Boston – A federal appeals court in Boston has upheld a lower court ruling that the Aroostook County Jail must provide a Madawaska woman with medication assisted treatment for her substance use disorder while she serves a 40-day sentence.

“This ruling sends the strongest message yet that jails and prisons need to provide incarcerated people with their doctor-prescribed medicine for opioid use disorder, just like any other medical condition,” said Emma Bond, staff attorney with the ACLU of Maine. “Other facilities should take note and do the right thing, and not wait for further legal action.”

The ruling from the U.S. Court of Appeals for the First Circuit comes in the case of Brenda Smith, who uses physician-prescribed buprenorphine to keep her opioid use disorder in remission. Lawyers for Smith brought the case against the Aroostook County Jail, arguing 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.

On March 28, the U.S. District Court for the District of Maine ordered the jail to continue Ms. Smith’s treatment, finding 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. The jail appealed that ruling to the U.S. Court of Appeals, which late Tuesday upheld the order.

Before the appeals court issued its ruling, several medication associations from around New England and nationwide, including the American Medical Association, American Society for Addiction Medicine, Maine Medical Association and Maine Association of Psychiatric Physicians, filed a motion to join the case as amici in support of Ms. Smith’s case.

More information about the case, including the order, can be found here: