People in Jail Deserve Effective Drug Treatment Not Forced Withdrawal

Under the ADA, opioid addiction is not a character flaw — it is a disability that requires treatment during incarceration.

Sy kept trying to overcome his OUD, which is a disability protected under the Americans with Disabilities Act (ADA). About 15 years ago, he went to a drug counseling center and received his first dose of methadone, one of three medications now used as part of MAT (Medication Assisted Treatment), a treatment of OUD. MAT limits the euphoric effects of opioids, relieves physiological cravings, and helps normalize body functions — all without the negative effects of having to obtain and use illicit opioids. It is widely regarded by the medical community as a very effective way to treat opioid use disorder and can be an effective way of reducing the risk of death from overdose.

With MAT, Sy has had success controlling his opioid use disorder. When he was booked into the Whatcom County Jail in September of 2017, Sy wanted to continue his treatment. But staff at the jail refused to let him — it only allows MAT to women who are pregnant.

Sy is a plaintiff in a lawsuit filed last week by the ACLU of Washington against Whatcom County. The class-action suit, Kortlever et al v. Whatcom County,could have national implications. It asserts the county’s policy of refusing to provide access to MAT to people with OUD in jail discriminates against them on the basis of their disability and exposes them to grave danger of relapsing and overdosing when they get out.

This is because the jail’s answer to OUD — withdrawal — does nothing to treat the underlying addiction and reduces one’s tolerance to opioids. There is a good chance that people who are forced into withdrawal in jail will start using again upon release, and now that their drug tolerance is lower, they’re more likely to take too much and die.

Utilizing the ADA to assert the right to medication for people with OUD is a novel approach and an essential one. America has long treated drug addiction as if it were a problem of morality rather than a public health concern. This has resulted in the favoring of abstinence-based programs, instead of more effective medical interventions.

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