Category Archives: drug addiction treatment

Treatment not jails

by Lois Ahrens
Published: 8/18/2019 by the Daily Hampshire Gazette

Michael Ashe, former sheriff of Hampden County, Massachusetts

Michael Ashe, the longtime former sheriff of Hampden County, was an excellent salesman. He sold legislators on the idea that he could see into the future, and the future meant more incarceration.

Legislators believed him and taxpayers footed the bill for a jail in Ludlow big enough to cage 1,800 men. His successor, Sheriff Nick Cocchi, has a problem. Ashe’s prediction has not come true.

As of July 1, the Ludlow jail is incarcerating 421 pretrial men and 273 sentenced men, according to information provided by an attorney for the jail in response to a public records request. Sixty-eight men are jailed under Section 35, which allows the state to jail men who are civilly committed for “treatment” for substance abuse disorder. That is a total of 762 men; way under the number Cocchi needs to justify keeping all of his big jail open.

If bail reform happened and real alternatives to incarceration were implemented, what would Cocchi do? One alternative is jailing people under Section 35. Another option Cocchi is exploring, according to a WBUR report, is a lucrative agreement — at least $91 a day per person — with U.S. Immigration and Customs Enforcement to lock up undocumented immigrants.

In 2017, it cost taxpayers $77,729,229 a year to run Hampden County jails, according to budget documents for the jail. The majority of women and men incarcerated there are being held “pretrial,” that is they are mostly too poor to make bail. They have been convicted of nothing. It costs $100,000-plus annually per person to jail someone there. If $77 million is not enough, Cocchi has just persuaded legislators to give him $1 million more to support “treatment” at the jail.

Cocchi maintains that he is locking up men with substance use disorder because he is the only one who is compassionate enough to do it.

No matter that this flies in the face of what health and mental health practitioners believe — that people with substance use disorder are not criminals and that stigmatizing and criminalizing people runs counter to best practices.

No matter that on July 1, the majority of state commissioners who studied Section 35 for a year voted to recommend that the state be prohibited from sending people to jails and prisons for addiction treatment.

One thing is true, Cocchi has a lot of empty cells and a lot of correctional staff, and has hired some treatment providers. He is able to do this because we have invested billions of our tax dollars in building and funding jails.

And, as long as millions are poured into jails, they will not go to community-based, community-run treatment on demand. Think about what kinds of quality services and programs could be purchased for $100,000 per person. If these same choices are repeated, jail for people with substance use disorder will be the default. And if Cocchi has his way, jailing people under Section 35 will not only expand in his jail, it will open the doors around the state to other sheriffs who also have empty cells.

Massachusetts is an outlier. We are the only state that civilly commits people to jail only because they are living with substance use disorder. Now is the time to end it. Let’s invest in treatment not jails.

Lois Ahrens is the founding director of The Real Cost of Prisons Project, a national organization based in Northampton. For more information, find The Real Cost of Prisons Project on Facebook and at

Prisons becoming obsolete in Holland

The Netherlands is running out of incarcerated people by treating them like individual human beings. From the BBC News and The Marshall Project.

By Lucy Ash BBC News, Veenhuizen 10 November 2016 Magazine While the UK and much of the world struggles with overcrowded prisons, the Netherlands has the opposite problem. It is actually short of people to lock up. In the past few years 19 prisons have closed down and more are slated for closure next year. How has this happened ­ and why do some people think it’s a problem? N

The smell of fried onions wafts up the metal staircase, past the cell doors and along the wing. Down in the kitchen inmates are preparing their evening meal. One man, gripping a long serrated blade, is expertly chopping vegetables. “I’ve had six years to practice so I am getting better!” he says.

It is noisy work because the knife is on a long steel chain attached to the worktop. “They can’t take that knife with them,” says Jan Roelof van der Spoel, deputy governor of Norgerhaven, a high­security prison in the north­east of the Netherlands. “But they can borrow small kitchen knives if they hand in their passes so we know exactly who has what.”

Some of these men are inside for violent offences and the thought of them walking around with knives might seem alarming. But learning to cook is just one of the ways the prison helps offenders to get back on track after their release.

“In the Dutch service we look at the individual,” says Van der Spoel. “If somebody has a drug problem we treat their addiction, if they are aggressive we provide anger management, if they have got money problems we give them debt counselling. So we try to remove whatever it was that caused the crime. The inmate himself or herself must be willing to change but our method has been very effective. Over the last 10 years, our work has improved more and more.”

He adds that some persistent offenders ­ known in the trade as “revolving ­door criminals” ­ are eventually given two ­year sentences and tailor­made rehabilitation programmes. Fewer than 10% then return to prison after their release.

In England and Wales, and in the United States, roughly half of those serving short sentences reoffend within two years, and the figure is often higher for young adults. Norgerhaven, along with Esserheem ­ another almost identical prison in the same village, Veenhuizen ­ have plenty of open space. Exercise yards the size of four football pitches feature oak trees, picnic tables and volleyball nets.

Van der Spoel says the fresh air reduces stress levels for both inmates and staff. Detainees are allowed to walk unaccompanied to the library, to the clinic or to the canteen and this autonomy helps them to adapt to normal life after their sentence. A decade ago the Netherlands had one of the highest incarceration rates in Europe, but it now claims one of the lowest ­ 57 people per 100,000 of the population, compared with 148 in England and Wales.

But better rehabilitation is not the only reason for the sharp decline in the Dutch prison population ­ from 14,468 in 2005 to 8,245 last year ­ a drop of 43%. The peak in 2005 was partly due to improved screening at Amsterdam’s Schiphol airport, which resulted in an explosion in the numbers of drug mules caught carrying cocaine.

Today the police have new priorities, according to Pauline Schuyt, a criminal law professor from the southern city of Leiden. “They have shifted their focus away from drugs and now concentrate on fighting human trafficking and terrorism,” she says. In addition, Dutch judges often use alternatives to prison such as community service orders, fines and electronic tagging of offenders. Angeline van Dijk, director of the prison service in the Netherlands, says jail is increasingly used for those who are too dangerous to release, or for vulnerable offenders who need the help available inside. “Sometimes it is better for people to stay in their jobs, stay with their families and do the punishment in another way,” she says from her brightly lit office at the top of a tower block in The Hague.

“We have shorter prison sentences and a decreasing crime rate here in the Netherlands so that is leading to empty cells.” But while recorded crime has shrunk by 25% over the past eight years, some argue that this results from the closure of police stations, as a result of budget cuts, which makes crime harder to report.

Find out more

Listen to Lucy Ash’s report Prisons for rent in the Netherlands for Assignment on the BBC World Service Click here for transmission times, or to listen online Other critics, such as Madeleine Van Toorenburg ­ a former prison governor and now the opposition Christian Democratic Appeal party’s spokeswoman on criminal justice ­ blame the shortage of prisoners on low detection rates.

“The police are overwhelmed and can’t handle their work load,” she says. “And what is the government’s response? Closing prisons. We find that surprising.” What is clear is that many of Angeline van Dijk’s staff are not happy about the lack of people to lock up. Frans Carbo, the prison guards’ representative from the FNV union, says his members are “angry and a little bit depressed”.

Young people don’t want to join the prison service he adds “because there is no future in it any more ­ you never know when your prison will be closed”. One empty prison was turned into a fancy hotel south of Amsterdam, its four most expensive suites named the The Lawyer, The Judge, The Governor and The Jailer. But others, converted into asylum reception centres, have provided work for some former prison guards. The desire to protect prison service jobs has sparked another surprising solution ­ the import of foreign inmates from Norway and Belgium.

“At one point our state secretary met the Norwegian minister of justice and said I have some cells to spare ­ you can rent one of our prisons,” says Jan Roelof van der Spoel. So last September Norway began sending some of its convicts south to serve their sentences at Van der Spoel’s prison, Norgerhaven. The governor of the prison is now a Norwegian, Karl Hillesland, but the prison guards keeping an eye on the 234 men locked up here are Dutch.

A mild­mannered former bookseller with a bushy moustache, Hillesland strikes me as an unlikely jailer. His green uniform with epaulettes looks extremely formal, and is nothing like the relaxed clothing of his Dutch colleague, but in fact Norway has a more liberal prison regime than the Netherlands, he says. Norwegian inmates are allowed, for example, to give media interviews and watch DVDs of their choice because the underlying principle is one of “normalisation”, meaning that life in prison should replicate life on the outside as closely as possible to help exoffenders reintegrate into society.

“There are some differences in the way we do things,” says Van der Spoel. “We discipline a prisoner for breaking the rules straight away whereas the Norwegians do an investigation and wait a while before imposing the punishment. For our guards that style of working was a bit tough to begin with.” “But on the whole”, says Hillesland, “we share the same basic values about how to run a prison.” He adds that a few prisoners were forced to come here from Norway but most volunteered, partly because groceries and tobacco are cheaper in Holland.

A recently installed Skype room is another big attraction at Norgerhaven. Relatives who want to visit have to pay their own travel costs, and a round trip costs at least 500 euros with an overnight in a hotel. But many of the long­term prisoners are foreign nationals who very rarely saw their families anyway when they were behind bars in Norway. Michael’s immaculately tidy cell is decorated with pictures of his football team and his four small children. A welder from northern Poland he was convicted in Norway but didn’t have access to Skype in prison there.

“My wife is busy looking after four kids and trying to hold down a job and anyway she doesn’t have the money to come and see me”, he says. “So I opted for this prison so I could see my family and not just hear their voices on the phone.” He stares at the floor for a moment or two. “After the Skype call it’s very hard ­ especially at Christmas and Easter but it is better than nothing.” As I leave through security doors and clanging gates I wonder what will happen to Norgerhaven once the Norwegians have gone in a few years’ time. The guards know that one of the Veenhuizen jails ­ Norgerhaven or Esserheem ­ will be listed for closure next year.

But could the numbers of prisoners in the Netherlands ever rise again? A walk through the village is a reminder that, in the distant past, the Netherlands locked up large numbers of citizens. It’s located in the remote, sparsely populated Drenthe province ­ a land of peat bog, fens and heather known as the “Dutch Siberia”, and a place where beggars, tramps, penniless orphans and other “undesirables” were exiled from the cities in the 19th Century.

An army general founded a reform colony in Veenhuizen, which he believed could eradicate poverty. Over time the institution morphed into a penal colony which was closed to outsiders until the 1980s. According to a demographer, one million of Holland’s 17m citizens alive today are descendants of people exiled to Veenhuizen. “That’s a huge chunk of the population,” says Amsterdam­based author Suzanna Jansen, whose grandfather was sent there for begging. “And being raised in poverty, in a difficult environment is something that could happen to any one of us, so I think we should remember that when we think about those behind bars today.”

More from the Magazine Two Norwegian institutions vie for the title of the world’s “nicest” or “most humane” prison. Inmates on the prison island of Bastoey, south of Oslo, are free to walk around in a village­style setting, tending to farm animals. They ski, cook, play tennis, play cards. They have their own beach, and even run the ferry taking people to and from the island. And in the afternoon when most prison staff go home, only a handful of guards are left to watch the 115 prisoners.


This is cause for hope

This article published on The Marshall Project, an online news agency founded by former New York Times journalists, is dedicated to reform of our country’s justice and corrections systems.

FILED 7:15 a.m.

Massachusetts Mobilizes to Treat Addicted Moms

Jail time increasingly gives way to residential programs.

Clients at the Edwina Martin House take part in a music expression therapy class in the home’s living room on Jan. 6, 2016. MEREDITH DERBY BERG

Kayla Duggan, a heroin addict, had just started a one-year jail sentence in Massachusetts when she was startled to learn she was pregnant. Only a few months earlier she had given birth to a baby girl who was immediately taken into foster care and whom Duggan then gave up for adoption.

This story was produced in collaboration with Fusion.

This time she wanted to be part of her child’s life.

Her chance came about because of a policy changes in Massachusetts in which women addicts, particularly mothers, are increasingly directed to intensive drug treatment and away from time behind bars.

Duggan, who was imprisoned in late 2012 for a domestic violence and drug related conviction, was paroled after serving four months of her sentence and entered a residential drug-treatment program for mothers run by Spectrum Health Systems. Spectrum, a private company that works with the Department of Correction, also has smaller outpatient clinics across the state. Duggan gave birth to her son, Giovanni, while living there, still under correction department custody, and remained until he was six months old. Afterward she moved into a Boston halfway house.

“I got a beautiful second chance to be a mother to my son,” said Duggan, now 26. “I had to learn to be responsible, be available today. Because I wasn’t available before.”

Because of the opioid drug crisis sweeping New England, and the crime that accompanies it, women have become the fastest growing group heading to jail or prison, a situation reflected nationwide. This cohort includes young mothers — who are usually the primary caretakers to young children — and the long-term effects on children and families can be devastating.

Mothers, separated physically from their children while in prison, can come to experience emotional separation as well, said Judy McDonough, executive director of Edwina Martin House, a residential treatment center for women outside of Boston. A growing number of its clients are referred by the courts and probation officers.

“And then they start to lose their confidence in who they were as a parent and feel their kids are better off maybe with their parents. So it really fragments the family,” McDonough said.

A panel convened last year by Gov. Charlie Baker of Massachusetts, a Republican, concluded that mothers and pregnant women need “specialized care.” Its report recommended that treatment centers make pregnant women a priority. In 2014 the state funded two new recovery homes specifically for women, bringing the state’s total to 14.

Those who work in the field say there’s a growing recognition within the Massachusetts criminal justice system and among policymakers that intensive drug treatment can be a key to helping women transform their lives in a way that prison does not.

“The courts were not so involved with treatment as they were with let’s say punishment in a sense. And thankfully that’s turned around, and it’s really a positive now and we work very well together,” said Donna McDade, McDonough’s colleague at the Edwina Martin House, where she has served as director for 24 years.

Massachusetts is among a number of states working to address the needs of addicted mothers who are facing criminal charges.

“We’re unique because being counselors and being here, when we come to work, we see [clients] where they live every day,” says Donna McDade, center, program director at the Edwina Martin House.

A 2010 report by the National Women’s Law Center and The Rebecca Project said that 32 states had programs that offered mothers who are nonviolent offenders the possibility of what is called “family-based” treatment rather than prison or jail time. Family-based treatment permits mothers to live with their children at a site within the community or have visits with them regularly while receiving drug abuse treatment.

But keeping such alternatives funded can be challenging, said Edward Latessa, director of the School of Criminal Justice at the University of Cincinnati. He said that despite the rise in the number of incarcerated women, they still constitute only eight percent of the national prison population.

“As a general rule there tend to be fewer [alternative sentencing] programs for women, but it really varies by state and jurisdiction,” he said. “Of course many female offenders have substance abuse problems and are in need of treatment and recovery programs, but again, for service providers, since the numbers are smaller it is not always economically feasible to open a facility for women. In addition, if you are including mothers with young children the costs go higher, which again makes it more difficult to operate.”

The Federal Bureau of Prisons has its own long-standing program called Mother and Infant Nurturing Together, or MINT. It allows pregnant women — among them drug addicts — in minimum security prisons in their last trimester to reside in halfway houses before they deliver and usually for three months after they give birth. These women, who are eligible for release within five years, are taught parenting skills with the goal of encouraging bonding with their babies and are also eligible to be treated for addiction.

For both men and women addicts charged with crimes, the doubling of the number of drug courts nationally in the last decade, to 2,966, has increased opportunities for defendants to serve at least part of their time at residential treatment facilities or halfway houses instead of prison or jail.

But diversion or treatment programs have not found universal acceptance. In Tennessee, South Carolina and Alabama, women are being prosecuted and locked up for endangering their children by using drugs when pregnant. Eighteen states have laws stating substance abuse during pregnancy is child abuse.

The evolution of Massachusetts’ approach has been aided by the jump in the number of drug courts established in the last two years, adding five new ones for a total of 18.

Drug courts are vitally important now because it’s where the state can refer people to residential drug treatment homes instead of jail or prison. And even though more women are being arrested and convicted, fewer female defendants are actually being sent to serve time. According to the Massachusetts Sentencing Commission, there was a four percent drop, to 1,625, in the number of women incarcerated from 2012 to 2013.

In previous years a woman who was addicted to drugs and charged with a non-violent crime could be given the choice between jail and a residential drug treatment center, but the numbers of court-ordered referrals now appear to be rising dramatically. It’s now more likely that residential treatment will become part of an offender’s sentence. The average number of probationers at 12 women’s-specific recovery homes in Massachusetts rose to 60 percent in 2014, from 25 percent in 2009, according to annual enrollment reports from the Massachusetts Bureau of Substance Abuse Services.

The minimum stay is at the Edwina Martin House in Brockton, Mass., is four months but a woman can live there for a year.

In 2014, the opioid crisis led to a record 1,000 fatal overdoses. The state has tested a range of responses, from trying to ban the powerful painkiller Zohydro to offering prostitutes mental health or medical treatment instead of jail. One city, Gloucester, created an amnesty program for addicts.

The state does not track the number of people who are offered—or manage to win—an alternative to incarceration. But judges say they are becoming more aware of the harm incarceration can have on families and that addiction may not be adequately addressed in jail. Longtime program directors report that they now get more referrals from judges than they once did.

“Many of us, and I am one of them, firmly believe that you cannot just lock people up and incarcerate them and expect their substance abuse issues to go away. It’s just not working anymore,” said District Court Justice Mary Heffernan, who runs two drug courts. “You have to put the resources into treatment.”

Beyond residential centers, treatment options include intensive outpatient addiction programs that require daily, daylong attendance. These programs can mandate community service combined with substance abuse counseling, job training, electronic monitoring, and drug testing.

Vincent Lorenti, regional program manager of the Massachusetts Office of Community Corrections, described his department’s program as “halfway between traditional probation and incarceration.” Annual community corrections statistics show that women make up an increasing percentage of the program, up five percent between 2011 and 2014.

At residential recovery homes such as Edwina Martin House, which receives significant state funding, the average four-to-six month stay costs $12,000 to $18,000. At the women’s prison in Framingham, the oldest women’s prison in the country, it costs $60,000 a year to house an inmate, according to corrections department data.

Part of the rehabilitation process is helping women to relearn basic life skills that atrophied as they began their descent into addiction. These include structuring their days, keeping appointments, shopping for groceries and cooking. Group and individual therapy sessions emphasize self-esteem. They also work to rebuild connections with their families and children. At some homes mothers live with their infants and pregnant women await delivery.

About 6:45 each morning the ringing of alarm clocks echoes through the corridors of the Edwina Martin House. The women shower, make their beds and tidy their bedrooms. By 9 a.m. they are attending group meetings on topics like music expression, relapse prevention, household budgeting and family dynamics. Some women go to work, others go to vocational training or take classes. In the evenings they attend Alcoholics Anonymous or Narcotics Anonymous meetings.

Though jail time can include access to substance abuse programming, it’s not considered to be as intensive. “Jail doesn’t fix the issue of addiction. You’re there, and it’s just time. You’re idle,” said Stephanie, who asked to be identified by her first name only. She is a mother who was ordered by a drug court to attend Project Cope, a Boston area women’s recovery home.

It’s not an easy road, and treatment is no panacea. At Edwina Martin there is a 48 percent program completion rate, but that is still better than the state average of 31 percent completion, according to McDade.

The clients Edwina Martin has seen in recent years are young, usually in their early 20s. Typically they did not experiment much with other drugs before becoming hooked on opioids. “We have great success with them, because they are young,” says McDade. “They have not had as many losses. But their losses come quick with heroin.”