Katrina Ciraldo-Maryniuk, a family medicine intern at Boston Medical Center, lies on the ground in the Massachusetts State House in protest of Governor Baker's recent budget cuts to substance abuse prevention programs. "My best friend died from an overdose in my first year of med school," she said. Photo by Sarah Toy/BU News Service

By Noor Adatia

BU News Service

BOSTON — In Massachusetts, men suffering from drug addiction can be sent to prison even if they have not committed a crime — even where access to treatment is limited and sometimes more damaging for recovery — according to prisoner rights’ advocates.

The Commonwealth is the only state in the country where men with substance use disorders who are not charged with a crime can be civilly committed by a judge. Women cannot be incarcerated for treatment.

And, according to Alex Sugerman-Brozan, an attorney with Prisoners Legal Services, the Massachusetts Department of Correction has not provided effective treatment to drug-addicted inmates. More than half of all prisoners in the state have substance use disorder, Sugerman-Brozan wrote in an email.

“The DOC needs to greatly expand the availability of programs, and to make sure that the programs offered are evidence-based and effective,” he wrote.

In 2018, the Massachusetts Legislature passed a major criminal justice bill. It specifically loosened sentencing laws, which could help people with smaller drug offenses on their record receive necessary treatment outside of the prison system.

“We don’t incarcerate people simply because they have a disease,” he wrote. “SUD is no different.”

The DOC announced in November that it will allocate more than $1 million to treat opioid use disorder, which supports its recently launched opioid treatment and prevention initiative. As many as 8,300 inmates in Massachusetts state prisons are diagnosed with opioid disorders.

“The goals of the project are to reduce crime and violence, associated costs and recidivism rates by improving prison safety and promoting the health of inmates with opioid use disorders prior to their release,” the DOC statement said.

The state’s 14 counties maintain separate houses of correction and five of them were participating in a pilot treatment program launched last year. Bristol County Sheriff Thomas Hodgson opted out of the program, telling Southcoast Today that inmates sometimes hide and sell the medications and hiring staff to oversee administration could be costly.

“I know everybody is anxious to find an answer, but we want it to be the right answer,” he told the paper.

Current solutions

A current bill, which has been discussed on the Senate floor, would prohibit incarcerating people suffering from addiction in the event of a relapse by requiring less frequent drug testing.

The bill, entitled “An Act relative to treatment, not imprisonment,” will support people suffering from addiction more effectively, said state Rep. Lindsay Sabadosa, D-Northampton, adding that she believes treatment for substance use disorder needs to be community-based.

“We need to have treatment in real facilities where people are constantly treated with dignity and respect,” she said.

She emphasized that relapsing is a part of recovery and the passage of this bill could help reduce the stigma surrounding drug abuse.

In testimony to the Legislature’s Judiciary Committee in October, Dr. Peter Friedman, president of the Massachusetts Society of Addiction Medicine, said that substance use disorder should be viewed as a “chronic brain disease.”

“Incarceration does not effectively address substance use disorder,” he said. “And persons with this disease deserve evidence-based, patient-centered treatment, not stigmatization and punishment.”

Sabadosa said the fact that other medical patients aren’t sent to correctional facilities for treatment speaks to the heightened stigma around addiction.

“There are still these ideas idea that anybody who uses opioids is somehow a criminal,” she said. “While the use of opioids may be illegal, this is a disease — it is addiction at the heart.”

She said it is important to treat these people with compassion instead of sending them to prisons because of the empty beds available.

The representative pointed out that in Western Massachusetts, a region that sees some of the highest number of opioid-related deaths, there are a limited number of treatment facilities.

In the city of Northampton, 26 people have died from the epidemic over the last five years, according to the Massachusetts Department of Public Health.

Hampden County Sheriff Nick Cocchi has a designated a wing of his prison to men civilly committed for substance use charges. Cocchi has reported success and satisfaction from these men, with less than 5% having to reenter the program.

Bonnie Tenneriello, a staff attorney with Prisoners’ Legal Services, and other opponents have criticized Cocchi’s model, which largely takes place in a jail setting, saying no matter how nice a facility is, a prison environment is not conducive to treatment.

“The shame and stigma around addiction are an enemy to treatment,” she said. “We only compound that when we send people to prison.”

This article was originally published in The Berkshire Eagle.