Judge orders Aroostook County Jail to provide opioid treatment to inmate

A federal judge has ruled that the Aroostook County Jail must make an opioid treatment drug accessible to a Madawaska woman while she serves her 40-day jail sentence.

The 28-page ruling released Wednesday is a “landmark” decision, according to the American Civil Liberties Union of Maine, which argued on behalf of Brenda Smith, who uses Suboxone, a medication-assisted treatment, to treat opioid use disorder.

“All jails in Maine should take heed of this ruling that found not providing access to MAT is in violation of federal laws,” Emma Bond, staff attorney for the ACLU of Maine, said in an interview.

Maine and much of the nation has been ravaged by the opioid crisis, with 418 drug overdose deaths in the state in 2017 and a projected 376 deaths in 2018. Improving access to medication-assisted treatment in the correctional system is one of the goals of Democratic Gov. Janet Mills, and her administration already has started examining ways to improve access in the state prisons.

U.S. District Court Judge Nancy Torresen presided over a weeklong trial in February in federal court in Portland. On Wednesday, Torresen ruled that denying Smith her medication in jail would “cause serious and irreparable harm to Smith” and would violate the Americans With Disabilities Act.

“This ruling is a breakthrough in the fight against the opioid crisis. The court rightly found that jails must provide necessary medical care for opioid use disorder, just like any other disease. We don’t expect jails to solve the opioid crisis, but the least they can do is not make it worse,” Bond said in a prepared statement. Bond presented arguments on Smith’s behalf. “This ruling is not just about Brenda Smith getting her medication in jail. This is about people in recovery staying in recovery and literally staying alive.”

Smith was sentenced for stealing $40 in change that another customer had left behind at a grocery store self-checkout terminal in December 2017, according to the ruling. She is due to begin her 40-day sentence Monday.

Torresen wrote that a “body of evidence has emerged that permitting MAT in correctional facilities offers substantial, and possibly essential, benefits to incarcerated people. One study of English correctional facilities found that treatment with buprenorphine (Suboxone) or methadone was associated with an 80 to 85 percent reduction in post-release drug-related mortality.”

Bond, in an interview with the Press Herald on Thursday, said that Torresen’s ruling is precedent-setting.

Many Maine jails already have started or are considering medication-assisted treatment for inmates, including jails in York, Cumberland, Penobscot, Androscoggin, Waldo, Cumberland and Kennebec counties. The jail population in Maine is about 1,700, according to the Maine Sheriffs Association.

According to research published in April in JAMA Psychiatry, Rhode Island experienced a 61 percent decline in fatal overdoses among prisoners released in the six months after medication-assisted treatment became available in its prisons, compared with before the state started the program.

Peter Marchesi, the attorney representing the Aroostook County Jail, wrote in a brief against the ACLU’s position that Suboxone “is prohibited because it is widely known to be coveted within populations of incarcerated individuals for its intoxicating effects.” Marchesi wrote that Suboxone is “so desired in the inmate population that inmates have been known to smuggle it in their dentures, to obtain it through contact visits, and even to have it diluted and mailed to them in the form of pictures and letters.”

But Torresen wrote that since the evidence points to released prisoners being less likely to relapse if being treated for medication-assisted treatment while in jail, “society will be well-served if Ms. Smith is able to continue to care for her children, maintain her housing and work. History has shown that if she relapses into active use, she will lose all that she has worked so hard to achieve.”

A separate case the ACLU of Maine settled in September allowed a client to continue taking medication-assisted treatment while in the state prison system.

Joe Lawlor can be contacted at 791-6376 or at:

jlawlor@pressherald.com

Twitter: joelawlorph