Must Jails Provide Addiction Treatment? First Circuit Says Yes

By William Vogeler, Esq. on May 13, 2019

Brenda Smith walked into a WalMart, and walked out in handcuffs.

She was arrested for taking $40 someone left in a change terminal, and sentenced to 40 days in jail for her wrongdoing. Then things got worse. Smith takes medication for an opioid addiction, but jailors said they wouldn't give it to her. According to the U.S. First Circuit Court of Appeals in Smith v. Aroostook County,  that was more wrong.

Opioid Addiction

Doctors said Smith needed buprenorphine twice a day to fight off her addiction. Before beginning her sentence, Smith asked a trial judge to order prison officials to provide the medicine. Judge Nancy Torresen granted her request, finding it would serve Smith and the public as well. "Society will be well served if Ms. Smith is able to continue to care for her children, maintain her housing, and work," the judge said. "History has shown that if she relapses into active use, she will lose all that she has worked so hard to achieve."

The First Circuit agreed and affirmed. Emma Bond, a staff attorney with the ACLU on the case, said it was a "huge step forward" and a "big signal" for jails across the country. "This is the first federal appeals court in the country to address the right to treatment for opioid addiction in jail," she said. "It represents a huge step forward in the fight against the opioid crisis and for our client who will get her medication in jail."

Right to Treatment

The American Medical Association, the American Society for Addiction Medicine, and a dozen other medical societies filed motions for leave to file amicus briefs in the case. The appeals court denied their motions as moot. As everyone knows, the United States is suffering an opioid epidemic. It's even worse in the concentration of prison populations. The National Institute on Drug Abuse says opioid use disorders are "highly prevalent" among people in custody. About half of state and federal prisoners are substance abusers.

"Even so, there has been reticence in criminal justice settings to using methadone, buprenorphine, and naltrexone to treat opioid use disorder," according to the institute.

With Brenda Smith's ruling, maybe that will change.

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