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Enter the former Massachusetts minimum security prison in Plymouth and you might think it’s still a prison. Men arrive in handcuffs, they wear orange jumpsuits, and they’re monitored by correction officers.
But the men have not committed any crimes. They’re at the new Massachusetts Alcohol and Substance Abuse Center — or MASAC — for court-mandated addiction treatment.
Each year thousands of Massachusetts residents go to court to ask a judge to take the controversial step of involuntarily committing someone else to substance use treatment.
Some say these commitments save lives, while others say forced treatment is ineffective and violates people’s civil rights.
MASAC Plymouth opened in May. It’s one of five places in Massachusetts where the courts send those involuntarily committed under the state law known as Section 35 — meaning a judge has decided that a person’s substance use makes them dangerous to themselves or others. The center is the only Section 35 facility overseen by the state Department of Correction.
MASAC Plymouth Superintendent Tom Neville says vans full of men arrive from courthouses all over the state at all hours of the day, and the facility is usually operating at capacity, which is 250 men. Most of the men are addicted to opioids and most have been to treatment before.
Neville says the facility is not a prison; the men are dealt with compassionately and are there for help.
“I’m not treating criminals, they’re not here serving a sentence,” Neville said. “They are here for the sole purpose of treatment and getting them back into society.”
The men stay for 30 to 90 days in small rooms, which are former cells with metal mesh on the widows, bunk beds and wooden foot locker like benches. There are no common areas except for the hallways, which are loud and bustling with staff, medical personnel and patients. Many of the men congregate in a patient’s room or in hallways in between their classes, programs and meals.
The treatment is provided by 17 substance use counselors who work for a private vendor. Neville says each man is assigned a counselor and treatment begins after a patient leaves the specified detox unit, which is typically after three to six days.
“Once they’re off detox protocol, then can begin the actual treatment phase,” Neville said. “First there is an introductory phase to help them understand addiction, second is the recovery aspect, and the last phase is relapse prevention and reentry. There are a number of different meetings here.”
Some 100 correction officers work in Plymouth to help monitor the facility, which is not locked. But if patients misbehave or if there are concerns, there are padlocked solitary so-called “watch cells” to remove someone for a short time.
“[The watch cells are] for the patients’ own safety and security,” Neville said. “It might be we have information they might be harmed, or harm themselves. We have to take precautions and make sure they’re safe. The primary goal is their treatment and their safety when they’re here.”
The facility was built in the 1950s and was called a “prison camp.” It is inside Myles Standish State Forest, a bucolic setting around a rundown complex of buildings.
The prison never had barbed wire fencing, but it does now. Neville says the fencing is required after several men ran away — or “eloped,” as he calls it — in the first two months after the program opened.
“The initial reason [to] put up the fence was basically the elopements,” he said. “It’s a bit of a deterrent for guys who just want to wander away and not participate in the program.”
The elopements involved more than a dozen men, including Sean, who doesn’t want his last name used in this story for medical privacy reasons.
Sean says he ran from Plymouth after he was there for a few days because of the bad conditions. When he was caught he was sent somewhere worse: a unit for convicted sex offenders at Bridgewater State Hospital.
“So I’m a Section 35 on a civil commitment and I’m housed next to someone who raped a mentally retarded 11-year-old girl and killed her,” Sean said. “The whole time he’s threatening me, threatening my family. These people are mentally ill and I’m withdrawing from methadone.”
Sean says part of the reason he fled from Plymouth was because of his withdrawal from methadone, a medication used to treat addiction. Although many physicians recommend using medication for addiction, it is not offered at Plymouth because it is not licensed to distribute it. Medication-assisted treatment is available at some of the other state facilities.
Sean is not part of a group of men who filed suit after being placed in Bridgewater when they were caught running away from Plymouth. Because of that suit, the Department of Correction agreed only to send men from Plymouth to Bridgewater for extreme disciplinary reasons — and only for a short time.
When we met with Sean at his home on Cape Cod, a few days after he was released from Plymouth, he said the overall experience — which also included solitary confinement — was traumatic.
Folks don’t get clean and sober until they want to do it for themselves. I don’t think this is a good way to approach treatment. There are a couple of thoughts here however; “I may have another spree in me, but I don’t have another recovery in me” is often shared by folks who had a rough time getting sober the first time. I happen to share that sentiment, I went through a God-awful treatment plant, have on sobriety date and fear relapse because I’d never want to go through the hell I did when I got sober. Coercive sobriety may work for some, but generally requires a big penalty for relapse (mine was my medical license–the FL PRN published a study that showed a 93% success rate–far better than the 12.5% of AA in it’s program where the risk was loss of licensure if relapse happened.
The other thought is to bring folks into recovery through attraction–there’s something about a clean, sober person that is magnetic. Good sobriety is attractive to other people. It’s the “kinder, gentler way” compared to coercive recovery.
Another major problem; Medication-Assisted Treatment is the “gold standard” of addiction treatment. It’s not practiced in this program!