Judges and others have praised Cocchi’s program in Hampden County, particularly for its role helping those in rural communities where services are scarce. In addition to touting the health benefits of the program, Cocchi has repeatedly noted, as an advantage, that he has filled unused jail beds. People who enter the program stay an average of 48 days, longer than patients can stay in private facilities. And unlike in other treatment programs, those in Cocchi’s program receive assistance reintegrating into society and resolving any open arrest warrants or criminal charges. Robert Rizzuto, a spokesman for the sheriff’s office, said, “Unlike other facilities, we help people through each stage of the recovery process. We don’t want to leave someone to figure things out on their own.” The state has added $1 million to the program’s budget for the next fiscal year, Rizzuto said.
But public-health experts and advocates largely oppose programs such as Cocchi’s. Bonnie Tenneriello, a staff attorney at Prisoners’ Legal Services of Massachusetts who has worked on the Section 35 lawsuit for years, told me that as prison and jail populations dwindle, officials may increasingly repurpose the space.
Leo Beletsky, a professor of law and health sciences at Northeastern School of Law and the faculty director for the Health in Justice Action Lab, argues that civil commitment is just a rebranding of incarceration. Beletsky, along with his colleague Denise Tomasini-Joshi, wrote in an op-ed for The New York Times that it is “clear how harmful it is for the health of patients—and public discourse—to describe detention in correctional facilities as ‘treatment.’”
Dionna King, a policy manager at the New York office of the Drug Policy Alliance, a group that seeks to reduce the criminalization of substance abuse, has vigorously argued that using locked facilities as treatment centers violates the rights of people with substance-use disorder. “Using tools of confinement and containment to remove people from their day-to-day life—that’s punishment,” she said.
King and Beletsky believe that jails are not adequate health-care facilities. They note that research indicates that people who spend time in jail have worse health across the board, and that evidence suggests involuntary treatment for substance-use disorder may not be effective in the long run. “Any period of incarceration impacts health long-term,” King said in a phone interview.
Others have suggested that it might be a violation of civil liberties to detain people for treatment. Alexander Shalom, an attorney for the American Civil Liberties Union of New Jersey, said, “The criminal legal system doesn’t get to dictate what people do if they haven’t committed a crime.”
In lieu of pursuing custodial treatment, King and Beletsky recommend that more counties look at new models like one in Rhode Island, where authorities have integrated MAT into reentry programs that help people leave jail and return to their communities, where they can work and be with their families while they are in recovery.