Coerced Treatment: An Oxymoron

According to a June 30, 2015 article in the Gloucester Times, “Responding to a scourge of heroin and opioid addiction, the head of one of [Massachusetts] largest jails wants to build a detox unit to treat addicts awaiting court dates for minor, drug-related offenses. Essex County Sheriff Frank Cousins is asking the state for permission — and money — to construct a 42-bed detox unit at the Middleton House of Corrections. ‘These are the people who are arrested for possession of drugs while committing quality-of-life crimes,’ Cousins said in an interview. ‘We need to get these people out of the jail cells and into treatment.’”

Jails and prisons are not optimal settings for providing drug treatment. The coercive nature of incarceration negates the possibility for individuals to be active participants in addressing their health issues. People may distrust the treatment provided in prison (often with good cause), or experience treatment as just one more hoop to jump through in order to get out.  Even in best case scenarios with willing participants and skillful providers, jail settings magnify the social and personal powerlessness that draw people into substance abuse in the first place.

Sheriff Cousin’s proposal is far from the best of scenarios. The jail-based detox unit he has called for is meant to house people who have not yet been tried; that is, people who have not faced a judge or jury – people who have not had their day in court. Not only does this sort of pre-trial detention potentially constitute a gross abrogation of basic human and constitutional rights to a fair trial, it also removes individuals from their families and local support networks – including their ongoing sources of medical and mental health care.

There are a number of bills currently working their way through the Massachusetts legislature that call for limiting the use of pre-trial incarceration and replacing it – when appropriate – with rational tools for assessing whether or not an individual is violent and / or a flight risk. For example, H.1584 & S.802 call for basing pre-trial detention on risk of not returning to court, rather than on an individual’s ability to pay monetary bail.

Ironically, a month before Sheriff Cousins’ call for jail expansion, Gloucester Police Chief Leonard Campanello launched a pilot drug amnesty plan, explaining that for addicts “Arresting them or coercing them into treatment just doesn’t work.”

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Click here to read Lois Ahren’s “A Less Expensive Option” letter to the Gloucester Times.

For more on the issue of carceral treatment see Incarceration by Any Other Name: A Return to the Cuckoo’s Nest?

For more on building carceral facilities see Civil Commitment: If You Build It They Will Come