Perceived coercion is defined as an individual’s perception of pressure to enter treatment, in this instance for drug and alcohol problems . This pressure may be sensed from sources that are either external or internal to the person. Most previous studies compared various treatment indicators between patients legally mandated to treatment and patients voluntarily committed to treatment. It was previously shown that patients that were admitted voluntarily often experienced informal pressures to enter treatment . Interviews with patients suggested that perceptions of informal coercion were common. The rate of perceived coercion tends to increase with increasing illness severity [9, 10]. Thus, it is simplistic to distinguish patients based only on their formal status (admitted involuntarily or admitted voluntarily), because this classification lacks the complexity of the coercion construct. Furthermore, the formal status classification fails to consider that individuals with drug or alcohol problems are exposed to a wide range of pressures to enter treatment that are not necessarily of a legal nature, including pressures from family, friends, healthcare professionals, or employers [11–13]. From the patient’s point of view, and based on daily law practice, the distinction between voluntary and involuntary admissions may often be ambiguous. Moreover, it is not certain that a legal mandate always causes the patient to feel coerced into treatment or that patients who are self-referred never feel coerced. Due to their condition, some patients may be quite ambivalent about their need for treatment. In other instances, patients may wish to enter voluntary treatment, but do not qualify, or for some reason cannot be offered treatment; then, they are actually relieved to receive mandated treatment [2, 8, 11]. It is important to gain a better understanding of the factors that influence the perceptions of coercion among patients with SUD that are admitted either involuntarily or voluntarily, by comparing these two formally different approaches to treatment. Understanding the coercive forces that contribute to patients entering treatment will provide valuable insight for improving treatment and the overall rehabilitation process. This information also has potential value in addressing multiple issues faced by the treatment provider, the legal system, and policy makers .