Forced Addiction Treatment Law in Massachusetts Under Scrutiny

By Paul Gaita 04/24/19

Section 35 has drawn criticism and legal action from patients who allege inhumane conditions while committed.

man who's being involuntary committed to get addiction treatment

A Massachusetts law that allows the courts to involuntarily commit an individual with substance use disorder to prison is under fire over allegations of improper and inadequate conditions.

It has, to date, generated two lawsuits against the Bay State.

Coverage of the law, known as Section 35, on NPR's health news program Shots and elsewhere detailed support for involuntary commitment by law enforcement and individuals who view it as a "last resort" to save their family members from substance abuse.

But Section 35 has also drawn criticism and legal action from both patients, who allege inhumane conditions while committed, and their family members, including one woman whose son committed suicide after his commitment.

As the NPR feature noted, Section 35 allows family members, physicians or law enforcement to petition the courts to commit an individual to substance abuse treatment without securing their permission.

The petition must present "clear and convincing" evidence that the individual in question has an alcohol or substance use disorder, and is likely to commit serious harm to themselves or others because of that disorder. 

If the court grants the petition, male patients in Massachusetts are committed to one of three locations, including the Massachusetts Alcohol and Substance Abuse Center (MASC), which is a minimum security prison in Plymouth. Women are sent to one of four addiction treatment facilities, but a lawsuit filed in 2016 bars the state from sending them to correctional institutions. 

The use of prisons as treatment facilities is at the heart of most concerns regarding Section 35. More than 6,500 Massachusetts residents were placed in involuntary treatment in the 2018 fiscal year—and while 37 states currently have statutes similar to Section 35, the Bay State is among the few that send involuntarily committed patients to prisons or jails for addiction treatment. 

Patients and their family members have alleged that conditions at such locations are, at best, inadequate to properly handle addiction treatment. In several cases, the prisons have reportedly subjected involuntarily committed patients to harsh conditions: a lawsuit filed against the state by 10 men committed to MASC alleged that they were subjected to strip-searches, placed in solitary confinement for minor infractions, and saw violent fights between other inmates—all while receiving minimal counseling or mental health treatment.

The NPR coverage also detailed the case of Sean Wallace, whose mother Robin committed him to a 90-day program in a state prison. She recalled his fear that he would be unable to continue with methadone treatment while committed, but because of her experience as an addiction treatment counselor, Wallace said, "I couldn't conceive that there would be an opioid treatment program that would not provide medication-assisted treatment."

As NPR noted, Sean's concerns were well-founded. Not only was he unable to continue with methadone, he was frequently placed in solitary confinement for no apparent reason. Upon his release, Sean struggled with adjustment. Anxiety issues led to hospitalization and another jail sentence before he took his own life.

His mother told NPR that she believes his time in involuntary commitment was a contributing factor.

The Massachusetts Department of Correction told NPR in an emailed statement that the huge demand for treatment has some centers turning away individuals who refuse voluntary commitment, and placement in prisons provides a solution.

The piece also quoted Denise Bohan, who said that involuntary commitment saved her son's life.

"This is a last resort," she said. "This is a desperate act of just trying to save your child's life."

While families continue to weigh the option of placing a substance-addicted member in such a program, state officials are considering whether to remove correctional facilities from Section 35 due to a growing understanding that addiction requires medical treatment and not incarceration.

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Paul Gaita lives in Los Angeles. He has contributed to the Los Angeles Times, Variety, LA Weekly, and The Los Angeles Beat, among many other publications and websites.