Many clinicians are reluctant to invoke coerced SUD treatment. For some, concern about patient autonomy is the primary deterrence to using coercive treatment, even when the individual’s autonomy is clearly compromised by the cognitive and neurobiological effects of alcohol or substance abuse . In modern bioethics, autonomy is considered one of the overarching ethical principles for protecting patients’ liberties and the right to make their own decisions, for better or worse . Coercion into SUD treatment is commonly equated with a legal mandate. This assumption gives rise to the view that patients referred to treatment by the legal system are coerced, and thus, they must enter against their will. In contrast, individuals that enter without a legal mandate are thought to participate in therapy freely and voluntarily . Our findings supported the view that these assumptions may represent an oversimplification. As expected, patients admitted involuntarily scored significantly higher on the Legal subscale than the patients admitted voluntarily. However, we found that some (14%) patients admitted involuntarily did not report the perception of coercion on any of the PCQ subscales, despite the legal status of their admission. Conversely, 92% of the patients admitted voluntarily agreed or strongly agreed that they perceived coercion, on one or more of the PCQ subscales. Apart from the Legal subscale, we found no significant differences between the IA and VA groups that evidenced greater perceived pressure to enter treatment. However, the VA group reported higher perceived pressure to enter treatment due to internal pressure (Self subscale) than the IA group; this finding indicated that the VA group had greater insight into their own problems, compared to the IA group.