Committed: Should substance abusers be sent to jail for treatment?

Two weeks after his family kicked him out for his criminal activity and substance use, Louis Pittman was out of cocaine with no cash to buy more. 

He knew that his parents’ house had valuable electronics he could pawn for money, so while his family was out during the day, Pittman, 48, broke into his former home and stole a video game console and a laptop. His family knew he’d stolen from them, so after two hours, Pittman decided to turn himself in. 

Last month, sitting in the Springfield location of the Stonybrook Stabilization & Treatment Centers, run by the Hampden County Sheriff’s Office, he recalled the thoughts that ran through his head at the time.

“‘I deserve to be locked up,’” he remembers thinking. “I believe, truly, that this was the only way I would probably stop using … that, if I got locked up in jail, I would stop using. That I won’t get high.”

The court let Pittman go. But over the next few weeks, his probation officer noticed through urine samples that Pittman hadn’t stopped using drugs. Seeing a pattern, the officer had him civilly committed under the state’s Section 35 law for his substance use.

“I’ve been here 62 days in section,” Pittman said in mid-October. “I believe now that if I was not sectioned … I believe I wouldn’t have stopped using.”

Pittman was one of two committed men who the Hampden County Sheriff’s Office facilitated conversations with during a daylong tour of the Stonybrook centers set up by sheriff’s office representatives. At least two people accompanied a reporter at all times.

Pittman was sent to the Stonybrook centers, the only state-funded facilities in western Massachusetts for Section 35 commitments for men. The program has two locations: one in the Hampden County Jail and House of Correction in Ludlow, and the other, a transfer spot for men discharged from Ludlow, in Springfield’s Western Massachusetts Recovery and Wellness Center. 

Massachusetts’ Section 35 law permits the courts to involuntary commit someone with a substance use disorder, for no longer than 90 days, if there’s a “likelihood of serious harm” to themselves or others. According to a state website, there are three state facilities for committed men: One is run by the Department of Public Health in Brockton; another is in Plymouth, run by the state Department of Correction; and the Stonybrook centers, which are operated by the sheriff’s office. Women who are involuntarily committed with substance use disorders are usually placed in one of three public health facilities; unlike men, they cannot be placed in jail due to recent legislation.

Massachusetts is the only state in the country that commits people struggling with substance abuse to correctional institutions, according to Prisoners’ Legal Services of Massachusetts.

If a man is committed to Stonybrook, like Pittman, he will be sent to the Ludlow facility first — a repurposed jail wing where people detox and begin clinical treatment. About 80 percent of all committed men booked into the jail do not have criminal charges pending at the time of intake, according to data provided by the Hampden sheriff’s office. The practice has led some activist groups and lawmakers on Beacon Hill to sharply criticize sending those suffering from addiction diseases to jail for rehabilitation.

One of those against the practice of committing men to correctional facilities is Lois Ahrens, the founding director of the Real Cost of Prisons Project, a national organization based in Northampton. In the wake of declining jail populations across the country, Ahrens said Hampden County Sheriff Nicholas Cocchi is using the program to fill unused beds.

“His good intentions aside, he is using this as rationale to keep his jail full,” Ahrens said. “How do you rationalize having that kind of space and that kind of budget without any bodies to lock up?”

Pittman said that at first, he was angry and frustrated over being placed in jail because of his drug abuse — but that he now recognizes some benefits in hindsight. Others, like Sophorn Sing, 38, say that being put in jail didn’t help matters. Sing believes he would have learned just as much about his alcoholism if he were only sent to the Springfield recovery center.

“People are different. For me, I don’t think I probably needed Ludlow,” Sing said of the jail, speaking at the Springfield wellness center last month. “I could have just came here and actually clicked with people. But for other people, they probably need it … People are sicker than others. ”

Both Pittman and Sing said they’re feeling better about their substance use, as they have learned strategies to deal with their disease when they’re discharged from civil commitment.

“I feel like I’m growing,” Pittman said.

Until May 2018, men who were civilly committed were sent two hours east to the treatment facilities in Plymouth and Brockton. With no public Section 35 beds west of Worcester at the time, Sheriff Cocchi started the Stonybrook Stabilization & Treatment Centers.

More than a year later, more than 1,000 men have been either directly committed or transferred to the centers, with the average person staying 18 days at Ludlow and 51 days in the program overall, according to data provided by the sheriff’s office. As of mid-October, 462 people from Hampden County had been directly committed to Ludlow, along with 41 from Hampshire County, 178 from Worcester County and 58 from Berkshire County.

When a court commits a man to the Stonybrook centers, he is taken to the same booking area in the Ludlow jail as an inmate would be taken, although those committed for substance use disorders are completely separated from the general population and go through different intake screenings with counselors.

They are eventually taken into one of the jail’s towers to a dedicated 150-bed “wing” of the facility that is solely for those who are committed. “Clients,” as the sheriff’s office calls them, stay in jail cells, but they are not locked. Committed men can move around some of the wing, watch television, work out, or play games such as checkers and pingpong.

Unlike the gray walls of the jail, the walls of this wing have been partially painted over in light blue. There’s a 24-hour clinic with medical staff for those who are struggling with their detox, and mental health counselors who assist clients with individual and group counseling. The jail does not rotate correctional officers or clinicians from the general population, according to sheriff’s office officials.

Clients are color-coded. A client wearing a blue shirt indicates that he has not been cleared yet by mental health clinicians and may pose a risk to himself; he is more restricted when it comes to participating in activities, while yellow-shirted clients, who have been cleared, can move more freely. There is a minimum of four hours of programming daily, whether that be daily meditation, exercise, group therapy or other programs, said Nick Melikan, director of the treatment centers.

The decisions on what programming the jail provides and the atmosphere of the living space all come from focus groups of people who had previously been civilly committed, Melikan said.

“We didn’t just try to figure out everything on our own,” Melikan said. “Any time we try to start something, we get input … talk to people who have been through it and get their input.”

Some of the staff have their own personal experiences with substance use disorders, Melikan said: “They can walk the walk, they can provide an example. A lot of clients won’t listen to somebody who hasn’t been through it.”

Out of the total 1,018 men who are in the program or have gone through it since May 2018, 63 have been committed a second time and 13 a third time, according to the sheriff’s office. Ian McCollum has worked for the sheriff’s department for 23 years and was committed to a facility in Vermont years ago for alcoholism. Now, McCollum comes to the Section 35 unit on his own volition — not as a client, but as a staff member.

“I’ve been where they are,” McCollum said. “And if they’re not here, they’re out dying.”

After being discharged from Ludlow, some men are sent to the minimum-security, 32-bed Springfield recovery center for further treatment, said Araeelis Fargas, a supervisor at the Springfield location. The center has been around since 1985, she said, and also houses male and female inmates struggling with addiction who live on different floors.

Here, the men who are sectioned have an even busier schedule of therapy and group sessions. They are expected to keep their four-person rooms clean and are given chores by staff, such as cleaning bathrooms.

At the Springfield center, committed men wear their own clothes — not the color-coded T-shirts provided at Ludlow — and they can leave at any time.

There’s a quiet room filled with books and armchairs, and peer-led groups every morning. One day last month, some men were playing hangman with each other on a whiteboard, part of “Fun Friday,” Fargas said, drawing attention to the session during a tour.

The average stay at this facility is 30 days, but Fargas said that setting up clients with places to go after treatment at Springfield or Ludlow is crucial. Staff make sure clients are checked on after their discharge into the community, Fargas said. According to the data provided by the sheriff’s department, of the program’s graduates, 128 men were released to programs in the area, 57 to shelters and 32 to the center’s Foundation House, a halfway home. Others have been released to family, friends or the court, while some are “self-sponsored.”

“Aftercare, aftercare, aftercare,” Fargas said. “I think that’s one of the most important things in both the Ludlow facility and our facility.”

State Rep. Lindsay Sabadosa, D-Northampton, has signed on to a bill on Beacon Hill that would end the practice of Section 35 facilities run by prison and jail authorities. But she said this bill, H.1700/S.1145, is still in the committee stages. Separately, Prisoners’ Legal Services has filed a lawsuit against the state Department of Correction, the Department of Public Health and others on behalf of civilly committed men from the correctional facility in Plymouth that could end the practice of sending men to jail for substance use disorders.

In 2016, Gov. Charlie Baker signed a similar bill that ended civil commitment of women to correctional institutions.

“People who struggle from substance abuse disorders, they have trauma in their lives — trauma that they’re suffering from,” Sabadosa said. “And when you’re putting them in a place like a jail or a prison, you are re-traumatizing them.

“The best thing we can offer is community-based recovery and facilities so they can go and when they come out they are connected with the community,” Sabadosa continued, “so when someone is committed for substance abuse issues, it’s not punitive.”

Sabadosa said she has toured the Ludlow facility, and even though she believes staff are doing their best to provide adequate treatment, she says they should instead be working in facilities run by the Department of Public Health (DPH) or the Department of Mental Health (DMH).

The current Senate draft of the 2019 supplemental budget includes a $16 million line item for Section 35 facilities that stipulate the funds go only to facilities run by DPH or DMH. But this line item, similar to the bill Sabadosa supports, is not guaranteed to become law.

“We’re at a total political stalemate,” Sabadosa said.

The draft also requires state officials to submit a report that includes recommendations to ensure geographical equity in regard to Section 35 facilities, as there aren’t any run by DPH or DMH west of Worcester.

“There are places other than jails in western Massachusetts that will do this,” Sabadosa said.

Cocchi, in an interview at the Ludlow facility, said all of the medical and psychological disciplines needed for a successful recovery program are available at both the Stonybrook centers.

Instead of referring to the Ludlow program as being in a jail, Cocchi instead used the term “correctional rehabilitation facility” with a “substance abuse treatment center.”

Cocchi doesn’t agree with the assessment that sending a person to the jail for recovery is re-traumatizing. He knows most people at first are upset about being committed to jail, but he said staff work with clients to accept why they are there and that they have a disease.

He claims to be saving the commonwealth “millions” of dollars with Section 35 treatment, saying that jails already have the “bricks and mortar” that a new DPH or DMH facility would have to build. Jails already have electricity, heat, food and physical beds for people, Cocchi said, adding that the centers have invested in recovery and mental health specialists.

There aren’t any dedicated Section 35 facilities for women in western Massachusetts, and Cocchi said he expects women’s beds to come to the area not in the form of Department of Correction facilities, due to the current legislation, but rather in facilities run by DPH.

Cocchi got emotional when talking about his staff and the success he said he has seen from the program. He said he has always to tried to save lives amid a lack of regional equity, regardless of what people say about his program.

“I’m a little tired of certain advocacy groups and people using this topic, this controversial topic in the commonwealth and around the country, as a political football. That’s disgusting,” Cocchi said. “People are dying.”

Correction:A previous version of this story incorrectly attributed a role in running the Stonybrook Stabilization & Treatment Centers to the state Department of Correction. They are wholly run by the Hampden County Sheriff’s Office.