Court case to tackle jails' medication-assisted treatment

PORTLAND, Maine — The American Civil Liberties Union of Maine started making its case in federal court on Monday against the ban on medication-assisted treatment in county jail amid the opioid crisis.

Democratic Gov. Janet Mills recently lifted the Maine Department of Corrections' ban on medication-assisted treatment. The ACLU's lawsuit filed in September argued that it's unconstitutional and harmful for Maine jails to prohibit such treatment.

Madawaska resident Brenda Smith sued, asking to continue using medication-assisted treatment to keep her opioid use disorder in remission. Smith, who is expected to report to Aroostook County Jail this year, testified Monday in U.S. District Court in Portland during a court case that is expected to last all week.

Smith wept on the stand while describing how access to the medicine is critical to stabilizing her life. ACLU lawyers said they will spend the week making the case that such access is a constitutional issue, as well as a protected right under the federal Americans with Disabilities Act.

"It makes me feel normal, like I'm a normal human being," Smith said.

Smith's lawsuit against the jail comes at a time when jails and prisons across the country are starting to provide addiction medications to inmates, as resistance from long-skeptical corrections officials appears to be loosening amid the national drug epidemic.

Attorneys for the jail have pushed back at the idea that a ban on medically assisted treatment is a violation of a prisoner's rights. Attorney Peter Marchesi, an attorney representing the jail Monday, has previously said medical staff members at the jail have the ability to manage prisoners' withdrawal symptoms.

Monday's court action also included an expert witness, Dr. Ross MacDonald, who has overseen medical care for New York City's jail system. The medical literature supports medication-assisted treatment for opioid use disorder, and it's important to have that option available to prisoners, he said.

MacDonald said "we're in the midst of a crisis in the U.S." regarding opioid use disorder, and keeping options available is critical to serving patients, including prisoners.

ACLU of Maine legal director Zachary Heiden said this week's case is about Smith's individual circumstance, but it has the ability to matter for many more prisoners. It's at least the second lawsuit filed about the issue in Maine in the last year. The case is being argued in front of Judge Nancy Torresen.

"This is a case about a person who is in recovery and uses medication, medication prescribed by her doctor, to remain in recovery," Heiden said. "We hope it sets a precedent."

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