Massachusetts inmates have long been denied medications that treat opioid addiction, even though the drugs are considered standard care. The opioid law passed last year included provisions intended to start the state’s correctional facilities on a path to remedying that, with a pilot program in county jails and a requirement that anti-addiction medications be provided in three state prisons.
But now a federal lawsuit alleges that instead of providing treatment, the Massachusetts Department of Correction starts weaning inmates off their medications as soon as they arrive, then stops them after 90 days.
The department denies this, saying in a statement that “there is no DOC policy restricting the dosage or length of treatment.”
The Massachusetts chapter of the American Civil Liberties Union, in a suit filed in US District Court in Boston on Thursday, asserts that the state prisons are denying medications in violation of the constitutional prohibition against cruel and unusual punishment and the Americans with Disabilities Act.
“By failing to provide the necessary, prescribed treatment for opioid use disorder, the Massachusetts Department of Correction is forcing people to needlessly suffer due to their illness,” said Carol Rose, executive director of the ACLU of Massachusetts, in a statement. “Public officials should support people in their efforts to overcome opioid addiction, not obstruct them.”
In a statement Friday, the Department of Correction asserted that medications are discontinued only when an addiction specialist determines they’re no longer needed.
But that’s not the experience described by the three plaintiffs.
One of them — Joseph Sclafani, a 43-year-old Gloucester man — said in an affidavit that before going to prison, he had received a prescription for 16 milligrams daily of buprenorphine (often known by a trade name, Suboxone), a drug that stops cravings for opioids, prevents overdoses, and helps keep people in treatment. It was the first treatment that worked for him after decades of drug use and multiple treatment failures. In an affidavit attached to the suit, Sclafani said that buprenorphine “took the pain and anxiety of addiction away.”
“I finally had space in my brain for my family. . . . I was able to be present for my wife and my four-year-old son,” his statement said.
Two years earlier, Sclafani said, he was arrested for operating a vehicle under the influence of drugs. He pleaded guilty, received a 2½- to 4½-year sentence, and entered Massachusetts Correctional Institution at Cedar Junction in August of this year.
There, he said, the prison doctor immediately cut his dosage in half, allegedly telling him that prison policy limits buprenorphine dosage to 8 milligrams a day. His dosage was then reduced by two milligrams every 20 days until he was off the medication completely after 90 days and transferred to MCI Norfolk, where buprenorphine is not available.
“Everyone I knew who was receiving buprenorphine at Cedar Junction had been told that buprenorphine treatment could only be administered for a maximum of 90 days,” Sclafani said.
The other two plaintiffs, Michael Feinstein and Bret A. Cappola, also said that doses were capped at 8 milligrams a day and stopped after 90 days.
Inmates typically stay at Cedar Junction for 90 days until assigned a longer-term location. None of the other Massachusetts prisons for men provide buprenorphine.
Cedar Junction is one of three prisons required by the new state law to provide buprenorphine and methadone to inmates. The others are the women’s prisons MCI Framingham and the South Middlesex Correctional Center. The prisons started offering buprenorphine on April 1 but have yet to start a methadone program.
The ACLU lawsuit doesn’t address the state law, instead pursuing the matter in federal court. The Americans with Disabilities Act requires equal treatment for disabled people, and addiction is considered a disability. Inmates routinely receive medications for other conditions.
But most prisons have resisted providing buprenorphine and methadone, because they are opioids than can end up on the black market. As a result, overdose death rates are extremely high among newly released inmates as they resume drug use with lowered tolerance. Vermont and Rhode Island provide the medications to all inmates who need them.
Dr. Ruth A. Potee, an addiction medicine specialist who provided an affidavit supporting the suit, told the Globe that the Department of Correction isn’t providing treatment, but rather detoxing inmates from their prescribed medication. And the detox is so quick that inmates are likely to suffer withdrawal symptoms, which can lead them to use again, she said.
“Just locking people up and keeping them away from the drugs does not stabilize them,” Potee said in an e-mail to the Globe. “Drugs of all sorts — heroin, fentanyl, Suboxone — are available in many correctional facilities in our state. It is not possible to ‘lock people up and they won’t use drugs.’ ”
The ACLU is asking the federal court to issue a temporary restraining order and preliminary injunction that would require prison officials to provide the medication.
A hearing has been scheduled for 2 p.m. Monday in US District Court.
Felice J. Freyer can be reached at firstname.lastname@example.org.