If all goes as planned, on Saturday morning a new inmate at the Essex County House of Corrections will be driven to a clinic to get his daily dose of methadone.
In making that trip, he will also make history: Geoffrey Pesce, sentenced on Friday, will become the first man in memory to take methadone while incarcerated in Massachusetts.
Pesce will get his medicine under a court order that applies only to him, the plaintiff in a successful suit by the American Civil Liberties Union. But he is in the vanguard as correctional officials prepare to meet new mandates to start offering methadone and another medication, buprenorphine, to some inmates. The medications stop withdrawal pains, control cravings, and prevent overdoses.
Opioid-addicted inmates who are pregnant routinely receive methadone because withdrawal can endanger the pregnancy. But, at most prisons and jails in Massachusetts and elsewhere, other inmates are forced into withdrawal, and then face a high risk of fatal overdose upon release.
Correctional officials have objected to providing methadone and buprenorphine because they are opioids that can be diverted for illicit use.
But Pesce and the ACLU argued successfully in federal District Court that it’s discriminatory to deny a prescribed medication for addiction when medications for other conditions are allowed. The suit also asserted that forcing Pesce into a painful withdrawal from methadone constituted cruel and unusual punishment.
In Newburyport District Court on Friday, Pesce pleaded guilty to operating a vehicle after a license suspension for driving under the influence, an incident that occurred before his recovery. Judge William Martin sentenced him to 60 days, the mandatory minimum.
Pesce, a 32-year-old machinist who until Friday lived in Ipswich, had tried for years to overcome his addiction to opioids; nothing worked until he started on methadone in 2016. By that time he was on probation for driving under the influence of drugs, and had lost his driver’s license.
He was living with his parents and relying on them to drive him daily to a methadone clinic. One day last July, when his mother was unavailable, he decided to drive himself rather than risk a relapse, according to his suit. He was pulled over for driving six miles over the speed limit and charged with speeding and driving with a revoked or suspended license.
He intended to plead guilty and serve his time, but filed suit because he feared the consequences of being forced off methadone.
Essex County Sheriff Kevin F. Coppinger said Pesce will be taken to the methadone clinic each day for at least 12 days, according to federal rules. After that, if the clinic doctor approves, he will come to the clinic only weekly to get six “take-home” doses that health care providers at the House of Correction will give to him each day.
Under federal law, only licensed clinics can dispense methadone for addiction treatment, so the correctional facility is obliged to work with an outside provider. For security reasons, Coppinger declined to identify the clinic or its location.
Asked whether any other inmates would also be provided methadone, Coppinger said such a decision would be made “on a case-by-case basis,” but Pesce is the only one right now. He noted that Pesce was a low-risk inmate based on his offense and history and it would be difficult to take more serious criminals out of the facility.
“We’re not set up for it,” Coppinger said. “I know people want it done years ago. I’ve got 1,500 inmates. I’ve got a county to worry about. I’m trying to find a happy middle ground.”
Meanwhile, Essex County and Suffolk County have joined a pilot program to provide medication-assisted treatment to inmates, bringing to seven the number of counties participating.
In the three-year pilot, created by a 2018 law, seven county-run correctional facilities (where people await trial or serve short sentences) will provide methadone and buprenorphine to inmates who had a prescription when they arrived and also to inmates 30 days before release. The pilot is due to start Sept. 1.
Additionally the state Department of Correction, which runs the prisons where inmates serve longer sentences, is required to start providing the medications on April 1 at two women’s prisons and at the Cedar Junction prison.
In another first, the Franklin County House of Correction in Greenfield expects to become federally certified as a methadone clinic, perhaps as early as May 1. That certification will enable the prison to dispense methadone to patients without an intermediary.
Dr. Ruth A. Potee, the medical director, said Franklin County would be the first correctional facility in New England, and possibly in the nation, to become a methadone clinic. The few that already offer methadone behind bars, such as the Rhode Island prison system, do so through contracts with community providers.