Christopher Hiltz was sleeping in his car, where he was living, when a police officer rapped on his window one afternoon in February and quickly put him in handcuffs. Within a few hours, a judge had ordered him, shackled, to ride in a sheriff’s van to a complex surrounded by barbed wire and run by the Massachusetts Department of Correction. Upon arrival, he was strip-searched.
But Hiltz had not been charged with a crime.
Instead, acting under a state law known as Section 35, his family asked a judge to commit him to be treated for drug addiction.
Advocates and addiction specialists have long decried the practice of forcing men into correctional settings for addiction treatment, saying that doing so shames and often traumatizes people who are sick but not criminals. But the state government continues to support these programs. Funding to operate the facility where Hiltz was taken — the Massachusetts Alcohol and Substance Abuse Center, or MASAC — has doubled since 2019 to $20.5 million, and the fiscal year 2023 budget now before the Senate would provide an additional $1.5 million. Some $36 million in capital improvements are underway.
“Rather than move away from correctional administration, the state is doubling down on it,” said Bonnie Tenneriello, a lawyer with Prisoners’ Legal Services of Massachusetts, which in 2019 sued the state over the issue.
The Department of Correction says MASAC, located deep within the Myles Standish State Forest in Plymouth, is not a prison, but a treatment facility run by medical professionals.
But Hiltz said it felt like a prison. His 32 days there, he said, left him angry and depressed. “My head isn’t right since then,” Hiltz said.
Some families see Section 35 as a critical last resort when addicted relatives refuse treatment or cannot find an opening in a treatment program, and thousands petition for commitment each year.
Representative Ruth B. Balser, a Newton Democrat and leading opponent of prison-based treatment programs, said it’s simply wrong “to be sending people who are seriously ill, who have not been charged with a crime, to a criminal justice facility.
“The Baker administration has continued to support incarcerating addicted individuals instead of building more robust treatment facilities in the community,” Balser said.
Some 38 states have laws allowing people to be committed to addiction treatment against their will. But Massachusetts is unique in sending some civilly committed people to facilities run by the Department of Correction or a county sheriff.
And only men go to such facilities. A 2016 Massachusetts law requires that women committed for addiction treatment be sent to a program licensed or approved by the state Department of Public Health or the state Department of Mental Health.
Asked to explain the discrepancy, a Baker administration spokesman said the circumstances are different for men. The women’s prison had provided little treatment, and after the law passed, the state opened new beds at Taunton State Hospital to treat women. MASAC, in contrast, is a full-fledged treatment facility, for men only, separate from other prisons, officials said.
Under Section 35, a police officer, physician, spouse, relative, guardian, or court official may petition a district court or juvenile court to commit someone with alcohol or substance use disorder to a treatment facility. A judge then determines whether the person’s alcohol or substance use disorder creates “a likelihood of serious harm.” The law allows people to be held for up to 90 days but most have much shorter stays.
Some civilly committed men are sent to the 108-bed Men’s Addiction Treatment Center in Brockton, which is licensed by the Department of Public Health.
But the majority of men end up in correctional settings. Most go to MASAC, which has 251 beds. Additionally, the Hampden County Sheriff’s Department runs the Stony Brook Stabilization and Treatment Centers, with 85 beds in Ludlow and 32 beds in Springfield.
Forced treatment is controversial, regardless of the setting. The state Department of Public Health found that people who had experienced involuntary treatment were 1.4 times more likely to die of opioid-related overdoses than people who had not undergone such treatment. But advocates are not currently fighting to end Section 35. Their focus is on ending involuntary treatment in places run by correctional officials.
Opponents are working to change the policy on three fronts. First, a class-action lawsuit by Prisoners’ Legal Services alleges that the practice unlawfully discriminates against men and people with disabilities, and violates their right to due process. The litigation, currently in the discovery process, is far from resolution.
Also, state lawmakers have proposed legislation that would require that men civilly committed for addiction be cared for in a health facility. On Tuesday, the Joint Committee on Mental Health, Substance Use and Recovery approved the bill, and it now is likely headed to the Joint Committee on Health Care Financing.
Finally, some legislators tried to change the fiscal year 2023 budget. Balser filed an amendment to the House budget requiring an adequate supply of Section 35 treatment beds outside correctional facilities, but the amendment failed. In the Senate, Senator Julian Cyr, a Cape Cod Democrat, filed a budget amendment requiring that the $1.5 million added to MASAC’s budget instead be spent on treatment outside a correctional setting. That amendment was also rejected.
Corrections officials say that MASAC has been improving in recent years and further improvements are underway, with $36 million in renovations to provide “an enhanced therapeutic environment.”
In 2020, the department hired Wellpath, the company that provides health services throughout the prison system, to run the program. “Administration of these medical services is aligned with standards at other facilities run by the Department of Public Health and Department of Mental Health,” a spokesman said in an e-mail.
But Hiltz, the man who was sent to MASAC in February, described his experience as traumatic and said he received little helpful treatment.
“They treated me like I was an inmate,” Hiltz said. He said he was twice “put in the hole’' — placed in solitary confinement, the first time for more than 30 hours and the second time for 12 hours. He described it as a cement room with a hard bed and an overpowering smell of urine.
Privacy rules prevent the Department of Correction from discussing individual cases, and a spokesperson said Wellpath “doesn’t use restrictive housing practices.”
But Tenneriello said she held a Zoom meeting with Hiltz while he was at MASAC and he gave her a similar account of his experiences.
In early March, Hiltz said, he was discharged and dropped at a shelter, which had no free beds. So he ended up back in his car, where he continues to live most days.
Meanwhile, a spokesman said MASAC has launched the process of seeking accreditation from the Commission on Accreditation of Rehabilitation Facilities and also intends to apply for licensure from the state Bureau of Substance Addiction Services, which would require MASAC to meet the same standards as treatment facilities in the community.
But while the state touts the plans for improvements and licensure, opponents are appalled by them. Tennierello said it would be “shameful” for the health department to license a correctional institution to do treatment and decried the continuing investment in such programs.
“No matter how much you try to make a prison kinder and gentler, people know they’re in a correctional facility,” she said.
Update: This story has been updated to reflect a legislative committee’s action on Tuesday.