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In this issue, authors Abhishek Jain and colleagues report the outcome of a survey of the physician membership of the American Society of Addiction Medicine, bearing on attitudes toward the use of civil commitment in the treatment of substance use disorders (SUDs). This comment considers the sources of the pejorative view in which civil commitment for SUD is often held, identifying several historical analogies with other illnesses. Resolution of the common confusion between toxidrome and addiction, with a renewed empha