Treatment, housing and employment opportunities – not incarceration – are what helps people overcome substance use disorder (SUD), says Muriel Castiel, M.D., the health and human services commissioner for Worcester, Mass.

“For ages, what we have been doing is incarcerating people for their addiction,” says Castiel, who previously served as a clinical associate professor of medicine at the city’s UMass Medical School and a physician at UMass Memorial Medical Center. “It’s a vicious cycle that needs to end.”

While a physician at UMass Memorial, Castiel founded the nonprofit Latin American Health Alliance in 2004 to help the poor and disadvantaged in Worcester’s Latino neighborhoods. About a fifth of the city’s 185,000 residents are Hispanic, according to the most recent data from the U.S. Census Bureau. 

In 2009, the Latin American Health Alliance partnered with UMass Memorial to open the Hector Reyes House, a 25-bed inpatient addiction treatment center for Latino men. It is a state-funded treatment center and an innovative transitional assistance program that provides those in recovery with training and jobs. The hospital provides medical and cognitive behavioral treatment. 

“The importance of UMass Memorial’s support – bringing primary care, psychiatry and infectious disease control – to this group of men can’t be overestimated,” Castiel says. “Our affiliation with the hospital is key to our success in working to keep the men physically and mentally well, sober and confident, so they can move successfully toward independence.”

Hector Reyes House is the only substance abuse treatment facility for Latino men in Central Massachusetts. Run by the Latin American Health Alliance, it allows for culturally competent care in substance abuse recovery. 

Hector Reyes was a Latino community activist who worked with Castiel to set up the recovery program before he died in 2009.

Casa Reyes, a transitional home next door, provides less expensive sober housing for graduates of the program. Residents pay $425 per month for all-inclusive rent. They get a $100 refund if they pay the rent by the fifth of the month. “The idea is to start working and start saving,” Castiel says. 

In 2015, the Latin American Health Alliance partnered with a community college to open Café Reyes, a Cuban eatery and catering business. It provides job training and employment for Hector Reyes House residents, and help them move on to careers at other restaurants. 

“Those who struggle with substance abuse and potentially get incarcerated aren’t able to sustain jobs,” Castiel says, “They don’t have the skills to find or keep jobs. We teach them those skills – from the importance of arriving on time to writing resumes. We want them to get to a point where they can find jobs on their own and maintain those jobs.”

“Being in a supportive and comfortable environment at Café Reyes gives the men the confidence that they can do it,” she adds. “It keeps them occupied, motivated and integrated in the community.”

With Café Reyes, the building blocks were in place for resident’s recovery from their disease, says Castiel, who handed over the reins of the rehab center, the transitional home and café when she became the city’s health and human services commissioner. She stays involved as a board member. 

“Education, housing and employment,” she says. “If any of those things are not in place, they probably are going to fall back on bad habits and end up back in prison.”     

Of the roughly 600 men who have entered the doors of the Hector Reyes House, slightly more than 40% have completed the program. It’s a daunting journey, Castiel says.

“You plant the seeds of what a sober life is going to look like,” she says. “They may not do it the first time around, they may not do it the second time around. But we tell them, ‘if you relapse, we will continue to treat you so come back.’ You plant the seed, and it is going to grow.”    

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