Withholding Medication from Prisoners with Opioid Use Disorder Violates the Constitution and the Americans With Disabilities Act

Bangor – The Maine Department of Corrections is violating the Constitution and the Americans with Disabilities Act by denying treatment to prisoners with opioid use disorder, according to a lawsuit filed today by the ACLU of Maine. The ACLU filed the lawsuit on behalf of Zachary Smith of Caribou, who suffers from OUD but has been in recovery for over five years with the help of doctor-prescribed medication. When Smith reports to prison in September, he will be blocked from taking his medication and forced into acute withdrawal.

Despite the medical consensus that medication-assisted treatment (MAT) is the standard of care for opioid use disorder, the Aroostook County Sheriff’s Office and Maine Department of Corrections (DOC) both have policies prohibiting MAT.

“Denying needed medication to people with opioid use disorders serves absolutely no good purpose, and actually undermines the important goal of keeping people off of opiates,” said Zachary Heiden, legal director with the ACLU of Maine. “Going to prison shouldn’t be an automatic death sentence, but that is the chance we take when we cut prisoners off from adequate medical care.”

Dr. David Conner, Smith’s primary care physician, and Dr. Jonathan Fellers, director of Integrated Medication-Assisted Treatment at Maine Medical Center, filed declarations in the case attesting to the importance and effectiveness of MAT.

According to Dr. Fellers, “Forced withdrawal is not medically appropriate for patients being treated with MAT. It disrupts their treatment plan, leading to a seven-fold decrease in continuing MAT after release. Discontinuation of MAT increases the risk of relapse into active addiction.”

“It is easier for people to get illegal drugs in prison than it is to get their doctor-prescribed medication, and that doesn’t make any sense,” said Heiden."We know that that the criminal justice system can't solve the opioid crisis, but the least it can do is not make matters worse."

The ACLU lawsuit argues that by denying adequate medical care to prisoners, these policies violate the Eighth Amendment to the U.S. Constitution, which prohibits cruel and unusual punishment. It further argues that the policies violate the Americans with Disabilities Act. Under the ADA, people with substance use disorders who are in treatment are classified as having a disability, and denying necessary medicine to a person with a disability constitutes illegal discrimination.

Smith recently pled guilty to criminal charges following a physical altercation with his father. As part of the agreed-upon sentence, he expects to report to prison for a term of nine months and one day, after a sentencing hearing on September 6. Smith has not learned whether he will serve his time at the Aroostook County Jail or at a Maine State facility.

The lawsuit names Dr. Joseph Fitzpatrick, DOC commissioner, and Shawn D. Gillen, chief deputy and acting Aroostook County sheriff, both in their official capacities, as defendants. It was filed in U.S. District Court for the District of Maine.

More information about the case can be found here: https://www.aclumaine.org/en/cases/smith-v-fitzpatrick-et-al