In a novel case that could have national implications, the Washington state chapter of the American Civil Liberties Union sued a county sheriff's office to force it to provide opiate-withdrawal medication to prisoners, rather than requiring them to go cold turkey.
The lawsuit, filed Thursday in U.S. District Court in Seattle, says the Whatcom County Jail's refusal to provide the medicine violates the Americans with Disability Act, because opioid addiction qualifies as a disability under the law. Prisoners suffering from opioid addiction are as entitled to medication as those with any other condition requiring medical treatment, the lawsuit says.
The lawsuit also says the jail's policy is counterproductive because inmates who go cold turkey risk severe relapse upon release — increasing the likelihood they'll commit new crimes to satisfy their cravings and that they'll overdose.
The Whatcom County Sheriff's Office, which runs the jail and was named in the lawsuit, said it did not have any immediate response.
"If a person in the Jail suffered from a heart condition and needed medication the Jail would provide it, but it denies access to Medication-Assisted Treatment, which reduces the risk of overdose and death," ACLU attorney Jessica Wolfe said in a written statement. "This is unsafe and discriminatory."
The medicines at issue include methadone and buprenorphine, which is also sold under the brand names Suboxone and Subutex. They work by inhibiting opioid receptors in the brain, counteracting the euphoric effects and physiological cravings.
While the Whatcom County Jail does provide the medicine to pregnant women suffering from opioid withdrawal, it does not provide them otherwise, the lawsuit says. Meanwhile, the county — like places across the country — has seen more and more opioid overdoses over the past 15 years. According to the lawsuit, at least 18 people died of overdoses in Whatcom County in 2016, a year the jail saw at least 253 prisoners self-report as abusers of heroin and other opiates.
Despite the effectiveness of the medicines, jails that provide them remain the exception nationwide, said Sally Friedman, legal director of the New York-based Legal Action Center, a nonprofit which has advocated for correctional systems to offer such treatments. Friedman said the lawsuit appears to be the first of its kind and could help alert officials that the ADA requires them to provide the drugs.
"The word is getting out that people — the judges, the police, the prosecutors, all the players in the criminal justice system who have prevented people from accessing these lifesaving medications — aren't going to be able to get away with that anymore," she said.
The Justice Department last month entered a settlement with a skilled nursing facility in Norwood, Massachusetts, that requires it to begin providing the medications to those suffering from opioid use disorder under the ADA. The Boston Globe has also reported that the DOJ is investigating whether Massachusetts prison officials are violating the ADA by forcing incoming inmates who had been taking the addiction medications to stop while they're behind bars.
Some in law enforcement have argued that allowing such medications, which are opiates themselves, enable users to replace one addition with another, or that the medications themselves can be abused in high doses.
But Leo Beletsky, a professor of law and health sciences at Northeastern University in Boston, said "maintenance treatment" with the drugs cuts the risk of overdose by up to 80 percent while allowing people to get their lives back on track. He noted that after Rhode Island began offering the drugs in its prison system, the state's total number of fatal overdoses fell 12 percent.
"This effort is not only timely, but is long overdue," he said. "There is no empirical or public safety rationale for the existing barbaric standard of care."
The ACLU filed the lawsuit on behalf of two prisoners: Sy Eubanks, 46, and Gabriel Kortlever, 24, both of whom have been addicted to opioids since their teens. The lawsuit seeks class-action status.
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