Addiction is a complex disease process of the brain that results from repetitive drug intoxication and is associated with genetic, developmental, experiential, and environmental factors. Substance abuse is recently seen as a disease, as well as a social problem and problem of public. A substance use disorder is an important and clinically challenging aspect of the management of patients in psychiatric hospitals. Patients with substance abuse are reported to have a higher risk of violent behavior and to be hospitalized, homeless, or in jail. These factors can affect the treatment process and the patients with substance use disorder often being sent between addiction units and general psychiatry clinics. In general psychiatry clinics, caregivers primarily try to treat patients voluntarily but sometimes patients with certain circumstances (such as having psychotic symptoms, having violent behavior like suicidality or homicidally) need to be restricted and taken into an involuntary treatment. The ethical questions related to the use of involuntary treatment are a growing concern. Although freedom of choice and rights of patients are important ideals in today’s Western society, compulsory practices are still needed and common in mental health care systems. Involuntary treatment is ethically problematic because it is an act against to an individual’s autonomy. In the other hand, autonomy is generally understood to refer to the capacity to be one’s own person, to live one’s life according to reasons and motives that are taken as one’s own and not the product of manipulative or distorting external forces. It is the ability of the individual to make his/her own choices has been perceived as the basic foundation of social freedom and moral responsibility. Standard definitions of substance use disorders point the loss of control about using of the substance. Patients with substance use disorders may not often have the full capacity to be self-determining or autonomous at all times. Therefore, involuntary treatment may be justified, even for only a short period, if the loss of control caused by the compulsive drug-taking habits consequent to substance use disorder is considerable in admission. In addiction treatment internal motivation for change increases the treatment success as two-times. Also external motivators such as justice pressure, family consent and presumably coercion, are often associated with positive treatment outcomes. Given that intrinsic motivation for change is the primary distinction between voluntary and involuntary patients in addiction treatment. The legal institution of restriction of freedom for protection purpose entered into our legislation by means of the new Turkish Civil Code. The aim of such institutionalization is to provide seclusion of the people who cause danger to the community by the reason of their mental or inşicting grievous bodily troubles and whose protection cannot be otherwise provided to a convenient institution for their education and rehabilitation. Reason of restrictions have been specified as limited in the article 432 of Turkish Civil Code which are mental illness, mental defect, alcohol or drug addiction, serious and dangerous contagious disease or vagrancy. In this course we will discuss unmet needs of patients with substance use disorders who need to be treated and challenges that health caregivers and families suffered.