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The court orders Essex County to provide methadone to the inmate

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A federal judge ordered the Essex County Correctional Chamber to provide methadone to a potential prisoner who relies on medication to treat his opiate addiction, saying that denying treatment could violate both the Americans with Disabilities Act and the ban constitutional against cruel and unusual punishment.

The preliminary injunction, issued on Monday by US District Judge Denise J. Casper. UU., Applies to one man and one installation. But the decision could resonate throughout the country because most prisons and jails do not allow drugs to treat addiction.

"This is the first time a court in this country has ruled that failure to provide drug-assisted treatment in the criminal justice system can violate the ADA and the Constitution," said Sally Friedman, legal director of the Legal Action Center. , a city of New York. Based on a non-profit organization that combats discrimination against people with addiction.

Such a decision "can have enormous implications," Friedman said, because it indicates that similar demands are likely to succeed. She predicted that lawmakers and correctional officials will take notice.

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Essex Sheriff Kevin F. Coppinger said in a statement that he is weighing his next steps "because of the potentially far-reaching effects of Judge Casper's decision, both at the state and national levels."

Judge Denise Casper ordered the Essex County Correctional Chamber to provide methadone to a potential prisoner who relies on the drug to treat his opioid addiction.

Pat Greenhouse / Globe Staff / File 2012

Judge Denise Casper ordered the Essex County Correctional Chamber to provide methadone to a potential prisoner who relies on the drug to treat his opioid addiction.

In Massachusetts, legislation passed this year is beginning to open doors to anti-addiction drugs in some prison settings.

About two-thirds of all inmates have a substance use disorder. Outside of correctional settings, methadone and another medication, buprenorphine, are considered a standard treatment for opioid addicts.

Medications relieve withdrawal pain, eliminate cravings and prevent overdoses. But correctional officials often oppose them because they are opioids that can be diverted for illegal use.

"In a prison environment," Coppinger said, "the administration of these drugs poses many security, logistical and fiscal problems, which are not problems for people who are not incarcerated." Coppinger noted that many inmates test positive for other drugs in addition to opioids. making the situation "complicated".

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

The suit was filed in September by the American Civil Liberties Union of Massachusetts on behalf of a 32-year-old Ipswich man whose years of struggle with heroin addiction ended 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 was imposed for a crime he committed before his recovery, when operating a motor vehicle under the influence of drugs in 2016. He is scheduled to appear on Monday for a hearing on his parole violation, and could face imprisonment immediately afterwards at the Essex County House. of Correction in Middleton.

According to Middleton policy, inmates like Pesce who take methadone undergo forced withdrawals and receive medication to treat the symptoms. Then they can participate in therapy, educational programs and re-entry services. As the release approaches, some inmates are offered an injection of Vivitrol, or injectable naltrexone, a drug that blocks the effects of opioids for up to a month.

The court decision indicated that this program has "great resemblance to the methods that failed in Pesce" and is contrary to the recommendation of his doctor. Pesce's doctor said in court documents that Pesce "is at risk of serious physical and mental illnesses, relapses in opioid addiction and death if he is denied access to methadone and submits to the treatment program of the accused. "

According to the ADA, people with addiction are considered disabled and people with disabilities can not be denied the services that other people would receive.

"Medical decisions based on stereotypes about the disabled rather than" an individualized investigation of the patient's condition "can be considered discriminatory," Judge Casper wrote. He also noted that the House of Correction did not explain "why they can not safely administer the methadone prescribed in liquid form to Pesce under the supervision of the medical staff."

Casper also noted that providing a treatment known to be ineffective for Pesce "could potentially put Pesce at a higher risk of relapse and overdose at the time of its release" and "would make him physically ill for several days while suffering a forced withdrawal."

She described as "alarming" Massachusetts statistics on addicted prisoners: people who have recently left prison are 120 times more likely to die of an overdose than the general population; almost 50 percent of all deaths among those released from prison are related to opioids; and the vast majority of these deaths occur in the first month after launch.

"This order will help save Geoffrey's life," said Jessie Rossman, an attorney with the ACLU. "We also hope that prisons and prisons throughout the Commonwealth state will see this as a good time to observe and change their policies to ensure that people suffering from substance use disorder have access to prescribed treatment by a doctor."

The defendants, Sheriff Coppinger and Aaron Eastman, superintendent of the Essex County Correctional Chamber, can appeal the preliminary injunction. But if they do not, the requirement to provide the medication will be in effect during Pesce's stay, Rossman said.

"This will encourage the use of drug-assisted treatment in prisons," said Elizabeth Matos, executive director of Prisoners' Legal Services of Massachusetts, a defense group that did not participate in the lawsuit. "We hope this helps push things in that direction."

Vermont and Rhode Island provide medications to all inmates, as do New York City and some other jurisdictions.

With the exception of two facilities in western Massachusetts, prisons and state prisons do not provide methadone or buprenorphine to inmates, even if they are already taking the medications with a prescription.

But that will soon begin to change. Legislation passed this year establishes a three-year pilot program in five corrections houses administered by the county, which will begin providing drugs in September 2019. Essex County is not one of the five pilot sites.

Correction houses are where most people go first after the arrest, and where those who are addicted are mostly those who are asked to leave.

The Legislature also required that the state Department of Corrections, which administers prisons for prisoners with longer sentences, institute a buprenorphine and methadone treatment program beginning in April.

The drugs would be offered in the two prisons for women and in Cedar Junction, where the inmates remain 90 days before they are assigned a permanent place. In addition, all inmates would obtain an evaluation by a specialist in addiction medicine 120 days before their release. The specialists will establish a treatment plan that could include buprenorphine or methadone.

The ACLU chapters in Maine and the state of Washington have also gone to court seeking access to anti-addiction drugs for inmates. In Maine, a lawsuit was resolved in September, which allowed a prisoner to receive buprenorphine, and a second lawsuit is pending. Washington's demand is in liquidation talks.

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

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