A 34-year-old Massachusetts man thought he was going to the Men’s Addiction Treatment Center (MATC), a facility where he had received treatment in the past, for his benzodiazepine and opioid use. Instead, he arrived at a state prison in the middle of a forest near the Massachusetts cape.
There, he was allegedly refused access to Suboxone, a medication used to treat opioid use disorder that had been prescribed to him by a doctor. He began detoxing cold turkey, he says, in a room that reeked of urine and feces.
This man, known only to Filter as “John Doe 4,” is not alone in his traumatic experiences at the prison. He is one of 10 men currently being held in a facility within a Massachusetts state prison without criminal convictions—or even charges. It wasn’t an arrest that landed them in Massachusetts Correctional Institution (MCI) Plymouth. Instead, it was overcrowding at Massachusetts drug treatment facilities.
The men, all identified as John Doe and numbered one through 10, each have alcohol or substance use disorders (SUD) and were ordered by a court to be involuntarily committed to a treatment program after the court was petitioned to do so by their parents or another party, such as a police officer (and sometimes even by the person with SUD themselves).
In a lawsuit filed on March 14 by Prisoners’ Legal Services (PLS), a nonprofit organization, these 10 anonymous plaintiffs “co-housed” at the Massachusetts Alcohol and Substance Abuse Center (MASAC) at MCI Plymouth are now suing state officials for alleged abuse, neglect and failure to even be provided proper SUD treatment.
Monetary damages are not being sought. Rather, the plaintiffs seek an injunction and declaratory judgement to end the incarceration of people with SUD in prisons solely on the basis of a civil commitment order. The plaintiffs understand that their case is “about helping everyone,” as Alex Sugerman-Brozan, a PLS attorney working on the class action lawsuit, described their intentions in a phone call with Filter.
Receiving over 10,000 such petitions in 2018, Massachusetts ended up committing more than 5,000 people.
The civil commitment of people in Massachusetts is made possible by Section 35, a law on the books in 37 states that permits people who have been referred to a district court by individuals, like family members or police officers, to be involuntarily treated because they are allegedly “addicted to alcohol or a controlled substance…and [present] a risk of serious harm due to his or her addiction.”
Receiving over 10,000 such petitions in 2018, Massachusetts ended up committing more than 5,000 people. Of the 7,000 petitions evaluated in court, around 23 percent concerned people who were homeless. Yet “civil commitment as a mechanism is supposed to be a last option,” Leo Beletsky, a professor of law and health sciences at Northeastern University and a member of the Section 35 Commission, told Filter. “It was constructed statutorily to be a last resort, but it’s being used as a first resort.”
If a court rules in favor of the petition, the person with an alleged SUD can “be committed for a period not to exceed 90 days.” Anecdotally, MASAC patients are held around “30 days,” according to PLS attorney Bonnie Tenneriello in an email to Filter, “but now that they have opened more correctional beds in Hampden County, those in MASAC are being told they will be incarcerated for 45 days—and they are not happy with this, since they do not feel more time at MASAC will bring them closer to recovery.”
People who have been “Sectioned,” as it is colloquially referred to, are supposed to be placed in an inpatient treatment facility, but they can, as in the case of the plaintiffs, be incarcerated in a “secure facility” if “no suitable facility approved by [the Department of Public Health] is available.”
Once a decision has been made, including whether a person is committed to a correctional institution, the petitioner cannot withdraw their request.
These petitioners are often parents who want to get help for their child, but don’t see any other way.
“For parents who are desperate, it becomes the most logical door to walk through,” said Beletsky. “Getting your loved one into treatment is very difficult.” And that’s especially true for the majority of people filing Section 35 petitions. “Most of the patients come from central Massachusetts,” said Beletsky, referring to the area as a “treatment desert.”
Simply put, “the reason it’s so popular is that it’s free, it’s readily available,” Beletsky pointed out.
Many petitioners just want to help their family member, yet “a very common theme is that families who Section their family members don’t know where they’re going,” said Sugerman-Brozan. “They think they are going to be sent to a treatment center.” Instead, they arrive shackled and handcuffed to a prison surrounded by barbed wire. (The fencing was erected around MASAC after a number of civilly committed people escaped.)
At this correctional facility with 250 beds, the plaintiffs at MASAC are treated “like criminals,” according to the complaint: They receive DOC identification information essentially classifying them as an inmate; they are isolated in solitary confinement, sometimes for detoxing; and they are surrounded by correctional officers, who outnumber alcohol and substance use counselors and are untrained in “behavioral issues” related to SUD.
A detainee’s experience at MASAC is “more punitive than therapeutic,” said Joel Kergaravat, a person formerly incarcerated at MASAC, while speaking on a panel before the Section 35 Commission, a review body established in August 2018 to provide oversight of the state’s civil commitment program.
MASAC correctional officers allegedly “routinely humiliate them, refer to them as ‘junkies,’ and make other degrading comments.” One patient reported that an officer said, “We should stop giving you Narcan, so you don’t come back.”
Key to the lawsuit, the 10 anonymous plaintiffs argue that MASAC does not actually offer effective treatment—purportedly the whole point of the commitment. Plaintiffs allege that programming and mental health care are scarce. According to them, minimal care is offered to people detoxing from illicit substances, as well as in John Doe 4’s case, denial of Suboxone.
In August 2018, a bill authorizing the availability of medication assisted treatment (MAT) to detainees at MASAC was signed by Governor Charlie Baker. Yet MAT remains inaccessible, according to Sugerman-Brozan.
Even the fact that MASAC detainees are compelled to detox is dangerous, said Sugerman-Brozan. “Detoxing [at MASAC] puts them at greater risk when they are released. Overdose risk is so much higher when they are forced to detox cold turkey.” According to the Prison Policy Initiative, recently incarcerated people are almost 42 times more likely to die from an overdose than the general population in the two weeks after their release.
The complaint boils down to one main problem: MASAC is “prison, not treatment,” says Sugerman-Brozan. “Correctional priorities take precedence over treatment priorities. It’s self-defeating and counterproductive.”
Alleging gender and disability discrimination, as well as due process violations, the lawsuit requests the court to issue an injunction to stop incarcerating men in correctional facilities “solely on the basis of their civil commitment.”
“We don’t want to put people who are civilly committed in prisons because that will traumatize them and exacerbate their addiction, [but] we also shouldn’t be putting anyone in those prison settings.”
PLS’s request is not unheard of: Section 35 has been revised multiple times in the past 10 years. In 2016, Massachusetts women could no longer be civilly committed for SUD under Section 35, and instead “will have the opportunity to get treatment instead of jail time,” as Governor Baker said in the press release accompanying his signed legislation. A similar piece of legislation, Senate Bill 1145, titled An Act Ensuring Access to Addiction Services, is currently under consideration in the state legislature, and it would specifically address the status of civilly committed men.
Additionally, MASAC was almost closed in its entirety back in 2009. But after officers protested about possibly losing their jobs, the DOC kept the facility open.
All 10 men are still currently incarcerated at the treatment facility housed in the state prison. Their release dates are undetermined.
“When most people hear about this, they recognize how absurd it is,” says Sugerman-Brozan. “Hopefully the judge and legislature will agree.”
For Beletsky, an injunction, declaratory judgement, and a bill signed into law are “steps in the right direction”—but he is concerned that they may come at the expense of a broader critical analysis.
“Yes, we don’t want to put people who are civilly committed in prisons because that will traumatize them and exacerbate their addiction,” said Beletsky. But “we also shouldn’t be putting anyone in those prison settings. That has to be part of the conversation.”
Photograph: Hédi Benyounes via Unsplash