Updated at 4:53 p.m. April 21
Advocates are calling for the end of a Massachusetts policy that allows men to be put in correctional facilities when they are involuntarily commited for treatment of substance use disorder.
The practice, which is allowed under a statute known as Section 35, ended in 2016 for women but is still in place for men. Under Section 35, "qualified petitioners" such as spouses, blood relatives, doctors and police officers can request a court order to commit someone to treatement.
According to the Prisoners' Legal Services of Massachusetts, around 38 states allow people suffering from substance use disorder to be civilly committed, but Massachusetts is the only state that allows them to be held in prison.
As debate quickly approaches for the state’s next annual budget, experts and advocates are calling for the state to strip correctional facilities of their funding under Section 35 and invest in other treatment options.
The Massachusetts House of Representatives recently released a budget that would give $21.9 million to the Department of Corrections’ Massachusetts Alcohol and Substance Abuse Center in Plymouth and $2.5 million to the Section 35 facility operated by the Hampden County Sheriff’s Department in Ludlow, according to the PLS.
Speaking at a press conference organized by the Prisoners’ Legal Services of Massachusetts on the steps of the State House on Wednesday, medical experts and people directly impacted by the policy talked about its harm.
Deborah Goldfarb, the director of behavioral health and population health at Boston Medical Center, said it can be traumatizing for patients and community members to be involuntarily committed in any setting.
"That can be amplified when they're put into a correctional setting, right?" she said. "And I think it can really erode trust in the healthcare professionals when they think they are going someplace sort of for help, and then they end up in a place that traumatizes them or harms them."
Goldfarb said that part of the problem is that there has been minimal research about the impact of Section 35 in Massachusetts.
The research that does exist in the state shows a higher risk of overdose when individuals are released from any form of involuntary commitment. According to the Massachusetts Department of Public Health, among those who receive treatment for opiates, people with a history of involuntary treatment are 1.4 times more likely to die of opioid-related overdoses.
Todd Kerensky, the president of the Massachusetts Society of Addiction Medicine, opposes placing people in correctional facilities under Section 35 — and that the risk of contracting COVID-19 makes such moves more inappropriate.
"Managing patients in the safest way possible for their addiction, but also not increasing their risk of contracting COVID, is important," he said. "And we know that congregate settings such as incarceration are a risk factor for getting COVID."
Rep. Ruth Balser of Middlesex has filed two amendments to the budget the House proposed. One would eliminate money for MASAC and the Hampden County Sheriff’s Office, the two facilities that provide what advocates describe as incarceration under Section 35. The other amendment would require judges to send those committed under Section 35 to non-correctional facilities, and mandate that the state provide enough beds outside of correctional facilities to treat the people who have been committed. The House is set to debate the budget next week.
It's a commonsense move for Goldfarb.
"In the healthcare setting, we sort of use the example of: if you had diabetes and you went to your healthcare provider and said you were struggling to manage your diabetes, you couldn't manage your sugars, you were having issues with exercise and diet and you were sent to a prison to fix that, that would seem ludicrous, right?" she said.
"Or you were sent to a prison because there weren't enough hospital beds, that would also seem ludicrous," she went on. "So I think this idea is that we should be offering the same quality of treatment to anyone with a medical disorder, which substance use is."
Christopher Hiltz was held at the MASAC facility earlier this year after his sister, Emily Smith, called for him to be placed in Section 35 since he was struggling with homelessness and was living in his car.
"We wanted him to get help, we want him to survive," she said. "We don't want him to die. ... We thought we were doing the right thing."
Hiltz said he relapsed after being released, and that being at MASAC made him want to continue to use substances. He described guards who yelled at him and being punished with solitary confinement. Neither the Massachusetts Department of Correction nor the Hampden County Sheriff's Department gave comments on the record about their services regarding Section 35.
"[The] place got me more depressed, honestly more angrier than I've ever been in my life because of that place," he said. "Like, I'm worse in a way."
This story was updated to clarify the response from the Department of Correction and Hampden County Sheriff's Department.
