Western Massachusetts, hit hard by opioids, embraces jail-based treatment

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SPRINGFIELD — As Berkshire County and the rest of Western Massachusetts struggle with a dramatic spike in fatal overdoses, officials are embracing a controversial solution: sending men who have not committed any crimes to jails and prisons for court-ordered addiction treatment.

Hampden County Sheriff Nick Cocchi has designated a wing of his jail for the treatment of men civilly committed for substance abuse reasons. It's the only facility in Western Massachusetts housing the men, and one of only three in the entire state for men.

In 2018, the Berkshire County Sheriff's Office transported 140 civilly committed individuals to the Stonybrook Stabilization and Treatment Center in Ludlow, as well as mental and addiction treatment centers as far away as New Bedford, according to Capt. Thomas Raymond.

For those who are detoxing, being in the back of a van for as long as five hours is not comfortable, but for many, it's the only way to get them into treatment, he said.

"We do get them there safe. We make sure they get there," Raymond said. "Sometimes we get calls from parents thanking us for getting them there safely."

While some are trying to end the practice, Cocchi and his supporters, including local mayors and lawmakers, say the jail's year-old Stonybrook Stabilization and Treatment Centers is key to curbing the opioid problem in the county, which includes the former manufacturing cities of Springfield and Holyoke.

Fatal overdoses surged more than 80 percent in Hampden County from 2017 to 2018, even as they declined statewide for the second consecutive year in 2018, according to state data.

"People coming into our program are angry, violent and sick," Cocchi said as he and other officials celebrated the program's anniversary this week. "They are at the end of the road, and their families have recognized that if they don't intervene, they might not survive."

But the civil rights group Prisoners' Legal Services of Massachusetts has sued the state in an effort to end the use of jails and prisons for forcibly treating men with addiction.

The class-action lawsuit was filed in March on behalf of 10 men who complained of poor conditions and mistreatment at another civil commitment program run out of a state Department of Corrections prison.

A state commission recently has recommended ending the practice of sending civilly committed men to jails and prisons, as the state did for women three years ago, after a similar lawsuit. Women are now sent to substance abuse treatment facilities run or contracted by public health agencies, as most civilly committed persons are in other states.

"This should not be a choice between prison or nothing," said Bonnie Tenneriello, a staff attorney with Prisoners' Legal Services. "Why are we giving money to a sheriff to run treatment programs rather than funding civilian treatment?"

Under state law, family members can ask a judge to order their relatives into treatment if they are unwilling to go voluntarily and are deemed a danger to themselves or others.

At least 35 states have such civil commitment laws, but Massachusetts is just one of a handful where it's widely used, The Associated Press found last year.

About 9,950 civil commitment requests were filed in state courts in the budget year that ended June 30. That's down from more than 10,770 the previous year but up significantly from the 6,105 in fiscal year 2016 and the fewer than 3,000 in fiscal year 2006, according to state data.

Tenneriello and other opponents say forcing people into jails and prisons for treatment only reinforces the stigma around addiction. And studies, including the state's own research, also suggest that forced treatment largely doesn't work and could raise the danger of overdose for those who relapse after treatment.

Like the state corrections-run civil commitment facility, Hampden County's program takes place, at least initially, behind the razor wire of its secure jail campus.

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Civilly committed men also are similarly segregated from the regular inmate population but required to wear corrections-issued uniforms and follow certain corrections protocols.

But, in an effort to make the program feel less institutional, cell doors remain largely unlocked and program participants aren't handcuffed, Cocchi and some recently released patients said.

"Yes, it's a jail setting. There are corrections officers walking around," said Keith Molyneux, a 40-year-old recovering from heroin addiction who was among the first to complete the program last year. "But they're more committed to helping you here than to actually being a correctional officer. You definitely feel like they're there to help."

After a few weeks of detoxing at the jail, most eventually are transferred to a less-secure facility located off campus in a converted nursing home. There, the men can wear civilian clothes and are housed in rooms that are larger and more dormlike.

Early results of the approach — it also includes health care professionals administering addiction treatment medications and leading counseling sessions — are encouraging, Cocchi said. Since opening last May, more than 850 men have gone through the program, staying 47 days, on average — weeks longer than they do at the state's other two facilities.

The longer stays increase the odds that the men will stay sober, Cocchi said. So far, less than 5 percent have had to be recommitted, though two fatally overdosed after leaving the program.

Raymond said that when transporting the men to the facility, sheriff's officers keep the detoxing individuals separate from the inmates in the back of their vans, but for some, especially those who don't have previous experience in jail, the experience might be intimidating.

While in the van, the drivers are watching them closely on camera to make sure they are safe, but sometimes they become too ill to continue the trip. In those cases, sheriff's deputies will take the individuals to emergency rooms on their way to the facilities and stay with them the whole time, he said.

While the opening of the Ludlow center has cut in half the number of trips the Berkshire County Sheriff's Office has to make to New Bedford, Raymond still believes that there should be another facility closer to Berkshire County.

If not, the Sheriff's Office should be given more funding toward transporting those who are civilly committed, he said.

"I think there should be more funding for transportation," he said. "I'd like to see separation from them and criminals completely."

Raymond, who has worked at the Sheriff's Office for 20 years, 10 of them running transportation, said that the number of people being committed for addiction issues has risen each of the past three years.

"When I first started, it was mainly alcohol Section 35 detox," he said. "The last five years, it's been mainly heroin."

It's much more dangerous to transport those detoxing from heroin for such long distances, and other counties have had individuals die in the back of their vans because they became so sick, Raymond said.

"It's nerve-wracking," he said. "It's somebody daughter, somebody's wife, somebody's daughter, somebody's husband."

Lawmakers have committed $1 million to the Stonybrook program in the current state budget, proving that the effort has strong support, despite its detractors, he said.

"Let us continue doing what we're doing," Cocchi said. "No one else is doing this work out here, but we're doing it, and we're doing it well. Why shouldn't we be applauded and supported?"

Berkshire Eagle staff writer Haven Orecchio-Egresitz contributed to this report.


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