ACLU challenges jail’s policy of denying methadone to inmates

The American Civil Liberties Union of Massachusetts filed a federal lawsuit Wednesday challenging a county jail’s policy of denying inmates access to the medications that treat addiction.

The lawsuit asks the US District Court to require the Essex County House of Correction in Middleton to provide methadone to an Ipswich man who has relied on the medication to maintain his sobriety for nearly two years.

While focused on one man and one facility, the suit is the latest salvo in an effort — in Massachusetts and elsewhere — to change policies and attitudes toward addiction in the correctional system. The ACLU has filed similar lawsuits in Maine and Washington state.

Like nearly all jails and prisons in Massachusetts, the Essex County House of Correction does not provide inmates with either methadone or buprenorphine, even when the inmate arrives already with a doctor’s prescription. These medications, which reduce cravings and prevent overdoses, are standard treatments for opioid addiction.

“To someone with a life-threatening medical condition, treatment isn’t optional – it’s critical,” Carol Rose, executive director of the ACLU of Massachusetts, said in a statement. “Public officials should support people in their efforts to overcome opioid addiction, not obstruct them.”

The plaintiff, Geoffrey Pesce, was arrested in July for driving with a suspended or revoked license and faces a mandatory minimum sentence of 60 days.

Deprived of methadone, Pesce will undergo withdrawal pains and then face a high risk of relapse into opioid use and possible overdose, the complaint states. State data show that people recently discharged from prison are 120 times more likely to die of an overdose than the general population.

The federal lawsuit, which the ACLU is bringing along with its pro bono partner, Goodwin Procter LLP, alleges that denying anti-addiction medications violates both the Eighth Amendment protection against cruel and unusual punishment and the Americans with Disabilities Act, which prohibits discrimination against people with substance use disorder. The complaint says that addiction is a chronic medical condition, and that prisons and jails routinely provide prescribed medications for other chronic conditions.

The lawsuit names as defendants Essex County Sheriff Kevin F. Coppinger and the House of Corrections superintendent, Aaron Eastman.

Coppinger said through a spokesman that his legal staff is reviewing the complaint but that he does not comment on pending litigation.

Matthew Segal, legal director of the ACLU of Massachusetts, said that public officials and health professionals agree that the opioid crisis requires a public health approach. But, he said, “The situation on the ground is that punishment is still the norm.”

The ACLU’s suit comes on the heels of a failed effort in the Legislature to require all prisons and jails to provide buprenorphine or methadone to opioid-addicted inmates. Instead, lawmakers enacted a three-year pilot program at six county-run houses of correction, which will start providing the medications in September 2019. Essex County is not one of the six pilot sites.

The pilot program “kicks the can down the road, and that’s not acceptable when a lot of people are dying,” said Leo Beletsky, a law and health sciences professor at Northeastern University. “Why create a pilot program when we need to be rolling this out? It’s extremely frustrating to see people die unnecessarily when we know we could be helping them.”

Although it can be expensive to provide medications to every inmate who could benefit, “there’s pretty conclusive evidence that providing people with medication is a huge cost-saving measure. You reduce reoffending and reincarceration.”

According to the complaint, Pesce is a 32-year-old machinist who lives with his parents and young son in Ipswich. After years of trying and failing to overcome his addiction, Pesce finally found a treatment that worked for him at the Lahey Health Behavioral Services clinic in Danvers, where he received daily doses of methadone along with counseling and other therapies. He has not used illegal drugs since 2016, the complaint states.

He lost his driver’s license as a result of what the complaint calls a “substance abuse-related conviction arising from a charge that predates his recovery.” He relies on his parents to drive him to the clinic.

But on July 19, his mother was unavailable, and rather than risk a relapse, he drove himself to the clinic. He was pulled over for driving six miles over the speed limit and charged with speeding and driving with a revoked or suspended license, according to the complaint.

At his court date Monday, Pesce intends to plead guilty and expects to start his sentence immediately.

But Segal said the ACLU hopes to get a temporary restraining order before Pesce is incarcerated. Such an order, if granted, would require the jail provide methadone to Pesce behind bars, or else drive him each morning to his current methadone clinic, located a five-minute drive away.