Pushing recovery: help if you want it or not, from jail, courts
Fred Mokley of Greenfield spends a moment of silent reflection during a Mindfulness Group meeting at the Franklin County Jail D Block. Shaun Spaulding of Worcester and Jonathan Bones of Turners Falls are behind him.
Recorder/Paul Franz Purchase photo reprints »
Nora Dillon, a ServiceNet clinician, leads a Mindfulness Group at the Franklin County Jail D Block.
Recorder/Paul Franz Purchase photo reprints »
Franklin County Sheriff Christopher Donelan in his office. Recorder/Paul Franz Purchase photo reprints »
Some believe the only path to lasting recovery is for the user to hit rock bottom and choose to stop, that recovery can’t be coerced.
Others believe that it can at least be prodded.
Voluntary or involuntary, most agree that a period of sobriety may give users the clarity to recognize the extent of their problem — and find a way into recovery.
Arrest or civil commitment to a state institution are the involuntary routes to sobriety, both usually a matter for the Greenfield District Court — but both affecting only a fraction of the addicted population.
“Only a small percentage of people that are suffering from heroin addiction are actually touching the court system, so we can only deal with the people that are brought before us,” Greenfield District Court Judge William Mazanec said.
That small percentage nevertheless accounts for 80 to 90 percent of court business and a similar percentage of the inmate population of the local jail.
Sheriff Christopher Donelan has been addressing this population with an expansion of treatment programs within the Franklin County House of Correction, which houses slightly more than 200 men on any given day. From one cell pod devoted to recovery, Donelan plans to expand to all four, with classes, support groups, and 12-step meetings.
The jail also offers a combined vocational and treatment program, the Kimball House re-entry program housed in the old jailhouse, and more have been added or are contemplated as the in-house efforts of the Sheriff’s Office have been bolstered by federal money.
Not only is the addiction treatment program growing, but it’s as close to mandatory as Donelan can make it.
“The theory is their (poor) decision-making got them here, so we’re going to do the decision-making for them,” Donelan said. The jail houses those convicted of all manner of crimes carrying relatively short sentences, including the frequent rashes of burglaries often found to be committed by users funding habits that can cost hundreds of dollars a day.
Inmates needing treatment are identified through the intake process, which includes their self-reported substance use as well as a look at their criminal history. Donelan said he can’t force an inmate into treatment, but if they opt out he can restrict their privileges, including television, time out of their cells, work programs and “good time” — the 10 days deducted from a sentence for every month of good behavior.
Treatment inside the jail looks very similar to that administered outside, Donelan said. There are fatherhood, anger management and domestic therapy groups and 12-step meetings, some on the peer-to-peer model and some led by on-staff counselors.
The main difference is that free recovering addicts can practice what they learn. In jail it’s all theory.
“There’s a limited opportunity to engage in lessons,” Donelan said. Transition is an important element, bringing in outside service providers — such as mental health and addiction specialists ServiceNet through a federal Second Chance Act grant — and transporting low-risk inmates to community AA and NA meetings, which are intended in large part to help inmates establish healthy connections once they are released.
New transitional housing for recently released men, paid for by the same federal grant, in the Winslow Apartments on Wells Street is part of this effort.
It’s not clear whether the jail’s programs help.
Stays in the Franklin County House of Correction range from five days to 2½ years, Donelan said, with 90 the average.
Does 90 days make a difference?
“In the old days with the typical drugs and alcohol it did, it made a significant difference. I don’t know yet if it makes a difference with this opiate addicted population,” Donelan said.
“The jury is still out.”
Drug Court route
Coerced treatment is not new. People facing serious charges may agree to enter Drug Court probation programs in a plea deal to avoid or shorten jail time, and while they must volunteer, it is often for fear of worse punishment. Drug Court is essentially a more demanding form of probation, with random drug screens, mandatory participation in Narcotics Anonymous, Alcoholics Anonymous or similar recovery meetings five days a week and a weekly group meeting with a judge, who looks for progress in their recovery and personal lives and can easily return them to the standard court process.
Court administrators are pushing for more Drug Courts like those already operating in the Greenfield and Orange, which typically supervise 30 to 40 people at a time.
“The trial court is really trying to make establishment of theses Drug Courts a priority,” said Paula Carey, chief justice of the Massachusetts trial courts.
Administrators are also angling for money in this year’s budget to back these programs with treatment resources.
Carey said the trial court is looking for more probation officers to replenish a depleted workforce, but the majority of the new spending called for in this year’s budget request is for treatment, a request made in partnership with the Department of Public Health and Department of Mental Health.
“Primarily the money is for beds and for clinicians ... because we can’t do it ourselves. F or us to try to operate without DPH beds and without clinicians, it would be an empty promise to the individuals that we try to serve,” Carey said.
Recent growth in the treatment system has been driven by funding for involuntary court committal to treatment institutions. Locally, the new Watershed women’s house was created primarily for this segment, and each of the three existing recovery homes was able to increase capacity by one person last year.
Chapter 123, Section 35 of the Massachusetts General Laws permits involuntary committal of alcoholics or substance abusers. Under the law, a spouse, blood relative or guardian, any police officer, physician or court official may petition the court for an order. The individual in question is then summoned to court for a hearing with medical testimony. If the judge determines that serious harm is likely as a result of the person’s alcoholism or substance abuse, they may be committed for a maximum of 90 days to an approved treatment facility — such as the local ServiceNet or Center for Human Development recovery homes — or the state prisons in Bridgewater and Framingham.
Upon the end of the mandatory stay, the patients are encouraged to consent to voluntary treatment and allowed to stay on if they choose.
The Bureau of Substance Abuse Services intends to fund 344 new treatment beds elsewhere in the state, 200 earmarked for Section 35 use.
Greenfield District Court Presiding Judge William F. Mazanec III said recently that five years ago he was accustomed to seeing one or two civil committal petitions a month, almost always for alcohol, and now sees up to three a day, always for heroin.
It is also possible to commit yourself through Sect. 35, an occasional last-resort recommendation from addiction counselors whose patients feel they need a long-term residential program but can’t get into one, or fear they wouldn’t be able to resist leaving a voluntary program.
Vincent Piro and Michael Higgins of the Woburn District Court — probation officers who have re-cast themselves as social workers in the face of the heroin problem in their area — say this varies from judge to judge.
Greenfield Judge Mazanec said it’s rare, but he has seen it.
“I’ve had it happen a couple of times; we will get a medical person here and if the doctor’s opinion substantiates (their addiction) often it will result in a placement. It isn’t common here but it certainly has happened.”
Not always successful
Like every other gateway to treatment, committal is not always successful. The legal standard to deprive someone of their freedom with no crime and no trial is high, and if they are committed, good intentions can have unintended results.
Jennifer Salvador of Holyoke said she had an alcohol and cocaine problem and was dealing with the suicide of her boyfriend when her parents applied for a Section 35 and the judge sent her to the Women’s Addiction Treatment Center in New Bedford.
There, she met a woman who introduced her to heroin.
At 35, Salvador is in recovery and has been sober for two years. After checking into detoxes again and again, Salvador said she finally checked into a transitional and then a long-term residential program and came out clean on the other side, but it wasn’t easy. Residential treatment takes people out of their element and away from their friends, then returns them to the outside world.
A hairdresser, Salvador feels lucky that she had a profession to go back to when she left the program. In one of the programs she connected with a director who was herself a recovering heroin addict, and she has since kept on track with daily 12-step meetings and by working with other women in treatment centers. She believes strongly two things: that the best support for people in recovery is other people in recovery, and that it has to be a choice.
“You can’t make anybody do anything,” Salvador said. “More than anything in the world you have to want to get clean.”