This section provides information about harm reduction. Harm reduction is a person-centered approach and a set of practical strategies to reduce the negative consequences of drug use. Harm reduction recognizes the dignity and autonomy (ability to make one’s own choices) of people who use drugs. Harm reduction supports and embraces any positive changes that people want to make in their drug use and health. Harm reduction recognizes that there are safer and less safe ways to use drugs and provides nonjudgmental services that meet people who use alcohol or drugs where they’re at. These services help people stay safe, improve their quality of life and health, prevent and manage disease, and prevent fatal overdoses.

If you need to access harm reduction services, a comprehensive listing can be found through the Massachusetts Substance Use Helpline.

Naloxone Training & Access

• Naloxone (commonly called by a common brand name, Narcan®) is a medication called an “opioid antagonist” used to reverse an opioid overdose. Naloxone works quickly and reverses an opioid overdose in three to five minutes. Rescue breathing, oxygen, and/or another dose of naloxone are sometimes needed. Naloxone is available as a nasal spray and as an injection.
• People at risk of an overdose can get naloxone and training on how to use it at Overdose Education and Naloxone Distribution sites. You can also get naloxone at most pharmacies without a prescription, and the pharmacist can show you how to use it. MassHealth and many other health insurers cover naloxone. If you use naloxone on someone else or have it used on yourself, withdrawal symptoms may occur.

Telephone Support for Overdose Prevention

• The SafeSpot helpline (1-800-972-0590) offers support for people using drugs alone, connecting them with a trained operator who can call for help if an overdose occurs.

App Support for Overdose Prevention

• The Brave App is an app that provides another option for support for people using drugs alone who want a trusted person to ensure they are safe if an overdose occurs.

Drug Checking

The drug supply is increasingly contaminated with known and unknown contaminants, especially fentanyl (a synthetic opiate) and xylazine (a tranquilizer). Drug checking allows people who use drugs to test what they are using so they can know what’s in the drug and stay safe from overdose or other accidental harm. Drug checking can be done with fentanyl test strips or with special devices like handheld testing devices that tell people exactly what is in a drug.

• The BSAS Harm Reduction Program locator allows users to select programs that provide fentanyl and xylazine test strips. Harm reduction programs will often have information on emerging contaminants in the drug supply.
• Street Check takes drug samples, analyzes the samples, and communicates the results back.
• Massachusetts Drug Supply Data Stream (MADDS) is a partnership to learn more about the local illicit drug supply to better inform public health and safety responses.

Overdose Prevention Centers

• Overdose prevention centers (OPCs) are spaces where people who use drugs can use under the supervision of trained professionals who can reverse an overdose if necessary. OPCs have been successfully implemented in many countries, including the United States. While they are not available now in Massachusetts, SPOT (see below) can help keep people safe who are over-sedated from substance use.

Safer Smoking Services

These programs offer supplies for safer smoking of drugs, which reduces the risk of infections that can happen with injection drug use and can reduce the risk of overdose. The BSAS Harm Reduction Program locator allows users to search for programs that provide safer smoking supplies.

Syringe Services Programs

Syringe services programs (SSP) serve people who inject drugs by providing a range of services including:

• HIV, hepatitis, and STI counseling and testing
• Free, legal, and anonymous needle exchange
• Overdose prevention education and training
• Risk reduction supplies to reduce HIV and hepatitis C transmission
• Risk reduction counseling and other harm reduction strategies
• Referrals to substance use treatment programs
• Fentanyl test strips
• Wound care

A listing of syringe services programs can be found on the Bureau of Substance Addiction Service’s Harm Reduction Program locator.

Wound Care

• If you are using drugs containing xylazine, you may experience difficulty in caring for wounds. This may occur even if you are not injecting drugs, and wounds may appear in areas where you did not inject. Many harm reduction programs offer wound care services and can be found in the BSAS Harm Reduction locator.

Rights, Protections, and Advocacy Suggestions

• You can get naloxone, syringes, and needles at many pharmacies in Massachusetts without a prescription.
  • At the pharmacy, tell the pharmacist you would like naloxone. MassHealth covers the whole cost, and many other health insurers cover naloxone. If you don’t have MassHealth, there may be a copay, depending on your insurance. Be sure to ask the pharmacist. Additional resources to find naloxone can be accessed at the BSAS Harm Reduction website or Next Distro, including naloxone by mail.
  • For syringes and needles, pharmacies can sell to anyone of any age without an ID. There are no limits on how many you can buy at once and no restrictions on what kind you can get.
• If someone is overdosing, don’t be afraid to call 911 for help. The Good Samaritan law in Massachusetts protects a person having an overdose and the people who call for help. The laws protect you from arrest when you’re trying to help in an emergency, but they don’t cover all scenarios. You can be arrested for the “Ws”: weapons, warrants, or weight. If you have an unregistered weapon, an open warrant out for your arrest, or enough drugs on you that it is clear you are trafficking drugs instead of just using them, the laws do not protect you.
• If you exchange sex for a form of payment and they become abusive or violent in any way (a “bad date”), you can view and share information on the Bad Date page on the Harm Reduction Boston website to protect others in your community.

Harm Reduction Resources

Resources to support family, loved ones, and providers supporting people who use opioids are in the Recovery Support section of this toolkit.

• Learn more about how to respond to an overdose and how to get naloxone. Additional places to get naloxone can be found at Next Distro.
• Find an Opioid Overdose Education and Naloxone Distribution (OEND) site on the Helpline website or call 800-327-5050. You can also find this at BSAS Harm Reduction.
  • You can also find Syringe Services Programs on the Helpline website. At a needle exchange program, you can get new needles and dispose of used needles. They offer other harm reduction tools and strategies, too, like bleach kits, HIV counseling and testing, and hepatitis C information. These programs can also give referrals to substance use disorder treatment.
  • Services for Active Users (AHOPE): AHOPE is one of the many harm reduction programs or SSPs on the Helpline website.
  • Boston Health Care for the Homeless Program (BHCHP) Supportive Place for Observation and Treatment (SPOT): The SPOT offers support and medical monitoring and helps people who are over-sedated from the use of substances and who would otherwise be outside or alone. It serves as an entry to primary care and treatment for eight to ten people at a time.
• Learn more about harm reduction principles from the National Harm Reduction Coalition.
• Learn more about opioids, overdose prevention, how to respond to an overdose, making a safety plan, and experiencing loss in this Massachusetts Department of Public Health Toolkit.

This section provides information on various options for people who wish to participate in recovery pathways. If you want to access resources related to treatment and recovery, including harm reduction services, the Massachusetts Substance Use Helpline website is a key resource. 

There is no “right” way to recover. Treatment and recovery don’t look the same for everyone. People with opioid use disorder (OUD) must be able to get accurate and unbiased information about the effectiveness of different treatment pathways. Accurate information allows you to choose what’s right for you, which might change over time—and that’s okay. Your route to recovery might be made up of different services and supports ranging from abstinence-centered approaches to those emphasizing harm reduction and from clinical and non-clinical pathways.

While there are guidelines in place to protect you from various forms of discrimination in treatment and recovery settings, you may experience significant challenges along the way. Each section of this guide provides additional information on who to contact for support or resolution of specific issues. General complaints about any licensed alcohol or drug counselor or licensed/funded substance use disorder treatment program can be made at the Bureau of Substance Addiction Services Complaint Line..

Non-Clinical Pathways or Peer-Based Recovery Support

Non-clinical pathways to recovery focus on community and peer-based supports, and some people find other activities like acupuncture, exercise, and meditative practices helpful, too. Peer-based recovery is about people with similar experiences offering support to one another. Some examples of peer-based recovery support options are:

Mutual/Self-Help Options

• Mutual and self-help groups either have a religious or spiritual lens (like Twelve-Step groups) or are secular (non-religious). Some groups may encourage abstinence-only recovery, while others may allow for a moderation approach.
• Find mutual/self-help resources/Twelve-Step groups: MA Substance Use Helpline, 12step.org, and Crystal Meth Anonymous Boston

Peer Recovery Support Centers

• Peer recovery support centers are peer-led drop-in spaces across the state that offer peers in recovery the opportunity for education and capacity building, social events, recreational and wellness activities, one-on-one peer support, and community engagement.

Recovery Coaches

• Recovery coaches offer services to educate and support individuals on their path to recovery. Find recovery coaching and Peer Recovery Support Centers: MA Substance Use Helpline.
• Recovery Support Navigators (RSNs) are people who can provide care management and support people as they navigate the treatment system. You are eligible for RSNs if you have a diagnosed opioid use disorder. The RSN can help you develop a wellness plan for your recovery. This is a covered benefit that does not need prior authorization from MassHealth, and other health insurance plans may cover. Ask your provider or call your health insurance company to find out.

Recovery High Schools

• Recovery high schools are public high schools for youth ages fourteen to twenty-one that provide educational environments to support youth recovering from substance use disorder (SUD). They serve thirty to fifty students per school and are supported by the state, local school districts, and educational collaboratives. Students receive support for their recovery within an academic setting consistent with Massachusetts State Standards. Students with a diagnosed SUD can choose to attend a recovery high school. A referral from a student’s sending district is not needed.

Recovery Wellness Supports

• Many programs across the state focus on running, CrossFit, yoga, drama, and other wellness activities run by people in recovery for people in recovery.
  • The Phoenix
  • Yoga Recovery Program

General Resources

• The Massachusetts Department of Public Health’s Bureau of Substance Addiction Services (BSAS) provides a complete description of each service type.
• You can learn more about the levels of care created by the American Society of Addiction Medicine at the Recovery Research Institute.
• You can learn more about Harm Reduction as a set of practical strategies and a social justice movement through the National Harm Reduction Coalition.

Resources for Families, Loved Ones, and Providers

• Learn to Cope is a nonprofit support network that offers education, resources, peer support, and hope for parents and family members coping with a loved one addicted to opiates or other drugs.
• The Massachusetts Organization for Addiction Recovery (MOAR) provides a detailed list of the types of treatment options available in Massachusetts in their Mini Guide
• Shatterproof’s “How to Support a Loved One in Recovery” provides many simple tools that will support you as you help your loved one navigate treatment and recovery.
• Allies in Recovery offers science-based training for families of people with addiction.
• You can learn more about how to talk with a loved one and the types of treatment options with Health Care Resource Center’s Helping a Family Member with Opioid Addiction.

This section provides information on various options for people who wish to enter clinical treatment, including medication for Opioid Use Disorders (MOUDs), withdrawal management (detox), inpatient, residential, and outpatient options. If you want to access resources related to treatment and recovery, including harm reduction services, the Massachusetts Substance Use Helpline is a key resource.

There is no “right” way to recover. Treatment and recovery don’t look the same for everyone. People with opioid use disorder (OUD) must be able to get accurate and unbiased information about the effectiveness of different treatment pathways. Accurate information allows you to choose what’s right for you, which might change over time — and that’s okay. Your route to recovery might be made up of different services and supports ranging from abstinence-centered approaches to those emphasizing harm reduction and from clinical and non-clinical pathways.

While there are guidelines in place to protect you from various forms of discrimination in treatment and recovery settings, you may experience significant challenges along the way. Each section of this guide provides additional information on who to contact for support or resolution of specific issues. General complaints about any licensed alcohol or drug counselor or licensed/funded substance use disorder treatment program can be made here.

Clinical Pathways or Clinical Treatment for Opioid Use Disorder (OUD)

Clinical pathways are treatments that involve the services of a trained clinician. The American Society for Addiction Medicine has developed levels of clinical care that, based on their intensity, range from Levels 1 to 4. These levels create a universal standard and are also used by insurance companies. Some clinical pathways are:

Medication for Opioid Use Disorder (MOUD)

Medication is an effective treatment for opioid use disorder. MOUD, sometimes called medication-assisted treatment or medication for addiction treatment (MAT), is the use of FDA-approved medications to treat OUD. These medications include, but are not limited to, methadone, buprenorphine, and naltrexone. Naltrexone can also be used to treat alcohol use disorder. All of them help reduce cravings and withdrawal symptoms. People take them differently and in different settings, so which medication you take is a decision you should make with your provider. MOUD is most often used with outpatient counseling or other recovery support services, but medication alone can be effective for some people. MOUD can be a short-term or long-term treatment option (known as maintenance).

Where to Access Medication for Opioid Use Disorders (MOUD) Services

Opioid Treatment Programs (OTPs), Office-Based Opioid Treatment Programs (OBOTs), and bridge programs provide MOUD and offer other counseling and support services. Access to MOUD has been expanded since 2023 and continues to grow. You can find treatment locations in Massachusetts that offer MOUD through the Massachusetts Substance Use Helpline and the 24/7 Boston Medical Center Addiction Warmline for rapid access to medication to treat OUD via phone at 617-414-4175.

Medication for Opioid Use Disorder (MOUD) Resources

• The SAMHSA brochure Know Your Rights: Rights for Individuals on Medication-Assisted Treatment contains information about MOUD, the non-discrimination laws that protect people on MOUD, and how to protect your rights.
• Legal Action Center’s MAT Advocacy Toolkit also offers helpful resources. You can learn more about MOUD and find MOUD programs near you by calling the Massachusetts Substance Use Helpline at 800-327-5050 or on the Helpline website.

Assessing Treatment Needs: Walk-In Opioid Urgent Care Centers

Opioid Urgent Care Centers (OUCC) are walk-in programs that assess a person’s medical, behavioral health, and substance use treatment needs. Other services include medication, opioid overdose education, naloxone kits, community-based support services, program referrals, and follow-up care. Program staff include doctors, nurses, addiction counselors, recovery coaches, case managers, and social workers.

OUCC Resources:

• You can find an OUCC by calling the Massachusetts Substance Use Helpline at 800-327-5050 or by visiting the Helpline website.

Withdrawal Management (Detox) Treatment Options

If you use alcohol or sedatives or need to be in a structured inpatient setting, you may get medical management for withdrawal (commonly referred to as “detox”) in a residential setting. Withdrawal management is also known as Acute Treatment Services (ATS). It can be a first step toward stabilization and starting longer-term treatment options for some people. Withdrawal management services provide three to five days of 24-hour care and monitoring for withdrawal. This time frame is based on the individual’s needs. Medical management might be needed because the symptoms of withdrawal from alcohol or benzodiazepines can be dangerous and even deadly. Inpatient settings can also be a structured space to start medication for opioid use disorder (MOUD) and allow a person to be closely monitored and given medication to manage withdrawal. For people who also have mental health disorders, Enhanced Acute Treatment Services (E-ATS) are available.

It is important to know that withdrawal management alone without additional supports can be difficult and may not work for everyone. If you use opioids or other substances after withdrawal management, the risk of an overdose is high. Your tolerance is lower after going through withdrawal management, so ongoing treatment and support are important to help prevent overdose.

In recent years, many illicit drug manufacturers have been mixing fentanyl with a non-opiate tranquilizer called xylazine in an attempt to extend the duration of effect for the substance. If you know or suspect that you regularly use drugs contaminated with xylazine, it is important to ensure that medical staff is aware of this, as it could complicate your withdrawal management.

Inpatient Treatment Resources

You can find inpatient treatment options by calling the Massachusetts Substance Use Helpline at 800-327-5050 or search on their website for inpatient treatment options for yourself or someone else.

Residential Treatment Options

Residential treatment can provide short-term intensive care (less than thirty days) or longer-term support. MOUD is available in all of these residential treatment options:

• Clinical Stabilization Services (CSS): These services offer 24-hour treatment for people who need a safe and structured setting to support their recovery after withdrawal management. Services include nursing support, case management, education and counseling, and aftercare planning. These programs help to bridge services between detoxification and rehabilitation programs, such as sober homes.
• Transitional Support Services (TSS): Like clinical stabilization services, transitional support services provide up to thirty days of residential services for people who need a safe and structured setting to support their recovery after withdrawal. The provider will work with the patient to decide the length of the stay based on the person’s needs. Services include nursing support, case management, education, and aftercare planning. Programs also provide intensive case management to prepare people for longer-term residential care, such as sober homes.
• Residential Treatment Over Thirty Days: These programs are for people who have recently stopped using drugs or alcohol, are medically stable, and can be in a structured residential recovery program. Options include recovery homes, social model homes, therapeutic communities, specialized residential services for women, specialized residential services for families, co-occurring enhanced residential rehabilitation services (RRS), and youth residential treatment. You can read more about these different types of residential recovery programs through the Bureau of Substance Addiction Services (BSAS).
• Sober homes, accredited through the Massachusetts Alliance for Sober Housing, offer sober living environments where people pay rent. You can call the Helpline at 800-327-5050 or search the Helpline website for details. You can find more about your rights in sober homes in the Housing section of this toolkit.
• For more information on various levels of care in Massachusetts, you can visit the American Society for Addiction Medicine. 

Residential Treatment Rights and Advocacy Suggestions

• Residential programs and sober homes cannot deny you because you are treated with MOUD.
• Not all residential programs are equal. Sometimes, programs “target” people for reasons other than support. It’s important to make sure you are getting quality treatment. Some programs offer very little or poor care but try to get as many people as possible to visit their treatment centers. They are often outside of Massachusetts and will use predatory practices to recruit new patients. Here are some ways to recognize when a program may not be legitimate:
  • They use “patient brokers” to recruit people to their program. A patient broker (sometimes called a patient marketer) is paid a fee to get people into a program. They might approach you in person or contact you by phone, text, or social media. Paying someone to refer people to a program is illegal in Massachusetts.
  • They offer to pay for your travel.
  • They offer to pay your health insurance costs.
  • They focus on luxury services or accommodations instead of treatment.
  • If you experience sexual misconduct or harassment in a residential setting, you can call BARCC or file a complaint with the Massachusetts Commission Against Discrimination (MCAD)

You Can Protect Yourself From Residential Treatment Scams

• Be careful when giving anyone your personal information, including your social security number or health insurance information.
• Ask upfront about billing and how treatment “add-ons” will be billed. Often, predatory treatment centers will provide additional services that are billed separately and at very high costs.
• Be aware of how often drug tests are given. Some treatment centers use drug tests very often, which can be expensive. Ask how testing is done and how much each test costs so you don’t incur surprise costs.
• Every treatment center should have a grievance procedure for making a formal complaint to the provider. Ask the facility if it has one, how to file one, and the timeframe for resolving the issue.
• Be sure to ask whether family (including your chosen family) can be involved in your care. Often, treatment scams will discourage and prevent the support of loved ones.
• If someone offers to pay your travel costs, call the treatment program or your insurance company to make sure they’re an employee. If you accept the program’s offer to pay for your travel, ensure you have a plan and money to return home.
• Be very careful about a program that offers to pay your insurance costs. They may stop paying anytime, and your insurance can be canceled.
• It is not legal to advertise statistics for marketing. For example, a treatment center cannot make statements such as, “We accepted 100 clients into our CSS program in 2020. 89% completed treatment and 75% remain drug-free according to a survey sent to those completing treatment in 2020.” or “Our program guarantees lifetime sobriety.” These statements are probably false and might mean the center should not be trusted.
• Programs that provide any residential service cannot discharge (release) you to a homeless shelter or the street as part of your treatment plan. Massachusetts Housing and Shelter Alliance provides a list of housing support agencies statewide.
• The law protects your privacy in residential treatment. Providers cannot disclose (share with others) your substance use disorder without your consent.
• If you think you are the victim of an addiction treatment scam, file a health care complaint with the Massachusetts Attorney General’s office or call the Massachusetts Attorney General’s Health Care Helpline at 1-888-830-6277 or 617-727-4765 (TTY). See Your Rights in Filing Complaints below for more information.

Outpatient Treatment Options

Outpatient programs provide assessment and counseling services while you live at home. Services are in a community-based setting, like a community health center. Depending on your needs and the level of services you get, you might participate in counseling weekly or many times per week. Counseling can be for individuals, families, couples, or groups. The most basic level of care for outpatient counseling is Individual and Group Counseling. Level 2, Day Treatment/Intensive Outpatient Treatment/Partial Hospitalization, is also available which has several daily groups or individual sessions.

Outpatient Treatment Resources

You can find outpatient counseling services by calling the Massachusetts Substance Use Helpline at 800-327-5050, the Behavioral Health Helpline (BHHL) at 833-773-2445, 988 Lifeline at 988 for suicide and crisis specialists for free, confidential support, or by calling the behavioral health line on the back of your insurance card.

Treatment Rights and Advocacy Information

• It is illegal to discriminate against people because they are receiving MOUD. You have a right to receive non-discriminatory services. If you are comfortable discussing any experiences of discrimination informally with the person, you may be able to resolve the issue. You can also ask for a different provider or file a complaint with the Massachusetts Commission Against Discrimination.
• Know what to look for regarding discrimination in healthcare settings. It can be subtle and difficult to name. Examples may include:
  • Doctors minimizing your pain or need for treatment
  • Being turned away from medical treatments, care settings (like nursing homes), or addiction treatment services, including residential care or sober living, because you are treated with MOUD
  • Having probation, parole, child welfare, or drug court require a specific treatment or not allowing you to stay on MOUD
  • Recommending treatment you can’t access and not referring you to other options when you ask
  • Treatment providers not considering the treatment you prefer and prescribing you something you don’t want
  • Treatment providers discharging you (releasing you from a program) before you say you are ready
  • Providers denying you your right to see your medical records
  • Providers not respecting your pronouns, name, and gender identity in treatment settings or not working with you to find gender-affirming OUD care
  • Any comment or action that discriminates against you because of your race, sex, sexual orientation, class, or age. These can be subtle, but remember: if it feels wrong, trust that and report it to the Bureau of Substance Addiction Services complaint line or the Massachusetts Attorney General’s Civil Rights Division. Read more about LGBTQ sensitivities at the Recovery Research Institute.
• You have a right to privacy. Personally identifiable information relating to OUD and alcohol treatment needs to be treated more confidentially than other medical information, based on the Confidentiality of Substance Use Disorder (SUD) Patient Records regulations.
• If you have MassHealth, there is no copay for OUD treatment, including MOUD. 
• Treatment centers must provide interpreter services when asked so that people who speak any language can get services. If the service or program can’t provide an interpreter, the Bureau of Substance Addiction Services (BSAS) at the MA Department of Public Health must work with you to find a treatment center that can. You can report it to the Bureau of Substance Addiction Services complaint line if they do not.
• The Americans with Disabilities Act (ADA) and state public accommodations laws protect your right to request “reasonable accommodations” for a disability that impacts your ability to access a treatment center. If your treatment center is not wheelchair accessible or can’t accommodate your needs, BSAS must work with you to find another treatment facility that can. If they fail to do so, you can report it to the Bureau of Substance Addiction Services complaint line.

Your Rights in Filing Complaints

Anonymity

When filing complaints, you sometimes have the option to do so anonymously. This ensures your identity is protected while allowing the relevant authorities to address your concerns effectively. This safeguard helps protect individuals from potential retaliation and encourages reporting of misconduct without fear. The Attorney General’s Office does not accept anonymous complaints.

Immigration Status

Your immigration status should not deter you from filing a complaint. Massachusetts law and policies are designed to protect all individuals, regardless of their immigration status. Organizations like the American Civil Liberties Union (ACLU) provide resources and support to immigrants facing legal challenges or harassment. When filing a complaint, it is important to know that:

• You have the right to remain silent about your immigration status and should discuss it only with your lawyer
• Legal protections are in place to ensure that your immigration status is not used against you in civil rights complaints
• If you are detained or face any immigration-related issues, organizations such as the National Immigration Law Center (NILC) and the Immigrant Legal Resource Center (ILRC) offer guidance and support
• For more information on your rights and resources, you can visit the Massachusetts Legal Resource Finder and the ACLU’s Immigrants’ Rights section

Additionally, the following resources may be able to assist in navigating discrimination and complaint processes:

• The Disability Law Center is a private, nonprofit organization responsible for providing protection and advocacy for the rights of Massachusetts residents with disabilities
• Massachusetts Commission Against Discrimination is an independent state agency that enforces anti-discrimination laws and provides online tools and phone numbers to help you along the process of filing a complaint
• Massachusetts Attorney General’s Office provides detailed guidance on filing civil rights complaints

By integrating these supports and safeguards into your complaint process, you help create a safer and more just environment for all individuals, regardless of their background or status.

This section provides basic information on accessing treatment through the healthcare system, including types of healthcare you may be eligible for, how to enroll or renew your healthcare, what to do if you are uninsured or undocumented, and your rights in accessing treatment, including medication for opioid use disorder (MOUD). If you are interested in harm reduction resources (ways to reduce the harms of substance use while continuing to use substances), the Harm Reduction section of this toolkit will provide more information.

As you navigate treatment and recovery, you have rights and protections with your health care and health insurance. Health insurance can be hard to navigate, but state and private health insurance policies cover a variety of services for people with opioid use disorder (OUD). The Mental Health Parity and Addiction Equity Act, for example, requires most health insurers to provide the same level of benefits for OUD treatment and services as they do for physical health care.

Accessing Treatment & Health Insurance

• If you are working, you may be offered health insurance as a benefit through your employer. For information about your rights in recovery in an employment setting, click here.
• If you are not currently employed or your employer doesn’t offer a health insurance benefit, you can find a health insurance plan through several pathways:
  • Massachusetts Health Connector: This online marketplace allows you to enroll or renew in private health insurance plans. The plans offered through the Health Connector by different carriers meet state and national coverage standards, and you can compare plans and see costs to find the plan that will work best for you with language support via phone in sixteen languages.
  • ConnectorCare: You may be able to get a ConnectorCare plan if you have a household income at 500% of the Federal Poverty Level or lower; you don’t qualify for MassHealth, Medicare, or other public health insurance programs, and you meet other eligibility requirements. ConnectorCare plans offer comprehensive coverage and have low monthly premiums, low out-of-pocket costs, and no deductibles.
  • Health Navigator organizations can help you understand eligibility, choose a plan that works for you, and assist with enrollment or renewing coverage, including completing paperwork. This service is available to all people regardless of income.
  • If you are eligible for help paying for coverage through MassHealth, Children’s Medical Security Plan, or Health Safety Net, you can use the Health Connector website to apply for these programs.
• MassHealth: If you meet certain income requirements, you may be eligible for MassHealth. MassHealth is a Medicaid program paid for by state and federal taxes. There are different types of coverage available through MassHealth based on your age, living and family situation, disability status, and certain health information. You can enroll or renew your MassHealth coverage.
  • Copays: Co-pays are a fixed amount you pay at the time of the service. There is no copay for drugs used to treat substance use disorder (such as medication for opioid use disorders) covered by MassHealth.
• Medicare: Medicare is the federal health insurance plan for people age sixty-five or older and people with certain disabilities or health conditions. Both original Medicare and Medicare Advantage provide coverage for OUD, ranging from screening to inpatient and outpatient treatment by a Medicare-approved provider. However, a person who receives treatment must still pay deductibles, copayments, and coinsurance. You can apply for Medicare through Social Security.

The most common types of health insurance plans in Massachusetts are Health Maintenance Organization plans (HMOs), Preferred Provider Plans (PPPs), and Major Medical/Indemnity Plans.

• HMOs cover hospital, medical, and preventive care within a network of providers. Care that you get from a provider outside of the provider network is not covered except for emergencies. You usually pay a portion of the cost of each service (called a co-pay), and the HMO pays the rest of the cost.
• Like HMOs, PPPs usually cover hospital, medical, and preventive care within a network of providers. In a PPP, you can also get care from providers outside of the network and the PPP will still pay a portion of the cost, but it may be a smaller amount.
• Major medical plans/indemnity plans usually cover hospital and medical expenses for an accident or illness. Some also cover preventive care. These plans will pay a part of the cost and you are responsible for the rest.

If you do not have health insurance, you can still receive treatment in Massachusetts. There are some programs funded by the state that offer free treatment to people without insurance. You can learn more about state-funded services and how to find them by calling the Helpline at 800-327-5050 or on the Helpline website. When you search for services on the Helpline website, you can choose “Only show BSAS-funded programs” to see free treatment options.

Rights, Protections, and Advocacy Suggestions

Accessing Treatment Services

Under the Massachusetts Mental Health Parity and Addiction Equity Act, certain types of health insurance plans are prohibited from putting smaller annual or lifetime limits on coverage of care for mental health and substance use disorders than on physical disorders. These laws also require certain health insurance plans to cover various mental health services without prior authorization.

If you think your insurer is not maintaining mental health and substance use copays, co-insurance, or deductibles at the same level for medical/surgical services (parity), you should contact your plan to determine if such laws apply to you; you can also file a written complaint with the Division of Insurance.

Skilled nursing facilities (often used for inpatient care after an accident, severe illness, or surgery) cannot deny care to people solely because they are prescribed a MOUD — this is a violation of the Americans with Disabilities Act (ADA) and you can contact the Attorney General’s office to file a complaint if you believe your rights were violated. For more information on your rights in filing complaints, see Your Rights in Filing Complaints in the Clinical and Treatment Pathways section in this toolkit.

Accessing MOUD

• Not all pharmacies stock MOUD for various reasons,¹ despite MOUD being a lifesaving medication.
• Your right to fill your prescription for medication for MOUD at a pharmacy is protected, but people may still experience discrimination in pharmacy settings. A pharmacist can refuse to fill your prescription because it is against their religion or the pharmacist believes the prescription is not appropriate. If that happens, you have a right to ask for a pharmacist who will fill your subscription. You cannot be denied your medication if the pharmacist serving you will not fill it.
• You can check with your healthcare provider or navigator for suggestions on pharmacists if needed.
• If you are already using MOUD for treatment and are incarcerated in Massachusetts, the correctional facility is required to maintain access to these medications under the ADA.
• Know what else to look for when it comes to discrimination in pharmacy. Here are some examples:

Immigrant Rights & Resources

• You have the right to health care regardless of your immigration or health insurance status. Healthcare providers, including emergency rooms, can give you care without asking for your immigration, citizenship, or insurance status.
• Applying for government-subsidized health insurance will not affect your immigration status. However, you will be asked to disclose your immigration status to apply for health insurance.
• Immigration and Customs Enforcement (ICE) usually cannot detain (take) you at hospitals or at other places that provide care.
• Your health information is protected information no matter what your immigration status is.
• If you are undocumented, you do not need to provide your immigration status information to workers at a hospital, healthcare center, or doctor’s office. If you don’t have health insurance, you can say, “I am not eligible for health insurance and do not want to apply.”
• If you want to talk to someone about your specific situation, there are people available to help. Explore these resources to find an advocate nearby:
  • Immigration Advocates Network
  • The Massachusetts Immigrant and Refugee Advocacy (MIRA) coalition also publishes “Know Your Rights” for all immigrants of all statuses.

Resources

• Learn more about how to get treatment without health insurance on the Helpline website.
• Find health insurance on the MA Health Connector website.
• Find out if you are eligible for MassHealth.
• Learn about common terms to understand insurance plans, such as copay, coinsurance, and deductible, on the Massachusetts Health Insurance Plans site.

¹Weiner, S. G., Qato, D. M., Faust, J. S., & Clear, B. (2023). Pharmacy availability of Buprenorphine for Opioid Use Disorder treatment in the US. JAMA Network Open, 6(5), e2316089–e2316089. https://doi.org/10.1001/jamanetworkopen.2023.16089

This section provides information on your rights as a pregnant person accessing treatment, including medication for opioid use disorder (MOUD) and your rights if the Massachusetts Department of Children and Families is involved with your family.

Seeking treatment while balancing family, especially a new or growing family, can be hard, but there are resources available to help you. If you are pregnant and are looking for treatment options, the MA Substance Use Helpline can point you in the right direction. MOUD is effective and safe during pregnancy. Treatment with MOUD during pregnancy improves both the health and safety of the birthing person and of the fetus.

Treatment Options for Pregnant People

• People who are pregnant can access the same services as the general population. This includes clinical and non-clinical treatment options, including MOUD.²
• Pregnant and postpartum people (people who have recently given birth) are federally identified priority populations. If you need residential treatment and can’t receive it right away because a bed is not available, you have the right to interim supportive services until a bed becomes available.
• You have options and people to turn to as you seek treatment and stay connected with your family. The Institute of Health and Recovery offers family residential treatment services to help support your recovery and your family. Refer to the Non-Clinical Pathways section of this toolkit for resources for family members.

Rights, Protections, and Advocacy Suggestions

• Social services agencies, child welfare agencies, and health care providers cannot discriminate against you because you are in treatment for or recovery from opioid use disorder under the Americans with Disabilities Act (ADA).
• You have a right to access your recovery plan, often called a Plan of Safe Care (POSC). The document is made between a pregnant or parenting person and their provider. This document helps people to think about what services or supports they might find useful, to record their plans for being a parent, and to organize the care and services they are receiving.
• Currently, many providers are mandatory reporters to the Massachusetts Department of Children and Families (DCF) for potential physical dependence on an addictive drug at birth, although there is a bill that is being considered that would change this.
• MOUD is part of your treatment plan, and you are not engaged in the illegal use of drugs; you are protected by the ADA as a person with a disability.
  • Document the incident (e.g., write down what happened, ask the worker to send their decisions in writing, and keep your treatment plan, paperwork, and any emails/letters)
  • It may help to give DCF access to your treatment plan and POSC before giving birth.

Identifying Discrimination in Child Protection 

It can be subtle and difficult to name. A few examples are:

Supporting Recovery While Working with the Department of Children and Families (DCF)

• The reunification process can be difficult and you have a right to access mental health and social support services throughout every step of the process.
• You have a right to see your child. You may ask DCF to see your child as soon as possible after your 72-hour hearing, and DCF must set up a visit within five business days, so long as the visits will not be harmful to the child.
• You have a right to an interpreter during your court hearing. Your lawyer will ask the judge for this if needed.
• Document your case at every step of the process. Keep a notebook with you at all times and record communications with DCF, questions, and notes from child visits.
• If you feel your lawyer doesn’t listen to you, you can ask the judge for a different lawyer. You can also file a complaint with the Committee for Public Counsel Services at 617-482-6212.
• You have a right to see your Service Plan, which is the list of services and action items written by DCF that you must complete to be reunified with your child. This could include counseling, substance use treatment, or parent education classes. The Service Plan needs to explain what the services are, and why you are asked to comply with them.

• You can ask a judge for a Court Appointed Special Advocate or a Guardian ad Litem (GAL).

Resources

Resources to support family, loved ones, and providers supporting people who use opioids are located in the Clinical and Treatment Pathways section of this toolkit.

Pregnancy and postpartum resources

• Pregnancy and substance use: A harm reduction toolkit
• Project Respect provides prenatal care, addiction treatment, peer support, and more for pregnant people with substance use disorders.
• Pregnancy Justice is a national legal and advocacy organization that works to advance the equal rights of all pregnant people.
• Moms Do Care is a peer-based recovery support program in ten communities across Massachusetts for people who are pregnant or parenting a child thirty-six months or younger and are concerned about their past or current experiences with substance use.
• Institute for Health & Recovery has a mix of projects that span housing, employment, and treatment services for pregnant people and parents.
• The Women and Family Referral Center provides referral support and information to anyone in Massachusetts with questions about substance use disorder treatment and recovery supports for pregnant and parenting people, including resources on developing a Plan of Safe Care and Birth Planning.

Parenting and family resources

• Parents Helping Parents is a resource made by parents working with DCF for other parents working with DCF
• The Parental Stress Line (1-800-632-8188) is a twenty-four-hour helpline staffed by trained volunteer counselors who are available to help you
• The Journey Recovery Project provides advice, information, and resources for parents at all stages of their recovery and family journey
• Supporting Our Families through Addiction and Recovery (SOFAR) provides support and medical care for both parents in recovery and their children
• The Children and Family Law Division provides attorneys to work with parents navigating family court
• The Family Engagement Project is an in-home treatment and case management program for mothers with SUD who also have an open case with DCF
• If you are a grandparent caring for a child involved with DCF, you can connect with Grandparents Raising Grandchildren, a support group for grandparents in Massachusetts

²American College of Obstetricians and Gynecologists. (2017). Opioid Use and Opioid Use Disorder in Pregnancy; Committee opinion 711 – reaffirmed 2021. https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2017/08/opioid-use-and-opioid-use-disorder-in-pregnancy

This section provides basic information on various types of housing, including sober homes, renting, owning, public housing, and shelters. It also provides information on your rights in these settings, advocacy tips, and other resources related to safe housing. For more information on residential treatment options, see the Clinical and Treatment Pathways section of this toolkit.

Everyone in recovery has the right to safe and livable housing in Massachusetts, whether you are looking to rent, own, or live in certified sober housing. In any phase of recovery, housing is important in making a person feel safe, supported, and connected to their community. Families with children and pregnant people in Massachusetts may be guaranteed shelter under the “Right to Shelter” law. You have rights and protections through all stages of getting and keeping your housing.

Housing Options

Your Rights in Housing

• Whether you are looking for a sober home, public housing, private rental, or to buy, the Massachusetts Fair Housing law prohibits discrimination in housing because of race, religion, nationality, age, ancestry, military background or service, gender, gender identity, sexuality, marital status, familial status (for example, if you have children), source of income (for example, a Section 8 voucher or RAFT), or disability.
  • Under this law, a person in treatment and on medication for opioid use disorder (MOUD), for example, cannot be denied housing.
• At sober homes, there can be barriers that make it difficult to follow a treatment plan that includes MOUD. However, under the Americans with Disabilities Act (ADA) they are required to make “reasonable accommodation” in some cases. Examples include arranging to take the MOUD offsite if that works in the treatment plan or keeping the MOUD in a lock box or cabinet.
• If you are staying in a homeless or domestic violence shelter, the ADA’s anti-discrimination requirements protect people who use MOUD as part of their treatment plan as long as they are not engaged in the illegal use of drugs. In reality, many shelters require sobriety or mistake MOUD as illegal substances, making it difficult for some people to follow their treatment plans. If this happens to you, you have the right to file a claim with the Massachusetts Commission Against Discrimination (MCAD) or the U.S. Department of Housing and Urban Development (HUD).
• The Department of Health and Human Services published a Know Your Rights document for people on Medication-Assisted Treatment.

Identifying Housing Discrimination

• A landlord cannot evict you; only a judge can. You may receive a “Notice to Quit,” but that does not mean you need to leave your housing. This also applies to certified sober housing units.
• Know what to look for when it comes to housing discrimination. It can be subtle and difficult to name. Some examples can include:
  • You call and get an appointment to look at a house, but when you get there, you are told that the house was just sold or rented.
  • You are told that the apartment you are looking at has been rented, but you see the posting still active on housing sites.
  • You are told a higher selling price than what was advertised or what you hear others being told.
  • You are given different terms or conditions for signing a lease than other applicants.
  • You are only shown homes in certain parts of town.
  • You are not given the opportunity to negotiate.
  • You are told that housing vouchers are not accepted by the landlord, or you see an advertisement that says, “People with vouchers cannot apply.”
  • You face harassment, intimidation, or questions about your ability to pay rent on time.

Advocacy Suggestions for Renting (Public Housing or Private) and Purchasing a Home

• If you believe you are being discriminated against, you have the right to file a claim with the Massachusetts Commission Against Discrimination (MCAD), the U.S. Department of Housing and Urban Development (HUD), the Massachusetts Attorney General’s Office Civil Rights Division, or your local Fair Housing Task Force. For more information on your rights in filing complaints, see Your Rights in Filing Complaints in the Clinical and Treatment Pathways section of this toolkit.
• If you were convicted before on drug-related charges, you may be told you are not eligible for public or federally assisted housing. This ineligibility usually lasts for three years after you leave incarceration. A public housing agency can lift or shorten that time period if you successfully complete a rehabilitation program. However, depending on the charge, some individuals may still not qualify for federally assisted housing unless they can present an argument for changed behavior. This includes:
  • Individuals who have been convicted of drug-related criminal activity involving the manufacture or production of methamphetamine on the premises of federally assisted housing.
  • Individuals charged with a violence-related activity that may pose a risk to the safety or well-being of other tenants.

Resources

• City Life/Vida Urbana has a hotline for people who are facing evictions and a list of resources for those looking for housing support.
• Find certified sober homes in Massachusetts. If you are in sober housing already and need to file a grievance (complaint), you can do so here. Massachusetts Alliance for Sober Housing can help you file a claim, investigate the realtor, and link you to further resources.
• The Massachusetts Commission Against Discrimination also has resources for people who experience discrimination.
• The Attorney General’s Civil Rights Division has a Know Your Rights resource for income-based housing.
• The Massachusetts Attorney General’s Office also has resources about fair housing laws and tenants’ rights, including specific information about eviction-related rights.
• If you are experiencing homelessness, you can find shelters in Massachusetts through the Massachusetts Coalition for the Homelessness database.
• The Office of Housing and Livable Communities has resources on a range of emergency housing assistance and longer-term support with housing for those facing homelessness to those seeking affordable rental housing.
• The Massachusetts Housing Partnership is providing resources and training to make affordable housing more accessible to potential Massachusetts homebuyers across identities and experiences.

This section provides basic information on education, including financial aid, overdose events on campus, and college health plans. It also includes information on your rights in these settings, advocacy tips, and other resources related to education.

Navigating college and higher education can be hard for anyone, but navigating while in recovery can bring new challenges. Many colleges now offer student support groups and resources to help people pursuing degrees while in recovery. Wherever you are in your recovery process, you should have the support and tools you need to be successful in your education.

Rights, Protections, and Advocacy Suggestions

• You are still eligible for federal financial aid. Your financial aid cannot be taken away if you are prescribed medication for opioid use disorder (MOUD).
• Every college campus has its own policy regarding The Good Samaritan law, even if it’s different than the state Good Samaritan law. See the Harm Reduction section for more on Good Samaritan laws.
• Many colleges provide peer-based recovery groups but do not prescribe MOUD. If you are interested in exploring MOUD services, you have a right to ask your campus provider for a referral to a community-based prescriber.

Resources

• The Association of Recovery in Higher Education (ARHE) is the only association that represents collegiate recovery programs (CRPs) and collegiate recovery communities (CRCs). The website provides a list of universities with active recovery programs, education, resources, and community connections for students in recovery and the faculty, staff, and peers who support them.
• Sober Living has compiled a list of undergraduate universities that offer sober, substance-free housing options on campus.
• The Massachusetts Organization for Addiction Recovery (MOAR) provides information on additional ways to fund your education or vocational training in their Mini Guide.
• Students for Sensible Drug Policies has regional chapters and resources for Good Samaritan Policies.
• For information about eligibility for financial aid, the U.S. Department of Education has created a financial aid FAQ.

This section provides basic information on employment, including discrimination, workplace accommodations, information privacy, treatment while employed, and workplace rights. There is also information on your rights in these settings, advocacy tips, and other resources related to employment.

All workers have rights to fair wages, safe workplaces, respect, and dignity. For people in recovery, it’s especially important to feel supported and empowered at their place of work. All workers have a right to advocate for themselves for the treatment supports they need and any accommodations that can help them return to work safely.

Rights, Protections, and Advocacy Suggestions

• You cannot be discriminated against in the hiring process or on the job for having a history of opioid use disorder (OUD) or for receiving medication for OUD (MOUD).
• Advocate for workplace accomodations.
• Know your privacy information.
• Keep your employment while getting treatment.
• Know your workplace rights about drug testing.
• Know what to look for when it comes to discrimination in the workplace.

Resources

• The Grayken Center has an Employer Resource Library for employers to help understand and support people in recovery from SUD.
• The U.S. Department of Health and Human Services offers the Know Your Rights toolkit for people on medication for opioid use disorder.
• The Bureau of Substance Addiction Services has a host of resources and job/internship postings through Careers of Substance.

This section provides resources available to you at various points in the legal system. While we have tried to outline your rights, laws do not always get applied fairly or accurately, and you may be denied rights in various parts of your legal process.

The legal system can be difficult to navigate, whether you are waiting for a trial, held in corrections, on probation, or in the process of re-entering the community. You have rights at every entry or exit point in the system and people to help you navigate. Maintaining your recovery after being justice-involved is key, and there are resources to help.

Navigating the Legal and Court System

What to Know If You:

• Have a case in a civil court: If you have a case in a civil court, you can’t be detained (held). Civil court includes Housing Court, Juvenile Court (child welfare cases), Probate and Family Court, and Appeals Court. To see if free legal representation for your civil legal problem is available, visit Mass Legal Services.
• Receive a criminal citation (either in the mail or from a police officer): If you receive a criminal citation, you will be assigned a court date for a Clerk Magistrate Hearing, also referred to as a “show cause” hearing. This is a preliminary (early) hearing where a clerk decides if a criminal charge should be issued and if you will be formally charged with a crime. You are not entitled to have representation from a defense attorney at this point, but you may bring your own lawyer.
• Are arrested or have a criminal complaint issued after a Clerk Magistrate Hearing: If you are arrested, you will be brought to the police station or a regional lock-up facility to be “booked.” You may be released by the bail clerk, or you may be held until the court is open and you are brought to court. If you are released by the bail clerk, they will tell you when you need to be in court.
• Your case will be heard in a District Court: The first court process is called “arraignment,” and at this point, you have the right to representation by a defense attorney. An attorney will be appointed to you if you meet the eligibility requirements (called “indigency criteria” by the court) and will work closely with you. For more information about public defenders in Massachusetts, go to the Committee for Public Counsel Services.

Rights, Protections, and Advocacy Suggestions for Appearing in Court

• When someone charged with a drug offense comes to court, the judge must tell the person that they are allowed to request an evaluation of whether they have a substance use disorder (SUD) and would benefit from treatment instead of incarceration. If you wish to exercise this right, you must make a request in writing within five days of your hearing.
• A judge can divert (direct) eligible people into treatment instead of incarceration. If you successfully complete a treatment program, the charges can be dismissed. Probation officers are required to screen each person charged with a drug offense for eligibility for a diversion program and to tell the judge. Some charges may make a person ineligible for this, such as a previous sex offense or arson charge. The District Attorney in your county may have a diversion-to-treatment program you may be eligible for.
• At arraignment, you have the right to ask to be placed in a treatment program while on probation. You can also request to be diverted through a drug court, which would require you to complete a treatment program instead of a two-year sentence. There are certain eligibility requirements for participating in a drug court session. You will want to work closely with your attorney to determine the best path for you.
• If you are released after your hearing, there may be conditions from the court you need to meet when you’re released. If you do have conditions, you will be assigned a probation officer who will communicate with you about what you need to do during the period of time before the next stage of your case.

Navigating the Correctional and Justice System

If you are pre-trial for a criminal case, you will most likely be held in a House of Correction. However, you may be held in a Department of Correction facility.

• Houses of Correction (HOC) facilities are under the jurisdiction (rule) of the county Sheriff. These HOCs provide treatment options for people with opioid use disorder (OUD): Essex, Franklin, Hampden, Hampshire, Middlesex, Norfolk, and Suffolk.
• Department of Correction (DOC) facilities are under the jurisdiction (rule) of the state. These DOCs provide treatment for people with OUD: MCI Cedar Junction, MCI Framingham, South Middlesex Correctional Center, and Massachusetts Alcohol and Substance Abuse Center (MASAC).

Treatment programs “behind the wall” (in corrections facilities) can be continued into re-entry services.

What to know if you are sentenced:

When your case is closed, you may be released with (1) no conditions, (2) sentenced to probation supervision, 3) sentenced to a correctional facility, or 4) you may have what is called a “split sentence.” A split sentence is when you serve a period of time in corrections and have a term of probation when you are released. If your sentence includes probation supervision, you will work closely with your probation officer to meet the conditions of your sentence.

• You have a right to receive MOUD treatment if you are imprisoned in state, county, and federal correctional facilities in Massachusetts.
• You have the right to talk with your probation/parole officer or court-appointed advocate and appointed judge about what kind of treatment you want to get, whether it’s clinical or non-clinical. Your probation/parole officer must communicate this to the judge.
• There are multiple treatment options available in all correctional facilities.

Reentering the Community After Incarceration

• You will want to work closely with the healthcare and treatment team, as well as your correctional and reentry caseworkers, to develop a reentry plan that will help you transition back to the community. Your plan may include help with:
  • Relapse and overdose prevention planning: the most common cause of death following release from prison is overdose. It is important to take any precautions you can to prevent overdose if you use opiates following a correctional stay (see the Harm Reduction section of this toolkit for more information).³
  • Health insurance enrollment
  • Refills for prescription medications
  • Appointments with health care, substance use disorder, and/or mental health treatment services
  • Connections to housing
  • Military and/or social security benefits
  • Support for reconnecting with children and family
  • Workforce opportunities
  • Recovery support`
  • Referrals to get Narcan (naloxone)
  • Anything else you may need to help you succeed after your release
• You may be released on parole and/or probation supervision: Probation and parole are two different programs that both provide supervision in the community. You will work closely with your probation and/or parole officer to understand and meet the conditions of your supervision. They are trained to help connect you to resources that include treatment, housing, employment supports, and other reentry programs. Maintaining abstinence is a common condition of parole and probation supervision, and you will likely be subjected to testing to confirm abstinence.
• You may be released from incarceration without probation and/or parole supervision. Not all individuals re-entering the community are assigned a parole officer, so there are programs people can use. Ask the re-entry team at the correctional facility if there are any post-release re-entry services that you can use after you leave the facility.
• Know your rights around privacy and disclosure. You can request a copy of your Criminal Offender Record Information (CORI), and you have the right to “seal” your CORI if you meet the eligibility criteria so that no one else can look at it.
  • How to seal your records: A judge in the court that handled your case has the power to seal a first-time drug possession conviction where you did not violate (break) any court orders connected to being on probation or a “CWOF” (continuance without a finding). The court orders might include going to drug treatment or doing community service.
    • Under state law, you have to show “good cause” to seal a record. To show there is “good cause” to seal records, you need only show there is a present or possible future disadvantage that stems from your criminal record. Things a judge can consider are:
      • A lot of time has passed since the case was filed against you
      • You are sober and have made efforts to rehabilitate yourself
      • You successfully completed probation in your case(s)
      • You have other evidence of rehabilitation from the date of the offense or dismissal
    • Your privacy is protected by state and federal laws in areas like housing and employment to protect you from discrimination.
      • Under the “Ban the Box” law, employers cannot ask about a criminal record at any point in the application process. Employers are generally permitted to ask about felony convictions and some misdemeanor convictions during the hiring stage (after the initial job application), but most employers are not permitted to ask about any of the following during any point in the hiring process:
        • criminal cases that did not end in conviction
        • an arrest or detention
        • first convictions for drunkenness
        • simple assault
        • speeding
        • minor traffic violations
        • affray, or disturbance of the peace
        • misdemeanor convictions where the date of conviction or release from incarceration was three or more years ago (unless there were subsequent convictions)
        • juvenile court records
        • sealed or expunged records
      • Know what to look for when it comes to discrimination for being justice-involved. It can be subtle and hard to name. Here are some examples:
        • Being denied housing because of your CORI or recovery status. Landlords have limited access to your CORI and may deny you housing because you have a criminal record, but housing providers that automatically reject all applicants with criminal records might be violating state and federal civil rights laws because using criminal records in this way can have a disproportionate effect on protected groups, including racial minority groups and people with disabilities. For more information about CORI protections in the housing process, please see the Attorney General’s Guide to Criminal Records in Employment and Housing.
        • Not being referred by your attorney or judge to drug courts if you are being tried for drug-related charges or have a substance use disorder. Drug courts that divert people from criminal courts still serve many more white people than Black, Indigenous, or other people of color. Be sure to ask about “diversion options” for court, including drug courts.

Resources for Justice-Involved Individuals

• The Sequential Intercept Model created by Policy Research Associates identifies resources and gaps for justice-involved people.
• The Massachusetts Department of Public Health created a summary of protections for people with substance use disorder through the criminal legal process, housing, and healthcare.
• Request your CORI online at the Massachusetts Department of Criminal Justice Information Services.
• Each facility uses a certified Housing Search Specialist to access residential programs, shelters, and sober houses as options to consider while working on reentry. They can use a database of housing options for releasing inmates at risk for homelessness in MA.
• Department of Corrections also partners with MassHealth to provide health care to people who are previously incarcerated.
• There are options available for people living in incarceration who are looking for tailored recovery programs. See the list of recovery programs.
• Coming Home has a list of re-entry programs for people in Greater Boston.
• Mass Legal Help has a “Know Your CORI Rights” toolkit that offers guidance on sealing a CORI.
• Massachusetts Commission Against Discrimination has a fact sheet on CORI issues and employment.
• Greater Boston Legal Services has several resources for reentry and CORI sealing; you can also request to seal your record through the Massachusetts Court System.

Resources for Justice-Involved Individuals who are Immigrants of Varying Status

• The MIRA Coalition has several resources for Massachusetts-based immigrants.
• The Immigration Advocates Network has a CORI Sealing Re-entry resource of Massachusetts-based immigration legal services providers.
• The ACLU provides Know Your Rights guidance about your rights if questioned about your immigration status.

Navigating Section 35 and Involuntary Commitment

If all other treatment and recovery options have been tried, Section 35 is a Massachusetts law that allows a qualified person to request a court order for someone to be civilly committed and treated involuntarily (against their will) for an alcohol or substance use disorder. Under Section 35, a person can be held for up to ninety days. This should only be used as a last resort if used at all.

Who can “section” someone (use Section 35 to have a person committed to treatment)?

• Only a “qualified petitioner” can ask the court to commit someone to treatment under Section 35. This includes a police officer, physician, spouse, blood relative, guardian, or court official.

What happens when a person is sectioned?

1. Summonsing: The court will review the petition and decide whether to issue a summons or a “warrant of apprehension.” If summonsed, a person will receive an order to appear in court. If the court believes the person is an immediate physical danger or will not voluntarily come to the court, a police officer will be sent to find the person, take them into custody, and deliver the person to court. Law enforcement often uses handcuffs and shackles when transporting the person to court and when they are in court.
2. Representation and Evaluation: Once the person is brought to court, they will be appointed an attorney who will represent them in court. Then the court clinician will evaluate them. The clinician will also interview the petitioner.
3. Hearing and Decision: After hearing testimony and argument, the judge will decide if there is “clear and convincing evidence” that the person has a substance use disorder (SUD) and is at risk of harming themselves or others as a result of their SUD. If the judge decides the person will be committed, they will be taken directly to treatment from the courthouse. If the judge decides the person does not meet the standard for commitment, they will be released.
4. Detaining: Once committed, an individual will be sent to wherever there are beds available. The person submitting the petition cannot choose and has no control over which facility the person will go to, which may include a house of correction. Refer to this list of treatment locations.

If you are being sectioned (committed under Section 35), you still hold these rights:

• The right to be represented by an attorney
• The right to refuse the medical examination the judge requests
• The right to choose your own witnesses for testimony on your behalf

Resources for Section 35

• Committee for Public Counsel Services provides legal representation to people who can’t afford an attorney.

³Vera Institute. Overdose deaths and jail incarceration: National trends on racial and ethnic disparities. https://www.vera.org/publications/overdose-deaths-and-jail-incarceration/national-trends-and-racial-disparities