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Opiate Debate

ACLU lawsuit demands jail opioid treatment

Wednesday, June 13, 2018

In a novel case with national implications, the Washington state chapter of the American Civil Liberties Union has filed a lawsuit against Whatcom County jail administrators to force the facility to provide opiate-withdrawal medication to prisoners, rather than requiring them to go cold turkey.

The lawsuit, filed last week in U.S. District Court in Seattle, says the Whatcom County Jail’s refusal to provide the medicine violates the Americans with Disability Act, because opioid addiction qualifies as a disability under the law. The lawsuit also says it’s counterproductive, because inmates who go cold turkey risk severe relapse upon release—increasing the likelihood they’ll commit new crimes to satisfy their cravings and that they’ll overdose.

The ACLU lawsuit challenges the Whatcom County Jail’s policy of refusing to provide people access to Medication-Assisted Treatment (MAT), including buprenorphine (Suboxone and Subutex) and methadone, even though the facility provides other clinically appropriate medications to inmates. The policy is in collision with the Americans with Disabilities Act, the ACLU charges.

The lawsuit asks the federal court to order the Whatcom County Jail to provide access to necessary medications for the treatment of opioid use disorder in compliance with Title II of the Americans with Disabilities Act.

According to jail policy, medication services must be “clinically appropriate and provided in a timely, safe and sufficient manner.” Health staff arrange for the distribution of prescription medication after obtaining an order by the jail’s physician. The jail stocks buprenorphine but only distributes it to pregnant women with opioid use disorder (OUD).

The county’s Subutex protocol for pregnant women illustrates that the jail officials recognize that MAT is a safe, effective treatment for OUD, the ACLU notes in its filing. It also indicates the county has the means and resources, including trained staff and internal protocols, to provide Subutex to anyone with OUD, the ACLU contends.

Whatcom County has been developing a plan since March to provide medically-supervised buprenorphine for roughly three to five days of detoxing for all inmates who report opioid use and are evaluated.

But the ACLU’s action follows quickly on the reported suicide of an inmate, who fashioned a noose and hanged himself in Whatcom County Jail last week. Kirk Daniel Powless, 38, was booked into jail May 30 on suspicion of identity theft, second-degree possession of stolen property and possession of narcotics. Sheriff Bill Elfo told the Bellingham Herald he didn’t know if Powless was detoxing.

The Bellingham Police Department has been asked to conduct an investigation into Powless’ death. It is the fourth suicide at the Whatcom County Jail in the last decade, according to records.

“People addicted to prescription or illicit opiates have OUD, a chronic condition often accompanied by changes to brain chemistry,” notes Amy Roe, a senior writer for ACLU Washington. “It is a protected disability under the ADA.

“By stabilizing physical and psychological cravings for opioids, MAT can help people manage their OUD and achieve better outcomes in recovery,” Roe said. “Many people with opioid use disorder need to remain on MAT for years, and in some cases, their entire lives to decrease the risk of relapse and overdose.”

“The Whatcom County Jail’s categorical refusal to provide people with opioid use disorder the treatment keeping them in recovery violates federal law,” said ACLU-WA Equal Justice Works Fellow Jessica Wolfe. “It’s also dangerous.  If a person in the jail suffered from a heart condition and needed medication the jail would provide it, but it denies access to Medication-Assisted Treatment, which reduces the risk of overdose and death. This is unsafe and discriminatory.”

The lawsuit was filed on behalf of two plaintiffs the ACLU claims have been harmed by the discriminatory policy:

Sy Eubanks, a 46-year-old man with OUD, became addicted to opioids at 18 when he was prescribed opiate painkillers while recovering from knee surgery to correct a high school wrestling injury. By his mid-20s, Eubanks was using heroin, the ACLU notes in its briefing. He has requested MAT in the Whatcom County Jail but has not received it.

Gabriel Kortlever, a 24-year-old man with OUD, first used heroin when he was 16 years old. His heroin addiction caused him to make poor decisions, and he became involved with the criminal justice system. In an effort to get back on track, Kortlever started Suboxone treatment in an effort to control his opiate cravings. 

“Unfortunately, when Mr. Kortlever entered the Whatcom County Jail, he was not permitted to continue his Suboxone treatment,” the ACLU charged. When he is released he will have a hard time being reconnected to Suboxone services, the lawsuit claims.

Washington state is in the midst of an opioid epidemic. In Whatcom County, the situation is especially dire. The County has seen large increases in opioid drug overdose deaths over the last 15 years and had the second-highest opioid treatment admission rate in Washington from 2011 to 2013.

Between the years 2012 and 2016, 69 people died from opioid related overdoses. And in 2016, more people died from opioid related overdoses than motor vehicle accidents in Whatcom County.

In 2016, Whatcom County Jail recorded incarcerating at least 253 people who self-reported as abusing heroin and other opiates, according to documents filed in the action.

The ACLU reports that the U.S. Department of Justice recently reached a settlement with a nursing facility in Massachusetts for violating the ADA due to its policy of not allowing patients to use MAT. The President’s Commission on Combating Drug Addiction and the Opioid Crisis has also called for the use of MAT in criminal justice settings.

“When people who are getting Medication-Assisted Treatment for their opioid use disorder are able to stay on the medicine, the entire community is better off,” said Mark Cooke of the ACLU-WA’s Campaign for Smart Justice. “Government agencies should be supporting people in their efforts to overcome opioid addiction—not obstructing them.”
Compiled with materials from Associated Press.

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