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March 31, 2019

Federal judge rules ADA requires Maine jail to provide woman with access to medication-assisted treatment during her 40-day term

As explained in this ACLU posting, a US District Court judge in Maine issued a notable ruling last week about prisoner rights and the ADA.  Here are the basics from the posting:

In a landmark decision, a federal judge has ordered the Aroostook County Jail to provide a Madawaska woman with access to medication-assisted treatment (MAT) for her opioid use disorder during her 40-day jail sentence, which is scheduled to begin on Monday.

The 28-page ruling comes in the case of Brenda Smith, who uses physician-prescribed buprenorphine to keep her opioid use disorder in remission. Lawyers for Smith argued that continuing this medication while in jail is essential to treating Smith’s medical condition, as well as preventing painful withdrawal symptoms and an increased chance of relapse, overdose and death upon release....

U.S. District Court Judge Nancy Torresen of the U.S. District Court for the District of Maine heard testimony from Smith as well as medical and corrections experts over the course of a week-long trial in February. In her ruling, Judge Torresen found that denial of MAT would cause serious and irreparable harm to Smith, and would violate the Americans With Disabilities Act (ADA). The ADA prohibits discrimination on the basis of disability, including against people in recovery for opioid use disorder....

Despite the medical consensus that MAT is safe and effective in combating substance use disorder, most Maine jails have policies explicitly prohibiting this treatment for incarcerated people. The Maine Department of Corrections had a similar ban until it was lifted by an Executive Order from Gov. Mills on February 6, 2019.

Noting the high risk of overdose and death for people who suffer from opioid use disorder, Judge Torresen wrote that, "[g]iven the well-documented risk of death associated with opioid use disorder, appropriate treatment is crucial. People who are engaged in treatment are three times less likely to die than those who remain untreated."

Additionally, Judge Torresen found that the Aroostook County Jail’s prior refusal to provide access to MAT was “consistent with the broader stigma against MAT observed by [plaintiff’s expert] Mr. Hayes, who noted that correctional staff often resist providing MAT because they equate MAT to giving addicts drugs rather than giving people treatment.”

The full ruling, which is available at this link, gets started this way:

Plaintiff Brenda Smith’s doctor has prescribed her a twice-daily dose of buprenorphine as part of a medication-assisted treatment (“MAT”) program for her opioid use disorder.  Ms. Smith brings this lawsuit against Defendant Aroostook County and against Defendant Shawn Gillen, in his official capacity as Sheriff of Aroostook County, alleging that the Defendants’ refusal to allow her to continue taking her medication during her impending 40-day term of incarceration at the Aroostook County Jail (the “Jail”) violates the Americans with Disabilities Act (“ADA”) and the Eighth Amendment.  Before me is the Plaintiff’s motion for a preliminary injunction requiring the Defendants to provide her with access to her prescribed medication.  Pl.’s Mot. for Prelim. Inj. (ECF No. 9).  For the reasons that follow I GRANT the Plaintiff’s motion for a preliminary injunction.

Notably, the judge's ruling was based entirely on the ADA, and the judge expressly decided not to address the Eighth Amendment claim.  But the judge did drop this footnote suggesting where she might have been headed on that front:

The evidence presented in this action suggests that a scientific consensus is growing that refusing to provide individuals with their prescribed MAT is a medically, ethically, and constitutionally unsupportable denial of care.  E.g., Pl.’s Ex. 32.  Cognizant of the principle of judicial restraint and given my ruling that the Plaintiff is likely to succeed on her ADA claim, I sidestep the constitutional issue at this time. See Ashwander v. Tenn. Valley Auth., 297 U.S. 288, 347 (1936) (Brandeis, J., concurring) (“The Court will not pass upon a constitutional question although properly presented by the record, if there is also present some other ground upon which the case may be disposed of.”).

March 31, 2019 at 12:14 PM | Permalink


"the medical consensus that MAT is safe and effective in combating substance use disorder"

That's hilarious. We've been fighting opioid addiction in the Appalachians for about two decades now. You know what is by far is the most abused opioid we now face? You guessed it: buprenorphine. And every time we turn around some idiot is trying to pressure us to give it to people in our drug treatment programs who are there because of their abuse of . . . wait for it . . . buprenorphine.

Posted by: Ken | Mar 31, 2019 10:27:01 PM

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