug-involved offenders are characteristically impulsive and irresponsible.
• These offenders frequently fail to meet their obligations and often do not stay out of trouble unless they are closely monitored and face immediate, consistent, and severe consequences for their noncompliance.
• Such close monitoring may be as therapeutic as or more therapeutic than coddling offenders in treatment because it instills a sense of accountability and provides highly efficacious behavioral contingencies (e.g., Satel, 1999).

Neither the pure public health position nor the pure public safety position is often borne out by research.

The available evidence suggests that both may be correct, but with reference to different clients. Some clients perform better if they are left alone to develop an effective therapeutic alliance with their counselor and to focus on their problems and recovery in treatment. Others require consistent and intensive supervision by criminal justice authorities in order to succeed.