Sheriff Frank G. Cousins Jr. in Essex County is pioneering a new way to address Massachusetts’ opioid crisis: He wants to add a 42-bed detox unit to one of the state’s largest jails, the Middleton House of Corrections.
The unit, which would serve inmates who are facing charges for nonviolent offenses and have not been convicted and sentenced, would be the first such unit based at a jail in New England, Cousins said.
The sheriff has no model for the plan, and no other jail he can point to as having had success with it. That concerns some inmate advocates who question whether a jail is the appropriate place to treat addiction.
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For Cousins, the need is obvious — 85 to 90 percent of the jail population struggles with substance abuse. He hopes drug users who finish the 28-day program will be able to demonstrate their sobriety to a judge and get probation instead of jail time.
“There’s just too many people in jail,” Cousins said. “Bottom line, we’ve got to do better than what we’ve been doing in the past.”
Cousins has yet to secure grant funding, but hopes to do so with the help of officials in the state’s Executive Office of Public Safety and Security, whom he met with this week. A spokesman for that office said that officials are studying the proposal.
“There’s nobody else in Massachusetts doing this — there’s no one in New Hampshire, no one in all of New England,” Cousins said.
Fred Wilson, an outreach director for the National Sheriffs’ Association, could not say whether such a unit would be the first of its kind in the country, but he said he sees jails and prisons across the country seeking alternatives to traditional incarceration as the nation grapples with drug addiction and overcrowded facilities.
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Cousins’ project, which would be housed in a now-vacant part of the jail, is expected to cost about $2 million annually. He said he hopes to eventually roll the expense into the facility’s overall budget.
Currently, inmates with addiction issues often wind up detoxing in the jail infirmary, then cycle back into cells, according to Middleton correction officials.
“They get in there, get off their high, and then are kicked into the jail,” said Dana Margolis, the jail’s assistant director of maintenance, during a walk-through Thursday of the area where the detox unit would be located.
The jail had 1,174 inmates this week, twice the intended capacity when it was built in the 1990s. Of those inmates, 570 were in the pretrial process.
The proposed detox program is meant to help inmates who are awaiting trial for nonviolent, drug-related crimes and cannot afford even low bails.
David Hallinan, the executive director of Essex County Bar Association Advocates, sees the unit as a much-needed remedy to a debilitating problem.
“I speak with my advocates almost every single day. One in particular, he just went through his open 22 cases, and more than half of them were heroin addicts,” he said. “Something has to be done.”
The detox unit would be located in a 5,000-square-foot space once used for overflow inmates. It would have no cells, and its inmates would be kept away from the general jail population, Cousins said. They would wear green jumpsuits to differentiate them from other inmates, enter the jail through a back entrance, and have their own recreational and dining spaces.
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An intimidating steel gate leading into the unit would be replaced with a door, Margolis said. The goal is to “make it like a hospital,” he said. The dozens of prison-style bunks now filling the room would be replaced with “more comfortable” single hospital-style beds. Cousins said licensed health care professionals would work in the unit.
But critics such as Lois Ahrens do not think the unit is the right response, especially for people who have not been convicted and may never be. Ahrens is bail reformer, working to end what advocates call a problem of economic inequality that leaves people who cannot afford low bail for nonviolent offences incarcerated.
“There will still be guards,” said the director of Northampton-based The Real Cost of Prisons Project. “They will still be in prison.” Ahrens said she would like to see the community have input before the plan is a “done deal.”
She and other bail-reform advocates would rather see the $2 million annual expenditure for the unit go into creating a program that detains drug addicts before trial in community detox beds, where they say successful rehabilitation is more likely.
“You’re not allowed to make decisions about anything [in jail],” said Susan Sered, a sociology professor at Suffolk University who opposes the unit. “There are just no choices to make, but in the real world, every minute involves choices and not just about drugs, but about life.”
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But Steve Valle, the president of AdCare Criminal Justice Services, the care provider for addictions treatments in the Middleton House of Corrections, said the proposed care plan for inmates — including a mix of one-on-one and group counseling — would function well at a jail.
“It would be great if we had the resources and could just send someone to the resources in the community, but the reality is this is such a crisis, they just get sent to jail,” Valle said. “Rather than do nothing, we get them on a path of being productive so they can break the cycle.”
James Pingeon, the litigation director for Prisoners’ Legal Services of Massachusetts, said he supports Governor Charlie Baker’s call to add 100 beds to detox units within a year.
“There’s certainly a need for more,” he said. “I don’t think the place to create more treatment beds are in a jail.”
But in Lynn, Chief of Police Kevin F. Coppinger sees the Middleton proposal as step in the right direction, a way for the addicts he sees regularly to “get the help they need.”
He is hoping to break the cycle, too, as he sees opioid use climb in his city.
Reflecting on how many of the users arrested in Lynn wind up in the Middleton jail, Coppinger said, “We’re a part of the whole epidemic.”
Sara DiNatale can be reached at sara.dinatale@globe.com. Follow her on Twitter at @sara_dinatale.