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Court orders Essex County to provide methadone to inmate




Globe Staff





A federal judge ordered the Essex County Correctional House to provide methadone to a future inmate who depends on his medications to treat his opioid addiction. Punishment.

The preliminary injunction, issued Monday by US District Judge Denise J. Casper, concerns only a man and an institution. But this decision could have national repercussions, as most prisons do not allow drugs to treat addiction.

"This is the first time a court in this country has said that the lack of drug-assisted treatment in the criminal justice system can be a violation of the ADA and the Constitution," Sally Friedman said. Legal Director of the Legal Action Center, a New York center. non-profit organization that fights against discrimination against drug addicts.

Such a decision "can have huge implications," Friedman said, as it indicates that similar lawsuits are likely to succeed. She predicted that legislators and correctional officials will take note of this.

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Essex Sheriff Kevin F. Coppinger said in a statement that he is considering his next steps "because of the potential consequences of Casper J.'s decision, both nationally and nationally."

Judge Denise Casper has ordered the Essex County Correctional House to provide methadone to a potential inmate who relies on drugs to treat her opioid addiction.

Pat Greenhouse / Globe Staff / File 2012

Judge Denise Casper has ordered the Essex County Correctional House to provide methadone to a potential inmate who relies on drugs to treat her opioid addiction.

In Massachusetts, legislation passed this year is beginning to open the door to addiction medicine in some correctional facilities.

About two-thirds of inmates have a substance use disorder. In addition to prisons, methadone and another drug, buprenorphine, are considered a standard treatment for opioid addicts.

Medications relieve withdrawal pain, suppress cravings and prevent overdoses. But the prison authorities often oppose it because they are opioids that can be diverted for illegal use.

"In prison," said Coppinger, "the administration of these drugs raises many security, logistical and tax concerns that do not concern people who are not incarcerated. make the situation "complicated".

"We understand the seriousness of this problem and want to do it right," said his statement.

The lawsuit was filed in September by the Massachusetts Civil Liberties Union on behalf of a 32-year-old man from Ipswich, who ended his years of fighting heroin addiction when he started taking methadone two years ago.

The plaintiff, Geoffrey Pesce, faces a 60-day sentence for violating probation while driving with a revoked or suspended license. Probation had been imposed for a crime he had committed prior to his recovery, having driven a motor vehicle under the influence of drugs in 2016. He must appear Monday for a hearing on his breach of probation conditions . He could be immediately incarcerated at Essex County House. correction in Middleton.

Middleton's policy is that inmates on methadone, such as Pesce, are forced to withdraw and receive medication to treat their symptoms. They can then participate in therapy, educational programs and reintegration services. In the run-up to release, some inmates are offered a Vivitrol tablet, or naltrexone for injection, a drug that blocks the effects of opioids for up to a month.

The court noted in its judgment that this program was "very much like the methods that failed Pesce" and goes against the recommendation of his doctor. Pesce's doctor said in court documents that Pesce "risks a serious physical and mental illness, a relapse into opioid addiction and death if he is denied access to methadone and that he is submitted to the accused treatment program ".

Under the ADA Act, drug addicts are considered disabled and people with disabilities can not be denied services that others would receive.

"Medical decisions that are based on stereotypes about people with disabilities rather than" an individualized investigation of the patient's condition "can be considered discriminatory," wrote Judge Casper. She also noted that the House of Correction had not explained "why she could not administer to Pesce, in liquid form, methadone prescription, in liquid form, under the supervision of medical staff.

Casper also noted that providing a treatment deemed ineffective at Pesce "could increase the risk of relapse and overdose at the exit of Pesce" and "would make him physically ill for several days while he withdrew by force. "

She described as "alarming" Massachusetts statistics on drug-addicted prisoners: Those recently released from prison are 120 times more likely to die from an overdose than the general population; nearly 50% of all prisoner deaths are opioid-related; and the vast majority of these deaths occur in the first month after release.

"This order will help save Geoffrey's life," said Jessie Rossman, a lawyer with ACLU staff. "We also hope that Commonwealth prisons will have a good time to review and change their policies to ensure that people with substance use disorders have access to treatment prescribed by a physician."

The accused – Sheriff Coppinger and Aaron Eastman, superintendent of the Essex County Corrections Chamber – may appeal the preliminary injunction. But if they do not, the requirement to provide the drugs will be in force throughout Pesce's stay, said Rossman.

"This will encourage the use of medical treatment in prisons," said Elizabeth Matos, executive director of Prisoners' Legal Services Massachusetts, a rights group that did not participate in the lawsuit. "We hope this will help move things in that direction."

Vermont and Rhode Island provide drugs to all inmates, as does New York and some other countries.

With the exception of two institutions in western Massachusetts, state prisons do not provide methadone or buprenorphine to inmates, even if they are already taking their medication with a prescription from their doctor.

But that will soon begin to change. The legislation passed this year establishes a three-year pilot program in five county-run penitentiaries, which will begin supplying drugs in September 2019. Essex County is not one of the five pilot sites.

Correctional homes are the places where most people go first after arrest and drug addicts generally prefer to withdraw.

The Legislature also requested the State Correction Department, which operates prisons for longer-term prisoners, to institute a buprenorphine and methadone treatment program beginning in April. .

The drugs would be available in both the women's prisons and at Cedar Junction, where the inmates stay 90 days before being assigned to a permanent place. In addition, all inmates would be assessed by an addiction specialist 120 days prior to release. Specialists will develop a treatment plan that may include buprenorphine or methadone.

The sections of the ACLU Maine and Washington State have also gone to court to gain access to drug addiction drugs for inmates. In Maine, a trial was held in September, allowing one prisoner to receive buprenorphine, and another is pending. Washington's lawsuit is under discussion for settlement.

Felice J. Freyer can be contacted at felice.freyer@globe.com. Follow her on Twitter @felicejfreyer


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