That's a lot of words to come around to the conclusion that you believe we should force people to undergo unwanted medical procedures for "the greater good". I'm sorry, but that idea is even more harmful than anti-vaxxers. This exact same sentiment was used to justify unbelievable atrocities in the past, such as sterilizing minority groups and things like the Tuskegee Syphilis Study.
I agree with you that people need to want to change to change, but bullying and belittling them is counterproductive to encouraging people to want to change.
The fact is that you just want to feel justified in treating people badly, because you (totally justifiably) feel that those people are doing bad things. You need to recognize that you need to choose between working towards solving the problem, or just making yourself feel better by shitting on them.
Societal shame and alienation may have worked in a pre-Internet world, but it works no longer. No matter how depraved, destructive, or horrible someone's behavior is, there will be a community on the Internet who supports and encourages it. The ONLY WAY to reach those people, to keep them from falling deeper down rabbit holes, is through compassion.