Court establishes incarcerated Mainers’ right to medication-assisted treatment

BOCA RATON, FL – FEBRUARY 04: In this photo illustration, a bottle of the generic prescription pain medication Buprenorphine is seen in a pharmacy on February 4, 2014 in Boca Raton, Florida. The narcotic drug is used as an alternative to Methadone to help addicts recovering from heroin use. (Photo illustration by Joe Raedle/Getty Images)

A federal judge on Thursday agreed with the argument made by the American Civil Liberties Union of Maine that denying inmates access to medication-assisted treatment (MAT) for substance-use disorder is in violation of the Americans With Disabilities Act (ADA).

U.S. District Court Judge Nancy Torresen ordered the Aroostook County Jail to provide Brenda Smith of Madawaska with access to her doctor-prescribed buprenorphine to keep her opioid-use disorder in remission when she begins a 40-day jail sentence for petty theft next week.

“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’s lawyer Emma Bond, a staff attorney for the Maine ACLU, said in a statement. “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.”

Smith, who has regained custody of her four children, has been in active recovery for 10 years. During the first five years, before being prescribed buprenorphine, Smith relapsed nearly 20 times, according to the Maine ACLU.

In addition to the precedent of recognizing protections for substance-use disorder under the ADA, advocates involved in the case say Thursday’s decision was crucial to validating the studies that have demonstrated the effectiveness of treating people with prescribed medications like methadone and buprenorphine.

Judge Torresen wrote in her 28-page decision, “[G]iven the well-documented risk of death associated with opioid use disorder, appropriate treatment is crucial. People who are engaged in treatment are three times less likely to die than those who remain untreated.”

In her decision, Torresen also addressed the stigma surrounding medication-assisted treatment and the carceral system’s broader opposition to allowing access to it. “[C]orrectional staff often resist providing MAT because they equate MAT to giving addicts drugs rather than giving people treatment,” she said, citing expert testimony presented by the plaintiffs.

According to the Maine ACLU, most Maine jails have policies explicitly prohibiting this treatment for incarcerated people. The Maine Department of Corrections had a similar ban until it was lifted by an executive order from Governor Janet Mills last month.

Portland attorneys Andrew Schmidt and Peter Mancuso originally filed suit on behalf of Smith in September 2018. In addition to Bond, Smith was also represented by Monteleone and David Soley from Bernstein Shur.

The Maine ACLU filed a similar lawsuit in July 2018 on behalf of Caribou resident Zachary Smith, who was forced to end five years of recovery using doctor-prescribed medication when he began a sentence last September.

Rhode Island was the first state in the nation to provide medically-assisted treatment to inmates in its prison system. One study credited the policy with lowering the number of overdose deaths among people recently released from jail and prison.

(Photo: Joe Raedle | Getty Images)

About Dan Neumann

Avatar photoDan studied journalism at Colorado State University before beginning his career as a community newspaper reporter in Denver. He reported on the Global North's interventions in Africa, including documentaries on climate change, international asylum policy and U.S. militarization on the continent before returning to his home state of Illinois to teach community journalism on Chicago's West Side. He now lives in Portland. Dan can be reached at dan(at)

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