The Maine Department of Corrections will allow a Caribou man to receive medication in prison to treat his opioid use disorder.

Zachary Smith, 30, sued the department in July. The American Civil Liberties Union of Maine filed the complaint on his behalf in U.S. District Court in Portland, claiming Smith was being denied his rights to medication in prison under the Americans with Disabilities Act. His Eighth Amendment rights, which prohibit cruel and unusual punishment, were also being violated, the lawsuit said.

The parties filed a settlement agreement in federal court Friday that will give Smith access to his regular treatment while he is in custody.

“This outcome will spare Zachary Smith from incredibly painful, and potentially deadly, forced withdrawal,” Zachary Heiden, legal director for the ACLU of Maine, said in a statement. “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.”

The agreement means a judge will not rule on the broader legal arguments in the lawsuit. But the ACLU of Maine said the settlement will make it harder for other corrections facilities to argue that providing this treatment to prisoners isn’t feasible.

“This settlement is an important first step to making sure that people with opioid addiction can get the treatment and care they need while they are incarcerated,” staff attorney Emma Bond said. “The solution to the opioid crisis has to be a multipronged approach, and one important part of that is making sure that jails and prisons are not making the problem worse.”


Joseph Fitzpatrick, commissioner of the Department of Corrections, did not immediately respond to a message left at his office and an email request for comment.

Smith is scheduled to report in October for a nine-month sentence for a domestic assault against his father. It is not yet clear where he will serve his time.

Maine is in the midst of an opioid crisis, with 418 Mainers dying of drug overdoses in 2017, and the state on track to experience a similar number of overdose deaths this year.

The ACLU of Maine said Smith has been in recovery for more than five years with the help of medication-assisted treatment, which is considered the “gold standard” for opioid treatment by addiction experts. Smith takes buprenorphine, or Suboxone, which is used as a long-term drug to help people recover from opioid use disorder. Some patients are on a maintenance dose of Suboxone for years.

Some states, including Rhode Island, New York and Florida, allow medication-assisted treatment in jails and prisons. But the Maine Department of Corrections generally prohibits it for inmates other than pregnant women.

“With certain limited exceptions, it is the policy of the Department not to provide treatment of opioid use disorder with buprenorphine or equivalent medications,” the settlement says. “In his complaint, Plaintiff claims that he will suffer irreparable harm if his treatment is not continued when he is in the custody of the Department. The Department disputes this claim. The parties nevertheless wish to end this litigation and resolve this matter.”


In court documents, the department argued that it monitors people who experience withdrawal symptoms and uses alternative medications to manage those. Programs to help people cope with addiction are available in prison. The department also said medication-assisted treatment could encourage drug trafficking, already a problem in correctional facilities.

“Introduction of Suboxone and related medications into the state’s correctional facilities will most likely increase the level of trafficking, causing a corresponding rise in the level of violence, strong-arming and threats within those facilities,” Assistant Attorney General James Fortin wrote in a response from the department.

Smith’s attorneys submitted testimony from experts including Dr. Ross MacDonald, the chief medical officer for New York City jails. They submitted information about how similar programs are managed in their own facilities, as well as evidence that people who go through forced withdrawal in custody are more likely to overdose later.

“Based upon my experience implementing medication-assisted treatment programs in a correctional setting, as well as collaboration with medical leadership of jails and prisons around the country, the defendants’ security concerns, including drug trafficking and diversion, are not sufficient barriers to treatment,” MacDonald wrote in his declaration. “Rather, there are numerous effective methods to reduce the risks of diversion, and providing treatment for opioid use disorder may, if anything, help ameliorate the underlying cravings that underlie drug trafficking in jails.”

A federal judge still needs to give formal approval to the settlement agreement. A telephone status conference in the case is scheduled for Monday.


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