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More than 6,500 people were forced into addiction treatment in Massachusetts in the last fiscal year. That is believed to be the highest involuntary treatment rate in the nation. Although many states are expanding forced treatment, Deborah Becker of member station WBUR reports the Massachusetts program is facing criticism.
DEBORAH BECKER, BYLINE: Among those asking Massachusetts to change its civil commitment practices is Robin Wallace of Cape Cod. She went to court in 2017 to ask a judge to involuntarily commit her then-33-year-old son Sean because of his heroin use.
ROBIN WALLACE: His behavior was erratic. I think that he had some mental health issues that were worsened by his use.
BECKER: The judge agreed that Sean's substance use was dangerous and ordered him committed to up to 90 days of residential treatment. In court, Sean told his mother he was being sent to a program where he would be locked up and not allowed to continue taking his addiction medication, methadone.
R WALLACE: I thought that he misunderstood what the judge had said because I couldn't conceive that there would be an opiate treatment program that did not provide medication-assisted treatment.
BECKER: Turns out Sean was right. Although many providers say medication is the gold standard in addiction treatment, Sean was sent to a program in a state prison that does not provide it. When we spoke with Sean in 2017, shortly after he spent about a month committed, he said the conditions were inhumane, and he was often placed in segregation or the hole. And remember, he had not committed any crime.
SEAN WALLACE: I was punished for not eating. That's how I ended up in the hole. If you refuse your tray, they consider it a behavioral issue. I didn't know that. I'm just sick.
BECKER: Sean also said he was having trouble adjusting.
S WALLACE: I just feel different. I have a lot more anxiety. I feel scared. I feel like I'm going to wake up and be back there.
BECKER: Less than a year after that interview, Sean killed himself. Robin Wallace says after his civil commitment, Sean could no longer hold a job. He ended up in psychiatric hospitals and then was jailed on a charge of trying to break into a house. Robin Wallace believes that being locked up for addiction treatment contributed to Sean's suicide.
R WALLACE: I think that his trauma was very much triggered by him being in the cell and that he just felt like he couldn't take it anymore.
BECKER: The sheriff wouldn't comment, but jail documents confirm that Sean tried to take his life there. He later died of his injuries. Sean's longtime partner Heather McDermott says he was never the same after his civil commitment.
HEATHER MCDERMOTT: He was like a big, sad, depressed tumor that I was trying to bring back to life. We had a home. We both had, like - it's like, I can't even believe we got here. And then he died.
BECKER: The Massachusetts Department of Correction wouldn't go on tape for this story but emailed a statement, saying that its mission is to promote public safety by providing a secure treatment environment. And many families believe that a locked setting is needed. Denise Bohan says families are desperate and can't rationalize with a loved one who's in the throes of addiction. She believes involuntary commitments saved her 33-year-old son.
DENISE BOHAN: This is a last resort. It's not something you do, like, just in a whim. This is really a desperate act of trying to save your child's life.
BECKER: There's so much demand for forced treatment in Massachusetts that 100 more beds opened in another jail last year.
NICK COCCHI: So this here is our Section 35 civil commitment, quote, unquote, "wing."
BECKER: Hampden County Sheriff Nick Cocchi says many traditional treatment centers aren't willing to take patients who don't want to be there. And with a declining inmate population, there's room.
COCCHI: This is a very dangerous, acute, sick and, I would say, not-so-well-behaved population.
BECKER: Many states are going down the same road as Massachusetts. But some researchers, like Leo Beletsky of Northeastern University, say more families are choosing to have loved ones locked up because it's the only way to get immediate treatment.
LEO BELETSKY: Limiting someone's civil rights should be the last resort and should be only reserved for those cases that are truly dire.
BECKER: The Massachusetts law may change. A class-action lawsuit is charging gender discrimination because the state stopped sending involuntarily committed women to prisons in 2016 after a different lawsuit. For NPR News, I'm Deborah Becker in Boston.
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