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Judge: Jail Must Provide Medication-Assisted Treatment

Andy Mooers

A federal judge in Maine has ordered the Aroostook County Jail to provide a Madawaska woman her prescribed medication for substance use disorder while she serves a 40-day sentence.

In a lawsuit against Aroostook County and the sheriff, Brenda Smith said the jail's general policy of refusing to allow inmates to continue medication assisted treatment is a violation of the Americans with Disabilities Act, and could put her at risk of overdose and death.

Judge Nancy Torresen agreed, saying that appropriate treatment is crucial "given the well-documented risk of death associated with opioid use disorder."

Emma Bond, a staff attorney with the ACLU of Maine who worked on Smith's behalf, says the decision is a "breakthrough" for Maine.

"In a prior case against the state Department of Corrections the state voluntarily decided to provide medication assisted treatment to the plaintiff,” Torresen says. “This is the first case in which a judge has ordered a jail to provide medication assisted treatment to someone with opioid use disorder."

In her 28-page ruling, Judge Torresen noted that people who are engaged in treatment are three times less likely to die than those who remain untreated, and she pointed out that a body of evidence has emerged that permitting medication assisted treatment in correctional facilities "offers substantial, and possibly essential, benefits to incarcerated people."

For example, she cited one study of English correctional facilities that found treatment with buprenorphine or methadone was associated with an 80 to 85 percent reduction in post-release drug-related mortality."

In addition, a study in Rhode Island's correctional system found that incarcerated people who were permitted to continue taking their prescribed methadone were seven times more likely to continue treatment after release than inmates who were forced to discontinue their medications."

Jail administrators argued that medication used to treat substance use disorder poses a risk for trafficking and diversion among inmates.

Peter Marchesi, an attorney for the jail, could not immediately be reached for comment, but he told the Associated Press that he would pursue "all legal opportunities" on his client's behalf.