September 28, 2018

As Part of Settlement, Court Will Enforce Treatment Plan

Bangor – The Maine Department of Corrections has agreed to continue providing necessary medication to Zachary Smith when he is in state custody, as part of a settlement in a lawsuit filed in July by the ACLU.

The lawsuit argued that the DOC was violating the Constitution and the Americans with Disabilities Act (ADA) by denying treatment to prisoners with opioid use disorder (OUD). The ACLU filed the lawsuit on behalf of Smith, of Caribou, who suffers from OUD but has been in recovery for over five years with the help of doctor-prescribed medication.

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 generally prohibiting MAT. Under this policy, Smith would have been blocked from taking his medication and forced into acute withdrawal.

“This outcome will spare Zachary Smith from incredibly painful, and potentially deadly, forced withdrawal,” said Zachary Heiden, legal director with the ACLU of Maine. “There is no justification for denying doctor-prescribed medication to prisoners with opioid use disorder. Withholding needed treatment actually undermines our chances of keeping people off of opiates.”

Several medical experts filed declarations in the case, attesting to the importance of continuing MAT during incarceration. According to Dr. Jonathan Fellers, director of Integrated Medication-Assisted Treatment at Maine Medical Center, “[f]orced 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.”

Dr. Ross MacDonald, the Chief Medical Officer in the New York City jails, and Edmond Hayes, the Assistant Superintendent of the Franklin County Jails in Massachusetts, also offered declarations on the feasibility and effectiveness of providing MAT in jails and prisons. As Dr. MacDonald explained, “many jurisdictions are now successfully implementing MAT programs in correctional settings.”

The ACLU and other advocates argue that providing supervised treatment actually makes jails and prisons safer, by decreasing overdoses as well as the demand for contraband. A study in Rhode Island found a dramatic reduction in overdose deaths among inmates who were offered medication to treat their OUD.

“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," said Heiden.

While the case did not reach a decision on the constitutional and ADA charges, the ACLU says the settlement will make it harder for other corrections facilities to argue that providing MAT to prisoners isn’t possible.

Smith 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 in October for a term of nine months and one day. Smith has not been told where he will serve his time.

More information about the case can be found here: