I recently got this comment to my blog and I hope the writer won’t mind that I’m highlighting his comment. This comment represents one of my pet peeves: patients in recovery from opioid addiction who dose with methadone/buprenorphine are frequently denied their medication if incarcerated.
“Hello, i was recently convicted of an addiction related crime that happened over a year ago, since the indecent I’ve cleaned up my act, have been taking suboxone for over 12 months, 8mg, 3 times a day and now have to go to jail were I’m going to be denied my medication by jail officials/laws, I’ve been in jail before and i kno they do next to nothing for withdrawing opioid patients? From what i hear, it could take months for that type of dosage to get out of my system? Now being a former i/v heroin user of about 7 years, I’ve done a#on my body and feel my health isn’t exactly top notch, i am legitimately concerned about this withdrawal! Should there be sum kind of law protecting us patients? Aren’t these dangerous withdrawal symptoms? Thanks in advance for your response in this matter!”
I am so sick of hearing about patients on methadone or buprenorphine being denied their treatment while incarcerated! I’d love to see someone sue the excrement out of a jail or prison for denying this life-saving medical treatment.
Most counties jails in rural North Carolina won’t allow patients who are prescribed methadone or Suboxone for opioid addiction to take their medication while in jail. I hear (second-hand) that some jails allow chronic pain patients with opioid prescriptions to take their medication, though this may vary according to the county.
As a health care provider, of course I’m opposed to any refusal to treatment a patient while incarcerated. I think it’s a violation of the 8th Amendment about cruel and unusual punishment, but since I’m no legal scholar, I’ve searched the internet for more information about this situation. I found a great article co-authored by a doctor and a lawyer. They make the point that opioid addiction is a complex illness, and forced withdrawal causes severe physical and psychological suffering. Also, because opioid withdrawal makes people especially vulnerable, they may be coerced into giving testimony that incriminates themselves. They are less able to make decisions. (1)
Prisons are charged to provide as much care as is available to prisoners as general population, yet opioid addicts are denied access to medication-assisted treatments for addiction. These treatments are, as you probably know if you’re a regular reader of this blog, one of the most evidenced-based medical treatments in all of medicine.
Jails face legal implications for the prisoners under their control if adverse health consequences occur during withdrawal. A healthy young person usually won’t die from opioid withdrawal, but a medically fragile patient may die. Then the jail can be sued successfully for wrongful death, as happened in Orange County, Florida. But what a shame that it has to come to that to see any change in jail protocol.
A few years ago, I wrote to both the Tennessee and North Carolina chapters of the ACLU (American Civil Liberties Union), thinking if any legal organization would be willing to take up this issue, it may be them. One person with the NC chapter wrote back that in order to take up a case, they need a specific person with a specific case, and that person needs a local lawyer with whom they can work.
I other words, as a physician, I can’t get something stirred up. It has to be a person who is denied treatment with methadone or buprenorphine while in jail.
That’s what I’m hoping to do with my blog post. My readers know many people. If you are reading this and know someone facing incarceration who will be denied their usual medical treatment of methadone or buprenorphine while incarcerated, encourage them to get a lawyer, and ask that lawyer to ask for outside help.
Here’s the website for North Carolina: http://www.acluofnc.org/
As one might imagine, Tennessee’s chapter of the ACLU has many issues to keep them busy, so check it out at http://www.aclu-tn.org/ On their homepage, there’s an article about Tennessee’s contract with a corrections company that operates facilities in that state. It’s interesting reading, and may help us make sense of some of Tennessee’s horrible decisions around addiction issues (follow the money!). Also check out the TN ACLU’s article of protest against the recent law that makes using drugs during pregnancy a crime instead of a health issue.
I know that AATOD (American Association for the Treatment of Opioid Dependence) works with the Legal Action Center in New York, and they have a great website: http://www.lac.org You can read about their advocacy efforts nationwide, and check out their blog, which has advocacy information about this specific issue of medication-assisted treatment behind bars. I believe that the Legal Action Center works with local lawyers nationwide to serve as a resource. I don’t think the LAC actually takes on the cases of patients in states other than New York, but they also may be able to offer help and resources to other lawyers.
My patients tell me it’s difficult to find a local lawyer willing to take on the case of medication-assisted treatment behind bars. Often, such patients are seen as “bad” for having the disease of addiction. Some lawyers may not want to risk the working relationships they have with the judges in their area by advocating for an issue that the lawyer may not find compelling.
Additionally, it’s easy to intimidate many patients on MAT because they already feel shame and stigma. They have a legitimate fear of making their situation worse if they protest poor treatment by the criminal justice system.
I understand all of that, and I’d probably feel the same way. But what’s being done to patients on MAT – forced withdrawal from life-saving treatments of methadone/buprenorphine – isn’t right, and it’s an abomination to human rights. Let’s support these patients in every way possible. Get lawyers, ask them to advocate for you. If they won’t, contact some of the above resources and write back to me about what their response was.
If you are a friend or relative of a person in such a situation, make noise. Write politicians, call the jails, and call judges, particularly those that are elected. Tell jailers how appalled you are at the senseless suffering of patients denied their usual medical treatment.
Most importantly for this issue and others: register to vote. Find out your elected officials’ positions on the legal issues surrounding addiction, and vote accordingly. If you are an addict in recovery, vote. If you are a friend or family member of someone in recovery or in addiction, vote. Let politicians know you will vote against them if they fail to make good laws based on science.
As for me, I have a standard letter I’m willing to send to my patients’ lawyers and to the judges hearing their cases, advocating strongly for them to be allowed to continue their evidence-based treatment with methadone/buprenorphine.
And yes, I vote.
1.Bruce RD and Schleifer, RA, “Ethical and Human Rights Imperatives to Ensure Medication-Assisted Treatment for Opioid Dependence in Prisons and Pre-trial Detention, International Journal of Drug Policy, 2008, February; 19(1): 17-23.
Janaburson's Blog 
Posted by ztalbott on May 11, 2014 at 5:25 pm
We’ve been able to ensure continuity of medication assisted treatment with methadone in a few TN counties on a case by case basis, but the vast majority of the time treatment is discontinued (illegally) when a patient is incarcerated in the States of TN, NC & GA. Like the NC Chapter of the ACLU has told you (and one of our biggest roadblocks in moving forward with advocacy on these issues), an “effected patient” who has legal standing to bring a lawsuit would first have to be willing to sue…and find an attorney. Then NAMA-R, AATOD, the Legal Action Center, ACLU, etc. can help “coach” and advise the attorney to make sure he/she is well versed in this area of the law. Just like most medical schools don’t cover MAT, most law schools don’t cover the ADA and other relevant laws in detail either. I would strongly encourage any patient in this situation to FIRST file a grievance with NAMA-R via http://www.methadone.org/grievance_report.html so we can advocate on their behalf. Having the grievance allows us to go to other organizations on the patients behalf – it’s sort of like a retainer for an attorney.
The Legal Action Center (LAC) also has a great policy paper titled the “Legality of Denying Access to Medication Assisted Treatment in the Criminal Justice System” that can be viewed/downloaded here: https://docs.google.com/file/d/0B7bluL_LdE9dcEpjZWphelR4eUU/edit?usp=docslist_api
Zac Talbott
NAMA Recovery of Tennessee
http://www.tnmethadone.org
Posted by Benjamin Keith Phelps on May 13, 2014 at 6:34 pm
Unfortunately, nobody’s in shape to be able to retain an attorney & do much of ANYTHING when they’ve been abruptly cut off from their medicine – particularly if they have nobody on the outside – like parents – willing to help them work on it. And then afterward, once out of withdrawals, what are you going to sue FOR? If you didn’t die, didn’t have a heart-attack, & made it through okay in general, most people just forget it & move on. Now I agree wholeheartedly that some people need to take this issue on – & I’ve wanted to myself!! But I just don’t have the money to hire an attorney on my own behalf, & then all I could sue for would be the pain & suffering I was put through. That would be more than enough, were I to get an attorney willing to work on contingency. But sadly, I doubt there are many (if any) attorneys willing to take a MAT case on contingency, given the likelihood (or unlikelihood) of actually winning it! Personally, I believe it’s cruel & unusual punishment, just like Dr Burson. Anybody who’s gone through withdrawals him or herself KNOWS it’s cruel & unusual punishment to put someone through it purposely. But that doesn’t make those who haven’t gone through it able to understand how cruel & utterly painful & horrific it is to go through &/or be put through withdrawal. I hear “flu” comparisons regularly. But the flu is an “I don’t feel good” or maybe an “I feel horrible” kind of illness. Withdrawal is an “I hurt so bad, I could scratch my own eyes out or saw my legs off to stop this RLS/akathisia” kind of illness. Those are 2 VERY different things!! I have almost broken my hand & arm from being in such pain that I finally punched a steel jail bunk-bed railing. I was out of my head & writhing around from the RLS/akathisia, & the pain just got to me to the point I couldn’t take it anymore. While it doesn’t make sense to cause yourself MORE pain at that point, the frustration builds until you do something stupid like that b/c you start at so much pain you can’t stand it, but the pain doesn’t stop. Then the pain keeps going til you feel like you might go crazy if it doesn’t stop soon, & the pain keeps going. Then it goes on until you feel like you could DO something crazy if it doesn’t stop, but it keeps going. And it goes on until you feel like you could hurt someone else if it doesn’t stop soon. But it keeps going. So then you start to think you could hurt somebody ELSE if it doesn’t stop soon. But it keeps going. And you twist your feet & your hands until you want to saw them off for relief, but you can’t stop twisting. So you hurt & you twist, & you hurt & you twist, & you vomit, & you hurt, & you twist, & you diarrhea, & you hurt & you twist, & you sit up straight, & you hurt & you twist, & you lie down, & you hurt & you twist, & you sit back up, & you hurt & you twist………………. This, in essence, is withdrawal… Day after day, week after week (from methadone). No sleep to relieve the pain & monotony, no food for the 1st week or slightly more, then you can’t eat enough & in jail, there’s nowhere NEAR enough food to satisfy this, even if you get canteen. You diarrhea until you are sore. If I try to force food down in the 1st week, I vomit; or when I am sleeping at night on about the 2nd or 3rd night in the jail, when the methadone is leaving my system to the point I’m at the edge of withdrawal starting to get bad, my stomach getting nauseous will make me vomit, start to choke, & wake myself up. After that, there’s no more sleep for about a month. My last time in jail, I’d been on MMT for long enough that it took almost 2 months to get back to where I wasn’t so weak I had to pull myself up a flight of stairs using the handrail b/c my legs couldn’t do it alone, & where I stopped writhing around at night & twisting my feet like a mad man. I’ve had the people in my block think that I was a crazy man b/c I would keep lying down & twisting my feet so bad that I’d finally get up & walk a lap or 2 around the block til I was too weak to walk anymore, lie back down & twist some more, & repeat this over & over until I’d finally get completely exhausted & my body would *slightly* settle down & I could rest, though I didn’t actually sleep.
People just don’t understand or realize, even when they hear about withdrawal, how bad it actually is for a person on a high (or even low, really) dose of opioids – particularly a long-acting one like methadone. It’s genuinely horrible, even though methadone withdrawal IS less intense on a day-to-day basis than short-acting opioid withdrawal, which is more intense by the moment, but is over MUCH quicker. And I just don’t see why – if a doctor deliberately put me on methadone as treatment – a doctor shouldn’t taper me off methadone, rather than just abruptly cutting me off in 1 day!! I understand that many felons end up in prison, & hence, since it’s not yet offered there, they HAVE to taper felons off to get them ready for prison. However, I believe it should be offered in prison, too! It’s not just about “Well, they can’t get to any heroin, so they don’t need methadone”. MMT, to me & many others, is about feeling normal – like Prozac does for a depressed person. Sure, we don’t die if you taper us off it. But our quality of life goes down the toilet!! So why is it ANY less viable to give to a prisoner than Prozac is, or an anti-psychotic like Thorazine is for that purpose? And they do give opioids for pain in prison, though it’s MUCH more sparsely seen… As well as barbiturates & benzodiazepines for epilepsy (& migraines for the former)… So controlled substances ARE more of a pain for them to give out in prison & jail b/c of the extra paperwork required. But that’s NOT a sufficient excuse to do away with MMT, nor the adequate use of opioids for pain, as they’ve done to a big extent. I was in jail with a guy who was shot, & we were both in medical segregation for our conditions. He was being given a SINGLE 5mg Vicodin for his pain, & it was a pretty new injury! This was not with the option to get another 5mg if the pain was bad… It was 5mg, period. That’s being stingy with pain control, & it should be monitored by some outside agency & set straight when jail & prison docs don’t treat illnesses appropriately, in my opinion!
Posted by dbc901028 on May 13, 2014 at 7:32 pm
Nice description of methadone withdrawals.. that’s about how it is :o. Note that methadone is probably the worst opiod to withdraw from due to its full agonism and long half-life. Those attributes makes it great for stability during opiod maintenance, but it means your body is super-acclimated to opiods. With short acting opiods, or street use, at least your body experiences *some* periods without the drug, or with less of it. I would agree with Dr. Burson and everyone else that it is cruel and unusual punishment. BUT, like you, after seeing a bit of the system myself, I am not optimistic about the possibility of success. Like you mentioned, they are anti-pain relief in any form. Many feel that prison should be all about pain, the more the better. That’s wrong, but is the attitude you are confronting here.
Posted by Benjamin Keith Phelps on May 15, 2014 at 3:51 pm
dbc901028 – That’s EXACTLY why they refuse to provide it in a nutshell – you said it best!!! People feel like you did something you shouldn’t have, so you deserve whatever pain & inconvenience you get, bottom line. That may be true when it comes to whether or not to provide cable TV & basketball courts, but they DO provide those things, often times! Why would medication be the thing that is viable to cut, but cable TV not so? I’m not saying they should do away with recreational things for prisoners here – they’d have nothing but fights to contend with if they gave them nothing to do all day. But I AM advocating for FULL medical treatment, comparable to what one would receive on the outside, when possible. I realize that they may not be able to provide the same level of cancer treatments one could buy with millions of dollars worth of insurance on the outside (or with cash of that abundance). But even then, if the family is willing to send the money in to pay for the treatments, there are times it can be arranged. Sure, there are challenges to storing methadone stock & dispensing it, but not really anything that they don’t already face when they dispense MS Contin, which I knew several people who took at 1 particular camp I was at in NC, & it was available at any camp. I understand more licenses are required, & there are greater requirements in the way of paperwork, but not so much as to make it more than they can handle. I’m quite sure the DEA is not going to hold them to the same standards as an OTP, when it comes to some things. But dispersible tablets would do away with the need for a pump system, computer, & software. They are easily available, even if they had to use 10 & 5mg tablets to achieve the dose (b/c of the 40mg tablet ban for any place but OTPs), dropped into a cup of juice, like my clinic used to do. The 40mg diskettes are the same size as 4 of the Methadose 10mg tabs, so it’s totally feasible to dose this way. So we’re talking about a very small number of bottles of tablets stored in a small floor safe that is bolted to the floor & only accessible by nurses &/or the doc(s). They already do this for their other controlled substances. A single counselor, I have ZERO doubt, could handle each patient at a particular camp. Or you could put all methadone patients at one particular camp. You break the rules of that camp or get shipped away for any reason, you lose your ability to be in MMT. Although I don’t like that so much b/c I could start a fight w/someone who doesn’t want to fight or cause trouble, but BOTH of us would be sent away for it. So the other person shouldn’t lose a treatment slot b/c of this type of thing. But heck, ANYTHING like this is better than NOTHING of the kind!! There is just NO REASON this is not doable. Not one that I can come up with, & I am quite familiar with clinic guidelines, regulations, & laws, having studied MMT/MAT for about 18 years now & being a certified methadone advocate by NAMA Recovery. I have attended the conferences they do every 18 months, & I am familiar with the state-by-state laws that govern them (though I don’t claim to have all of them memorized for each state…) If there is a single VALID reason this would be a problem, I have yet to come across it. What I HAVE come across are a lot of excuses for why it would inconvenience someone to do it. Paperwork, storage, logistics in general, blah blah blah. These are peoples’ LIVES & wellbeing we’re talking about here; not whether or not to allow them to throw a party with alcohol in prison. I relapsed less than 1 month out of prison (2 & 1/2 years in prison) – that never needed to nor should it have happened.
Posted by dbc901028 on May 11, 2014 at 5:53 pm
I totally get this situation. I’ve been in jail, when I was 18 (over 20 years ago), charged with sale of marijuana. That felony conviction has affected the remainder of my life. Fortunately, I am skilled in a high-demand profession, else I’d have had to try to explain that conviction to employers… though I can never vote, or visit many countries.
Anyway, so I’ve seen what county jails are like. They are abysmal. Prisons are much better. County jails get away murder, quite literally. Many continually fail certification and are like dungeons from medieval times. So, to me, the overall conditions of our local jails is a more pressing issue than is bupe/methadone treatment. That said..
I am very empathetic towards inmates going through forced and unnecessary withdrawals. Unfortunately, society at large has no will to make the lives of ‘criminals’ more comfortable. It’s certainly not an issue a politician will win an election with, especially since felons can’t vote in most states.
Further, no state will want to pay the cost associated with these medications, no matter how minimal it may be… But if you can make a case that the state will save money through opiod dependence treatment, that is something the politicians will listen to. It’s all about money to them, as you have astutely pointed out.
I think a reasonable compromise would be to allow short-term opioid dependence treatment with an aggressive tapering protocol. This would protect the states from liability over withdrawal related deaths and suffering, and give dependent prisoners some relief. Make sense to you?
Posted by janaburson on May 12, 2014 at 12:56 am
It would save jails money to provide treatment. But no, it doesn’t make sense to me to make a person taper off medication if they are doing well on it.
Posted by dbc901028 on May 12, 2014 at 12:59 am
No, it doesn’t make sense, but I offer it as a preferable option to full and immediate discontinuation. I honestly see the chore of trying to force counties to comply with the existing law and human rights as near impossible, again mentioning potentially more egregious violations of the 8th amendment. As a foot note, the US has the highest per-capita incarceration rate in the world by far, higher than the Soviet Union even has had, even during it’s prison camp era. (http://en.wikipedia.org/wiki/List_of_countries_by_incarceration_rate)
Posted by Benjamin Keith Phelps on May 13, 2014 at 6:00 pm
dbc901028 – Felons actually CAN vote in most states, but it almost always requires that they either wait until after prison, or until after probation/parole is over before they get that right back. And even then, you have to RE-REGISTER or you won’t be able to vote. If you were registered prior to a felony conviction, you are NOT still registered once you get off probation/parole or out of prison! You MUST re-register – there’s no way around this currently. Here’s a website that gives a state-by-state rundown of felon voting rights (or lack thereof, in a few cases…):
http://felonvoting.procon.org/view.resource.php?resourceID=000286
Posted by kevin on May 11, 2014 at 7:21 pm
Question..If someone is in jail and they are suffering from withdrawl, do you mean something has to happen like a heart attack or the such to be able to do something. The sleepless nights restless arms and legs, palpatations, care that u need outside of a jail. For instance. When I was in Mat last time and I came off 200mg at 10 mg a day and told I would be fine. I wasn’t I had to lay in hot water to make my arms and legs to stop moving like rubber bands. I would lay on my stomach with my arms under me and still they would force there selves out. I had to go find lortabs to make it stop. I don’t believe someone comeing off that much can do it without anything or anyone. Going this all that is not enough to sue a jail for letting someone suffer with out medical treatment to make the symptoms stop. And any doctor that knew what they were doing would not send that person back. They would admit the patient
Posted by janaburson on May 12, 2014 at 12:58 am
I don’t know. That’s a legal question. I think intentionally inflicting suffering by withholding medical treatment should be as illegal as it is immoral. But that’s just me.
Posted by Larry Berger on May 11, 2014 at 8:45 pm
If the ACLU would take on this case, that would be great, but I do have some ideas about other attorneys that might possibly be interested, and if you would like to discuss this, please e-mail me at LBERGER@SFMSLAW.COM.
Posted by ztalbott on May 11, 2014 at 11:48 pm
Reblogged this on Journeys with Zac.
Posted by RSONM on May 12, 2014 at 8:53 am
Our organization is proud to provide methadone maintenance treatment in a correctional facility, just as a patient would receive in the community. We struggled to get our program approved through multiple agencies but now we have been providing the service for over 4 years and our outcomes have been objectively proven by a university study. Read more here:
http://www.recoverynewmexico.com/treatment-in-jail.html
Please feel free to contact, have a great day!
Posted by janaburson on May 13, 2014 at 1:02 pm
Thank you for this great info. I checked out this website and your information shows the benefits of offering MAT to the incarcerated. I will be using your data in the future.
Posted by Diana Goodwin on May 13, 2014 at 7:36 am
I have been engaged in a battle with the Federal Bureau of Prisons since last summer over their refusal to provide MAT to prisoners, including my son. I have involved Human Rights Watch and various members of Congress. I have not found any organization that is willing to provide legal help. It is a long and tedious process for a prisoner at the federal level to be able to initiate a lawsuit against the BOP. While It appears that there may be some upcoming changes to policy with regard to MAT in halfway houses at the federal level, the fact remains that my son and countless others do not have access to these medications, And the current health services director at the Bureau of Prisons, RADM Newton
Kendig, does not view them as medically necessary. Anyone interested in learning more about my efforts or joining in with me should contact me through Twitter: @justicereformer
Posted by janaburson on May 13, 2014 at 1:04 pm
Thanks for writing. I’m interested in what you have experienced. Which organizations have you talked with that can’t or won’t help?
Posted by Diana Goodwin on May 13, 2014 at 1:24 pm
Good morning! It’s mostly “can’t” vs. “won’t”. Won’ts: ACLU at National and WV state levels, a few University-associated legal clinics, several independent pro-bono legal clinics. Can’ts: DOJ Disability Rights (and several other federal gov. agencies), as they can only get involved in state-level issues (odd, isn’t it?), state-level federally funded disability rights organizations (same reason as DOJ Disability), Legal Action Clinic (can help only in NY state), and others. This is an unpopular/lesser known issue with low “curb” appeal, making the struggle for access even more difficult. I have made some good contacts and think I have been responsible for some “chatter” going on at the BOP and in the halls of Congress, but the bottom line is that my son continues to suffer. Untreated illness leads to relapse, which in prison leads to punishment. It’s government sanctioned torture.
Posted by David Russell on July 27, 2015 at 6:49 pm
Hi my name is David R. and I was recently stopped at a roadblock by police at 11am on a Sunday morning and, because of my willingness to cooperate with officers was given a dui after officers asking if I took any medications of any kind. With the positive effect of buprenorphine has had on my life and quality of, I have resurrected myself and am a great father of a beautiful 6yr old girl who I take care on my own. With all its glory I’ve given this suboxone program for saving my life, I without any regrets told the truth when asked of my participation in this program. They then turned it into a bad thing, primarily because of lack of knowledge on this subject, that this rendered me unable to properly drive a motor vehicle. Upon going to jail I shared with them my prescription bottle of suboxone in my vehicle and once jailed was given every excuse in the world of why they couldn’t give me my medication. When one theory of why they couldn’t give it to me was dismissed, they would find another. I feel personally the jailers didn’t understand properly the lives that buprenorphine/methadone has saved when under a physician’s care and directions on usage. The extra paperwork, lack of knowledge, the negative stereotypes on this matter, were all on full display during my days there suffering thru unneeded and immoral withdrawals. Now upon release and a court date ahead set for August 25, 2015, I have to fear what lies ahead for me if imprisoned during the trail. I am a good man, a hard-working, God-fearing honest father who simply puts forth all efforts into continuing making my daughter’s life a great one and a childhood far better than mine. After 3 generations of drug-abuse and alcoholism in my family, I have now broken the chain and with the suboxone program live a normal, healthy life and feel proud to say that this has all been achieved thru care from my physician and his judgement to put me into the suboxone program. I fear now that if incarcerated that I will be forced to go thru a long, forced, grueling, life-threatening withdrawal process that will throw all of what I know as “normal”, out the window. Let’s assume I serve 60 days in jail. Before going I would have been doing great things and being a great father to my daughter. Upon incarceration, I would then be forced to withdraw from the same medication that has kept me on track and out of trouble. After this inhumane process of jailers being in charge of my healthcare and not a certified doctor, I will now be released and let’s take a look at the risks this 60 days will have caused. I now may relapse and start back a 3 generation family disease of drug and alcohol abuse. I then may be a way more risk/threat to society than while I was on the suboxone program. This is things that courts and judges alike need to take into consideration when addressing this matter. I am ready to fight for those who can’t. I feel this is something that needs to be visited by the state and federal government as to more knowledge of these patients being forced to stop a program that they are benefiting from. I will make it my life calling for yrs to come to fight for these people’s rights and that jailers and nurses working at the jail should not take the place of a licensed physician and what they have accessed needed on their patient. Thank you for your time and please let me know what I can do to help others. I am scared for myself, my own well-being, and fear of going back to a life I fought hard to get away from and how far I’ve came from that in my last 3 years of my doctor’s suboxone treatment. I am here to be apart of whatever is needed of me to help those this affects. My email address is TheDavidRussell3@yahoo.com. Thanks again for your time, hope to hear from you and most of all, God bless.
Sent from my iPhone
Posted by janaburson on July 28, 2015 at 12:36 pm
Hello David,
First, you need a lawyer. Then you need your doctor to work with your lawyer, and advocate for you. I agree completely that your rights were violated if anyone in law enforcement or the judge practiced medicine without a license and told you to get off an accepted treatment for a potentially fatal disease. I would love to see someone sue the pants off jails for doing this. I don’t know who can best undertake this – I personally have contacted the ACLU but they wrote back saying that they had to have a real case to work with. Maybe your is the one – I’d be interested to see what happens if you contact the ACLU in your state and if they could help you.
there’s an organization in New York, the Legal Action Center, that advocates for patients in NY state: http://lac.org/
I’ve contacted them in the past and they have some statements that you could print and take to your lawyer, but the LAC won’t get involved outside of New York.
Posted by dbbc11293018112 on July 30, 2015 at 7:10 pm
These people mostly can’t afford lawyers. If they have any money, the government will fine them so heavily for their charge (whatever it is), that they’ll be broke. Even then, jails and other correctional institutions will not readily submit to any random lawyer making a request. They consider Buprenorphine a narcotic and will simply not administer it. BUT, guess what, if you think this is the worst issue in our nation’s law enforcement system .. ahem, ti’s not by far!
Heck, look up Civil Forfeiture.
Or how about some stats on our nation having a higher incarceration rate than any major country in the world by an order of magnitude.
Or how about the vast overcrowding, especially in local jails, where inmates are stacked on top of each other in conditions that would *have* to be considered cruel and inhumane punishment by any objective person. And many of these people haven’t even been to trial yet!
And don’t even get me started on the emerging private prison industry.
Point it is, and I hate to say this, you are fighting a hopeless battle here, but at least you have the courage to say something!
Posted by janaburson on August 1, 2015 at 6:20 pm
I could not agree more!! This nation has lost its mind regarding how many people we put in jail. We know a majority of people there really have drug use problems. Let’s find a better option for these people and save jail for violent people.
I don’t write so much about the prison issues like overcrowding, privatization and the like because I’m no expert & don’t have better options. But even I can see something is desperately wrong.
I know these people don’t have money – that’s why I suggested some agency like ACLU.
Posted by William Taylor, MD on May 13, 2014 at 7:22 pm
I agree with your position, and I have talked to hundreds of previously incarcerated patients who uniformly describe a horrible experience of abrupt withdrawal.
However, I have some sympathy for the other side of the argument, when you consider the practical challenges of storing, dispensing, verifying outside dosage, assuming liability, accounting for every dose, drug screening, etc. etc., in a correctional facility, when even the best run OTP’s find these challenges difficult. All you need is one inmate who fools the system, overdoses on methadone, and dies, and the correctional facility (and, of course, the taxpayer) will be facing enormous liability.
Posted by kevin on May 14, 2014 at 12:24 pm
Then why not have them sign a waver. If you continue on with your maintenance while you are locked up and break the rules you will lose the privelidge, just like at your own clinic. If you overdose from the medication they are not liable. If I’m honest on the outside I’m gonna be on the inside. And I’m obviously not gonna get extra inside so not gonna od. They usually put u by yourself when on medication.
Posted by Benjamin Keith Phelps on May 15, 2014 at 5:03 am
Dr Taylor, I don’t see where this is sufficient to justify the cruel & unusual punishment they put us through by abruptly cutting us off. They are able to handle dosing other patients on every other medication. Why is this a problem then? And drug screening?? They don’t drug screen anybody else in jail – usually b/c PRISON is where drugs get in illicitly, not jail. I suppose there’s the aspect of other inmates selling/giving away their meds, but okay, fine – do a drug test once monthly like a clinic does. If maintenance is not feasible, at the very LEAST a taper should be! There’s no excuse for putting a human being through what they put us through when we were INTENTIONALLY raised up to have a tolerance & dependence on methadone by a doctor in a legitimate treatment setting. The argument that someone shouldn’t have gotten into trouble doesn’t hold water, b/c many a person who is found not guilty goes through the justice system. I was ordered by a judge to be on MMT a few years ago, then I was released 3 days early by mistake from the jail to start. A few months later, my probation officer tells me I have to go do those days, & the jail doc refused to maintain me over the 3 days. That was NOT my fault in ANY way, shape, or form, & I had takehomes I could bring with me. They store every other controlled medicine there almost – why is storing my takehomes a problem? They are sealed, so tampering would be evident. This is just bad practicing of medicine no matter how you look at it.
Posted by kevin on May 15, 2014 at 12:39 pm
Very much true. I agree. This is a good blog. Got a lot of people talking about this. We have got to stand up for our rights
Posted by William Taylor, MD on May 15, 2014 at 10:31 pm
I did an eye-opening search using “opiate withdrawal death incarceration” as search terms. There were quite a few references to fatal outcomes when opiate dependent persons are incarcerated. Esophageal rupture, electrolyte imbalance, and suicide are some of the ways people die.
One additional practical issue is that jail physicians are not licensed to prescribe or order methadone, and I’m sure very few of them are certified to prescribe suboxone.
One special kind of inmate usually gets treated, though; the jails will usually find a way to treat pregnant inmates, because of the enormous risk to the fetus of uncontrolled withdrawal.
Posted by kevin on May 16, 2014 at 12:54 am
How does the esophagus rupture due to withdrawl?
Posted by janaburson on May 16, 2014 at 1:01 pm
repeated forcefule vomitting can cause esophageal rupture.
Posted by janaburson on May 16, 2014 at 1:11 pm
Thanks Dr. Taylor. You probably found those two cases in Orange County Florida, where the family sued the jail and won something like $3 million. Eventually that county did work out an arrangement with a local OTP to keep dosing patients already in MAT.
That’s the thing – jails don’t have to be OTPs, only be willing to work with the patient’s own OTP. For example, once in a blue moon we have a patient in Wilkesboro for whom we can get approval to dose while in jail. Two nurses drive to the jail and give the dose, so the patient is still getting observed dosing by OTP personnel. Or, if the patient has take home doses, the jail can store and give the medication to the patient once daily. They do this for other controlled substances, at some jails. There’s so much variability, even between different counties. One county brought the person to the OTP every day to be dosed, which was very nice for the patient and the OTP, but I’m sure it took time from other law enforcement duties.
In other words, there are ways to dose patients while in jail without the jail docs having to be licensed as OTPs. I’m sure we could find creative solutions if jails & OTPs worked together.
Posted by Addiction Treatment Forum | Blog by Jana Burson Methadone and Buprenorphine During Incarceration on May 16, 2014 at 7:15 pm
[…] https://janaburson.wordpress.com/2014/05/11/methadone-and-buprenorphine-during-incarceration/ […]
Posted by Carlos on May 27, 2014 at 11:03 pm
I wonder if an American with Disabilities Act case can be made if one can find a creative and cleaver enough attorney willing to look further at this case. There are several comment made in on the ADA regulations. 1 The only time that an illegal user have right under the ADA is to receive medical and Substance use treatment. And 2 Suboxone and methadone meets criteria under the ADA as a person with a disability with enough substantial impairment.
Posted by Carlos on May 27, 2014 at 11:07 pm
The case in Orlando the Methadone Authority was very much involved. I believe to be all over the state. When I was on methadone in the 90s I was in jail for over 6 month and the clinic was bringing the methadone to the jail.
I also believe was available to patients that were on the Counties Methadone Program. About the only good thing they were doing as they were ignoring and frequently doing the reversed of what the State Methadone Treatment Guidelines were protocoling.
Posted by Carlos on May 27, 2014 at 11:16 pm
I also believe that the State of Pennsylvania, has a program inside the prison system. They also arrange with methadone clinics upon the persons release from prison.
Posted by Larry Berger on May 28, 2014 at 1:37 am
If Pennsylvania has such a program, that’s great,but that would be a program for state prisons and not county prisons. As recently as a few years ago, a person that I represented was incarcerated in a county prison in Pennsylvania and was denied methadone treatment for the duration of her time in the prison. This withholding of treatment was not only cruel, because of the suffering which it caused during the time of incarceration, but it also caused her lasting harm, which extended long after the time of incarceration.
Posted by Mike on June 30, 2014 at 3:41 pm
I’m a supervisor at a large jail. We are building a new jail now and I’m wanting to include a suboxone drug replacement therapy program along with aa and na. I have the powers that be convinced of the benefits of a program like this, not just honoring existing prescriptions but partnering with a local suboxone Dr to provide intervention and continuous care after release if such a thing is even possible. My problem is that I can’t find any jails that currently have programs like this. Rather than reinvent the wheel, does anyone know of a jail anywhere in the world that offers a program like this? I’ve looked at Rikers Island methadone program, but licensing for methadone seems more difficult than suboxone and with the affordable care act requiring medicare/ medicaid to cover DRT, it shouldn’t be prohibitively expensive. Any advice would be great.
Thanks.
Posted by Rachel on July 29, 2014 at 5:02 am
I am currently 9 weeks pregnant and am facing jail time for a misdemeanor larcony charge in Orange County NC. This çharge is my FIRST ever and was not a result of active addiction but starvation after my fiance was laid off AND the officer purchaced the $8 worth of food I tried to steal for me and gave me resources for help with food. The DA denied my request for a prayer for judgement and i guess want to make an example of me. I have been on suboxone for two years! I am terrified for my child (even tho this was not a planned pregnancy I am very much in love with this being inside me and cannot bear thinking about what withdrawl will do to him/her) If I wasnt pregnant, I dont think I would be this terrified but I probably should. I have a seizure disorder, hepatitis C, SVT (a heart condition), and I think there is a real possibility that withdrawl could kill me…add this innocent baby to the mix and I am scared my family will be planning two funerals if I dont get some help advocating for myself and my unborn child. I have made an appointment with my doc to discuss this but I am not sure how much help this is going to be. Any suggestions and advice would be helpful (and no we cannot afford a lawyer).
Posted by janaburson on July 31, 2014 at 1:10 am
I hope your doctor can help, but you really do need legal advice too. Can’t you get a court-appointed lawyer? Yes, opioid withdrawal can be harmful to the fetus, and increase the risk of miscarriage, so it’s essential the court gets the information that you will have to be dosed while in jail. In NC, I’ve had patients get transferred to Raleigh, where they can be dosed while incarcerated, but that was with methadone, not sure if that can be done with buprenorphine too.
But you need legal help!!
Posted by Benjamin Keith Phelps on July 31, 2014 at 5:14 pm
Dru Burson, to be clear, in case anybody misunderstood – Raleigh ONLY doses those on methadone who were a) in a clinic already, & b) pregnant. If you are neither, you are but off abruptly, & half the time they forget to bring your clonidine (which does virtually NOTHING, I know, but every little thing helps), & other meds, such as Bentyl/dicyclomine for stomach & such. I find that anti-histamines intensify withdrawals, so no Benadryl or Vistaril for me, & that includes tri- or tetra-cyclic antidepressants, like Elavil/amitriptyline or Pamelor/nortriptyline, Sinequan/doxepin, imipramine, etc, as they are POTENT anti-histamines. This may not affect you that way, but trust me, if you find it the hard way that it does, you will regret the day you were born until the effects of that drug wears off!!!! It makes the leg movements (kicks) 10X worse, in my experience, & I had to pace, but was so weak, I could barely pace twice before having to lye back down on the bed. Then it was back to packing within 3 minutes or less. It was HELL for a few hours, & each time on each of these medicines. No, antihistamines are NOT the answer for me during sickness from opioids, & THAT INCLUDES PHENERGAN for nausea, as it is an anti-depressant, as well. You can TRY & this is from research currently being conducted or just wrapped up, doses of Zofran (anti-nausea medication) – it may not help, but it won’t hurt you for sure. And if it helps, hallelujah!! If not, keep searching. I hate to advocate for this, but one thing you can do to ease your withdrawal pain is to tell them you are a drinker, which means they’ll give you super-doses of benzos like Librium or Ativan (we’re talking 1mg Ativan or 15mg of Librium). Now I’m NOT a fan of lying, but when you are suffering & the doctors won’t do ANYTHING for you, you do what you have to do. It may only last 10-14 days, & that’s not going to cover the whole run of withdrawal, but it will make those first 10-14 days SO MUCH more tolerable! It’s a TOTAL shame to have to do this in jail to get help, but telling them you’re a benzo addict won’t get you tapered, & that’s dangerous. And even though we’re (most of us) not benzo addicts – like me – I know that a benzo gets rid of the WORST part of the w/drawals – the RLS/akathisia – but nothing else will (tried trazodone, SSRI’s, tri-cyclics, tetra-cyclics, anti-psychotics, & a range of other meds to help – none did. so I merely claim I can’t stop drinking, & voila, they put me on a low-dose benzo over 10-14 days, which helps me TREMENDOUSLY & even lets me sleep a tiny bit, where otherwise, no sleep whatsoever. Now Please understand, I don’t like lying, I don’t want to lie. But when nobody will put into place a procedure to help us comfortable withdrawal (if we have no methadone access or bupe access), then I don’t feel guilty for doing what it takes to be able to live until I can get either back into my maintenance program or tapered altogether. God bless you all, & good luck! And Dr Burson, I apologize for writing about lying in jail to get help, but stopping benzos abruptly can be dangerous & often is, as you know, & most, if not all jails have no policy for withdrawing benzo addicts, as I found out when I was hooked on Lunesta & they stopped me overnight. Thankfully, I had enough sense to be put on the Ativan taper for alcoholism (even though I HATE the stuff – that & marijuana), which got me through a dual detox – methadone 120mg/day & 21mg of Lunesta every 24 hours. Just the Lunesta alone was causing heart palpitations & vomiting like crazy upon abrupt cessation. So I’m glad I did what I did – it coule easily be the reason I’m alive today to be living a life of recovery now. That was in 2011, & I’ve not returned to Lunesta since except a 1-time slip up for a small number of tabs, which I got 7 at a time over a week’s period before getting a refill. That was my 1 relapse, & I have not done so since, & have no plans to return to it. I enjoy being drug free w/the help of methadone, & I enjoy paying $0/day for it in DC ESPECIALLY!!!! So I hope you are well – that is my life currently in a nutshell. You take care, & write me a brief message when you get a moment to do so.
ONE LAST QUESTION: I asked this before, but never got an answer, which isn’t like you: if dopamine is a “pleasure chemical”, then why isn’t it a controlled substance? Why isn’t it addictive? It seems like injecting it or using it in ANY form would cause euphoria like crazy, rather than movement disorders. Do you know the answer to this, by chance? Any help is ALWAYS appreciated!!!! Thanks, Dr Burson, & have a splended future!!
Sincerely,
Benjamin “Keith” Phelps
Posted by anon on October 10, 2014 at 12:45 pm
At one point, a nurse “joked” with guards that McEvoy was “faking an illness,” according to court documents.
In August 2008, when McEvoy died, “the Hillsborough County Department of Corrections did not have a written policy or protocol on opiate detoxification,” according to the documents.
However, the corrections department did have a detailed policy for alcohol detoxification.
Posted by anon on October 10, 2014 at 12:47 pm
http://www.nashuatelegraph.com/news/933657-196/suit-settled-in-case-of-hudson-man.html
Posted by Jeffrey on December 5, 2014 at 6:33 pm
Hello im about to do a 120 day jail sentence on a matter that I’m actually innocent of and ive been taking methadone for almost a year Now. im so scared of the withdraws from this medicine again that im afraid i won’t turn myself in. The jails don’t do anything for you except give you vitamins and the dts from this medicine could be life threatening, please give me some advice, guidance or whatever i just need peoples help….thx
Posted by janaburson on December 6, 2014 at 3:37 pm
I wish I could help you. My patients have this same problem: being denied treatment of their medical condition, opioid addiction, while incarcerated. While most healthy adults won’t die from opioid withdrawal, it causes significant distress and suffering. In adults with other medical conditions, opioid withdrawal can be fatal.
Get your lawyer involved if you can, and ask your opioid treatment program if they can help you, assuming you are taking methadone prescribed by a doctor.
Posted by db312 on December 6, 2014 at 8:36 pm
I have some experience with the criminal justice system. As the doctor stated, there is nothing you can do. Well, unless you’re rich enough to hire lawyers, and even then, if they actually won you case, you’d have long been over the withdrawals. The way prisoners are treated in local jails especially is subhuman and overcrowded beyond belief. The jail in my county has lost it’s certification multiple times, and I think remains uncertified now. But they just keep stacking people in there. Eventually, they’ll expand to some minimum security unit, where they continue hosting as many addicts as they manage to arrest for ‘drug dealing’ (despite these people simply being middlers or causally exchanging drugs with ‘friends’). The US has no right criticize any country’s human rights until this issue is addressed. Truly, this problem is more severe than any other in our country. It’s just not right for the beacon of freedom in the world to have the highest per-capita incarceration rate anywhere in the history of the world. Even the gulags of Russia had fewer prisoners per-capita. BUT, the war on drugs, and now terrorism, has created such a massive buildup of infrastructure, basically creating a police state – and too many people make their livings from it. So, dismantling this system seems near impossible. It will take decades in a best case scenario.
Posted by Benjamin Keith Phelps on December 7, 2014 at 4:17 am
Unfortunately, all the above is correct – you don’t have much of a leg to stand on. I have gone through methadone withdrawal in jail 4 separate times now – the first 3 times, I had not gotten stable in treatment, so I came off after about a month to 1.5 months in treatment. The last time, I’d had a slip due to medicine the clinic put me on in addition to the methadone, & I ended up arrested & in jail. I was cold-turkey’d off 120mg/day after 8 years straight in treatment. It was utter hell for almost a full 60 days, but there was not a thing in the world they were willing to do to prevent the pain & torture I went through at the jail, even after 7 days straight of being totally unable to eat & dropping weight to the point I looked frightening to the CO’s. I am not gonna say I advise this & some will take issue with it (maybe rightfully), but in theory, one might mention severe alcoholism to the intake nurse, which usually gets one treated with either Ativan or Librium (benzos) for a very short time in very small doses, which won’t make you feel good or even normal – but they WILL enable you to get through a week or week & a half without the horrific leg stuff (I say it’s more like akathisia, but some people call it Restless Leg Syndrome) & will usually help you get a wink or 2 of sleep during the time they give it to you. They’ll taper it faster than it will take for your withdrawals to go away from the opioid – it takes forever to get methadone outta your system (& buprenorphine, from all I’ve heard). But it makes the first several days bearable, which are usually the worst once withdrawal hits. If you’re lucky, they’ll give you 2 weeks of that, but many only do 1.5 or even less. Either way, I’m not gonna say you “should” do it, but it’s probably the ONLY type of help you’re likely to get. Also, there are only a few times where this applies, but every once in a long while, a bending of the truth might be called for if it prevents them from torturing you halfway to death – like this instance, which I agree, is TOTALLY uncalled for & unnecessary. And besides, a more sympathetic doc would actually use benzos to aid in opioid withdrawal sometimes anyway, as one jail doc did for me back in the mid-90’s, by giving me Valium for the first week b/c he saw how bad off I was. One word of caution: many docs, not knowing any better, will offer antihistamines or tri-cyclic antidepressants (Vistaril, Benadryl, or Phenergan for the former, Elavil, Pamelor, or Sinequan for the latter.) I HIGHLY recommend you DO NOT take those if you’re offered, whether for sleep OR nausea. Both act as antihistamines, which make some people’s withdrawals (like mine) a million times WORSE than they already were! I will get up & pace the floor like a mad man if you dose me on any of those, & get so frustrated that I’ll do stupid things, like punch a brick wall or steel bed-frame, & I NEVER punch walls or whatever from anger or frustration in normal life. My BEST advice – stay away from those things. If you get nauseous, ask for Zofran/ondansetron, as it will not do that to you like Phenergan can. Even better, if he’d give you Lomotil for diarrhea, that’s actually an opioid, so it helps some, as well, & my doc in the mid-90’s that gave me Valium also gave me that. Between those 2 things & clonidine, I actually rolled over & went to sleep within 10 minutes after several days of horrible withdrawals prior to him getting those prescribed & no sleep at all! So it’s all according to what they’re willing to prescribe to help you, but unfortunately, that usually isn’t gonna be much, & I was merely lucky to have one instance where a doc actually CARED that I was being tortured at his jail. No other doc since ever has. It’s expensive as heck, but who cares, it’s not on your dime – if they won’t give you methadone for a few pennies, let them pay up for the Zofran, clonidine (for blood pressure, which won’t make you feel any better, but will keep you from having a stroke!), & whatever else they’ll give you to help, if anything at all. So this is about all I can say on the matter. Well, this & good luck. Believe me, most of us know what you’re talking about from our own experiences, & we feel your pain. So sorry you’re facing this, especially if you are indeed innocent of what you’re there for.
Posted by Jan on July 8, 2015 at 10:22 pm
Ihave been on suboxone for over 7yrs.. I am over 60yrs old and on disability… I have warrant out for me because I’m afraid to turn myself in due to not being able to get my medicine.. I want to clear this up and do what I have to do to be done but I don’t want to go without my medication eaither and go through withdrawels and sezures.. the dr has told me before my body can’t tolerate it. What can I do? I’m afraid..
Posted by janaburson on July 9, 2015 at 12:49 am
Have you talked to your doctor? Would she be willing to advocate for you to be allowed to stay on your medication? Or even better – get your doctor to work with a lawyer on your behalf.
Posted by Diana Goodwin on July 15, 2015 at 8:01 pm
I don’t know what state you are in, but in Kentucky a woman participating in drug court is suing the state because she was going to have to go off her MAT as part of the terms. We’ve been fighting the federal prisons for 2 years now for my son’s right to be provided with MAT, no luck yet, but a lawsuit is pending. Honestly, I think your only chance is to hire an attorney.
Posted by steven florence on March 17, 2016 at 7:06 pm
Hello, I’m looking at spending some jail time in Tennessee and I have been on methadone and other opiates over 10 years. I went without my medicine once before for about 72 hrs and ended up in hospital. I’m so scared and dont know where to turn.
Posted by janaburson on March 18, 2016 at 12:05 am
Please have your doctor and your lawyer advocate for you. You should not be denied medical care while incarcerated!!
Posted by da221Tura on March 18, 2016 at 12:31 am
Should not be denied, but he has to be realistic and expect the worst.
The conditions in Tennessee local jails is beyond words. The State has operated in a perpetual state of emergency over-crowding for decades, and the local jails are literally dungeons (see Hamblen County).
Access to prescribed medication is the least of the problems. A picture is here: http://www.facebook.com/tnreform (no http so you don’t think it’s spam).
BTW, there was a recent case of a mother administering buprenorphine (Subutex) to her baby, resulting in the baby’s death, and her charge with 1st degree mother. This was Knoxville. See: http://www.wbir.com/news/local/grand-jury-mom-gave-baby-drug-40x-stronger-than-morphine/84073993
The title of the article is misleading ’40x stronger than morphine’.
Posted by janaburson on March 19, 2016 at 1:02 pm
Thank you for the reference – I read it – very sad.
Posted by John won't know on March 19, 2016 at 7:08 am
Oviously I don’t know this person but because they are someone going through something like me, does this person have any rights. Regardless of the amount of sentence will they get there methadone. At what point would they not. Please go into detail for your readers.
Posted by janaburson on March 19, 2016 at 1:09 pm
I see this as a legal issue and a civil rights issue. Obviously, physicians prescribing medications for their patients don’t want treatment to be interrupted by a sentence of incarceration, no matter what the illness. But repeatedly, patients on MAT for opioid addiction are denied their medication and in some cases, denied all medical care for ensuing withdrawal. I know there have been some high-dollar lawsuits against jails in the past for doing this – one case was awarded 3 million, I think – but despite this it keeps happening.
For my own patients, I write letters of advocacy to the court, asking them to please continue prescribed medication. Sometimes it may help, but usually my perception is that my advocacy is ignored. At that point, I think it is a legal issue and patients need a lawyer to advocate for their rights.
Posted by josiew2yahoocom on April 28, 2016 at 7:50 pm
Im currently facing a 30 day sentence in a Georgia county jail for misdemeanor shoplifting charge. As little as that seems ive been in methadone treatment for quite some time now an made the transition to subutex as soon as I found out that im pregnant. Now maybe you see my concerns cause during this 30 days I will be denied my medication which will cause severe issues an withdrawal for my unborn baby. Id it really worth the risk of loosing a baby for a minor shoplifting charge which was for hygiene products an pull ups I needed for my other small child, not to support a drug habit. I have a public defender who doesnt seem willing to even discuss my case much less fight for me and im at a loss at what I should do at this point. Any chance you have any of this information listed for the state of Georgia??
Posted by tylogirl27aax on April 29, 2016 at 12:12 am
If I may…. you have to fight tooth and nail for yourself. You are right, your public defender will do the minimum you let them get by with. Tell them if they don’t listen to you, you’ll stand up in court and express to the judge your concerns about your baby’s health, and your concerns that you aren’t being adequately represented. You have to be assertive, or else the legal system will grind you up and spit you out. Given that you have the life of an innocent at stake, you have a substantial argument that can be made. If it were just your suffering you were trying to avoid (which may be what the idiot public defender thinks), then nobody would care. Tell them the health of your baby is being risked, and back that up with maybe a letter from a doctor asserting that is true, and you have an argument. But it’s up to you to speak up. Also you may want to try to speak to the District Attorney.
Posted by Candy may on November 7, 2016 at 10:41 am
I am being charged with complexity Manufacturer methamphetamine 1st offenses and they had me out on MCR but I was going to a suboxen clincet and they revoke my MCR because I miss a drug screen and I have Heartily spherocytosis Hummillic anima and I have Hep C and I can not take the bone marrow transplant for it to help me have hpelp with my chronic fatigue pain and the theldr understand but there out of state and I have to go for them because there Dr down here can’t take care of me and they are telling me I can not have my suboxen while in on House’s arrested should I pay me a lawyer and what they trying to get me on is one thing y no
Posted by Jessi Dorsey on January 29, 2017 at 1:37 am
Say I know of a person that has been a successful candidate of the methadone treatment program for a year and a half in another state than what you have listed. This person is also about to do a 30 day sentence and can’t find a way to be allowed to continue his treatment. What are the options, can I help them in any way. He doesn’t have much time before he has to go. I’m looking for any way to help him, without this program I’m scared of what he will do and at his dose dropping him in a day will be tragic for his health.
Posted by janaburson on January 31, 2017 at 2:35 pm
that’s a terrible situation, and should be illegal. Medical care shouldn’t be denied to anyone in jail. I don’t know what recourse this person has, but his lawyer needs to advocate for him!
Posted by Becky Janas on February 13, 2017 at 2:48 pm
Many prisoners are in jail bcuz of drug addiction. 80% of them will be back in jail bcuz of no treatment and how to face your addiction. YES, MANY NEED METHADONE OR SUBOXONE TO HELP THEM MENTALLY AND PHYSICALLY. Nobody grew up wanting to b an addiction. Drugs are so easy to get in jail that without the medical attention they will just forget their sobriety and go back to drugs. I truly feel for those who need the help and the state doesn’t give a damn. The state is only making it worse in each case for the inmate. They are still human beings. Let’s start taking care of our own and teach them by offering more drug abuse classes. DO NOT TAKE THEIR MEDICATION AWAY. IT HELPS THEM MENTALLY AND PHYSICALLY. IT COULD ALSO STOP SOME OF THE VILONCE THAT GOES ON IN PRISONS. UNFORTUNATELY THE STATE DOESN’T GIVE A DAMN, THE INMATES ARE JUST A NUMBER NOT A HUMAN.
WE TREAT OUR PETS BETTER THAN WE DO OUR OWN PEOPLE. CONSTITUTION MY ASS!!! THAT ONLY APPLIES TO THE PEOPLE WITH MONEY OR KNOW THE RIGHT PERSON.
Posted by Jessica Huff on April 2, 2017 at 12:59 am
Hi my name is Jessica and I live in Illinois. I am just starting Suboxone for my opioid addiction and I have to do some jail time in the Grundy county jail for driving on suspended and I’m scared to death bc I called the jail and I was told that I wouldn’t get my Suboxone. The jailer told me that I wouldn’t die from the w/d and that I would be “clean” when I get out! I told her that I was clean and this is life or death for me. I am scared to death to go to court now….Any suggestions on what to do??? Or who to contact for legal advice in Illinois.
Posted by janaburson on April 4, 2017 at 2:21 am
This IS a legal question, and I don’t know any lawyers in Illinois, sorry.
Also, please ask your doctor to write a letter outlining what the medication does, that it prevents relapse and overdose, and that it’s very important for the medication to be continued. That may or may not help. I’ve written plenty of such letters and it’s rarely helped, but at least I’ve provided the information.
I contacted the ACLU once, asking if they could get involved in these situations, which are all too common. They said the patient had to contact them, not the doctor.
there’s also the Legal Action Center in New York. I doubt they can do much in Illinois, but on their website you can read and print some position statements and eloquent legal arguments about why continued medication in jail should be considered a basic human right:https://lac.org/
Posted by Miranda on May 4, 2017 at 11:37 am
I am facing iminant incarceration and I know that I will be denied the methadone that has saved my life. I’m 6 months 12 days clean today after using IV heroin for over 8 years. So now I’m on the run constantly looking over my shoulder because I’m so scared of going in and withdrawing.
Posted by janaburson on May 7, 2017 at 1:37 pm
This is an awful situation. No one should be denied evidence-based, life-saving treatment because of incarceration.
Posted by Judith Gillett on June 11, 2017 at 8:47 pm
I am a criminal defense attorney in Maryland and I have offered my services for free to clients taking maintenance withdraw medications who face jail sentences in facilities that refuse to provide their lawfully prescribed medication and the problem I’ve yet to overcome is the refusal of the medical providers to come to court to testify. I know doctors hate coming to court, I get it. Letters don’t cut it and live testimony is absolutely essential. Once the precedent is set by several inmates successfully challenging this and the jail managing to provide the medication without issues, future inmates should find it much easier to obtain their needed medications. However, it’s not going to happen without a court battle, and court battles require live expert witnesses.
Posted by janaburson on June 12, 2017 at 12:31 am
I’m appalled that the physicians wouldn’t want to come and help.
I wish you practiced law in my neck of the woods.
Posted by liz3518 on June 12, 2017 at 1:06 am
Reblogged this on My Sharing Blog.
Posted by Marcee Adams on June 24, 2017 at 5:10 pm
I almost died from nonstop seizures while in Pima County Jail, in Tucson Arizona, when they refused all the medication I wa prescribed by my Psychiatrist for Bipolar, severe Anxiety and severe Depression. I have epilepsy and have been taking benzodiazepines for over 20 years. I SLO’s take Effexor, Gabapentin and Trazodone. The jail denied me any of my prescribed medications! I am 61 years old and have numerous physical medical conditions, as well as Severe Mental Illness. None of the medications I take are supposed to be stopped cold turkey, and death can occur if stopped suddenly. I was in severe pain as well as the numerous seizures caused by this sudden withdraw. I did not receive any medical care for my withdrawls and was put in the psyc unit, where I was left alone to suffer. I could not eat and lost over 20 lbs in three weeks. I weighed 94 lbs when I entered the jail and when I was bonded out after three months I weighed 72 lbs. I was lucky to be alive. I believe I would have faced certain death if I had not been released. No one cares in the system if inmates die of have constant seizures they just donn’t care at all!
Posted by janaburson on June 27, 2017 at 1:38 am
Horrible!
I think it is going to take lawsuits against these jails to get things to change.
Have you considered contacting the ACLU in your state, to see if you have a case?
I would say your 4th amendment rights were clearly violated…but then…I’m not a lawyer
Posted by Grace Crain on August 28, 2017 at 3:47 pm
Hello l want to contact you immediately. I apologize for the haste, however l am due to surrender 9/1/17 and am hoping for my extention paperwork to go thru and get an available bed in our local residential program. However, if denied l am facing up to 3 months without suboxone. I have recently gone from 60 mg of methadone down to 6 mg suboxone with a doctors care. The charge is petty theft and possesion of a controlled sub a year ago. I am 46 and have a laundry list of issues, while none life threatening on their own. I was in jail a few months ago on an old warrant out of county and thought my heart would stop a few times. This prejudice attitude infuriates me as much as it terrifies me. Can you help? Thank you for fighting for us. The struggle is real.
Posted by janaburson on August 29, 2017 at 1:38 am
I can only recommend that you get good legal help. This is a legal issue as well as a medical one. Your doctor may be willing to work with your lawyer to put treatment recommendations into writing for the judge. It’s worth a try. Let us know…
Posted by Peggy Ritchey on November 19, 2017 at 3:51 am
I am a patient of buprenorphine that is about to be incarcerated the reason I have been this prescribed beer for nephron is not for opioid dependence but actually for chronic long-term back pain management I am afraid that when I get sentenced to upwards of 5 years that I will be denied treatment. I am willing to start seeking a lawyer’s help as it is outside the scope of my attorneys practice
I do have a concierge physician willing to state that he put me on Suboxone therapy for long-term pain management
I do not know what type of attorney to contact. Please any information that you might be able to give me in this matter would greatly be appreciated.
Posted by janaburson on November 19, 2017 at 1:07 pm
Sorry, but I don’t know an attorney who can help you. In the medical field, if the doctor you are seeing can’t handle the problem, she refers you to a specialist. I would have assumed your attorney would do the same.
If you live in New York, The Legal Action Center can help you. But it’s my understanding they don’t practice outside that state.
You could try contacting the ACLU in your state.
Posted by Sheila miller on November 29, 2017 at 1:01 am
I find your letter here i just read very interesting. I also see it was wrote in 2009. My son just went to jail in washington state. He has been going to the suboxen clinic over a year now.. they let him have the last of his perscrition in jail. But he has a appointment every 2 weeks. And for all the good it has did. Now they wont let him out to go to his appointment to get a refill. Wow. Any advice?
Posted by Jennie on December 11, 2017 at 11:25 pm
Seems to me another controlled substance is not the answer. If these people want to get better they would want serious counseling and medications that are non addictive. Opioid addicts do not want true help they want an easy out and a quick fix
Posted by janaburson on December 12, 2017 at 12:41 pm
This is a commonly held view, despite all the studies that show improved quality of life (not to mention lower risk of death!) provided by medication-assisted treatments with buprenorphine and methadone. It makes me sad that so few people care what the science shows.
Posted by John on January 9, 2018 at 1:15 am
I know that forced withdrawal from Methadone is one of the most Inhumane things you could do to a person, I have had it done to me. I was lucky though that I wasn’t in Prison. I have spent close to 2 years in Prison though and could not imagine how vulnerable to being bashed, raped or suicide, it is just crazy making people go though that. I am so glad you are putting your hand up to help if you can. Luckily in Australia we can be dosed daily.
Posted by Summer Eger on February 12, 2018 at 2:07 am
Yes I am in the situation right now and for Non-jailable offenses and I have nobody to advocate for me my attorney isn’t really telling me anything except the fact that I got to meet him in a courthouse and hope that the judge will have mercy on me I’ve already been hospitalized had surgery from pregnancy I’ve already lost a pregnancy from stress over a warrant it’s just hard I don’t know how to take care of this I’ve worked so hard and so long to get where I’m at in my recovery and it could all be jeopardized by me trying to take care of my legal situation I can’t get an apartment I can’t get a job I can’t do anything but I also need to be on this medication because I’m not trying to go backwards in my life i’ve seen way too many of my friends lose their lives because of the alternative and I don’t ever want to go through that I really don’t know what to do myself I’m stop being scared really scared and I don’t have anyone to help me either no friends no family no nothing!
Posted by janaburson on February 13, 2018 at 1:03 pm
Your lawyer is the key person to be able to help you. Keep calling him/her!
Posted by Sarah on October 17, 2018 at 9:13 pm
So what if you’re on MAT Subutex and you’re pregnant?? There is a jail in Indiana that will refuse to give me my subutex and my baby is dependent on that as I am for the health of my baby. Is it possible to get a court order for subutex? I will be doing 100 days in jail and last year there was a pregnant woman 6 months who went to the methdone clinic and they refused to give her her medication and she went into preterm labor and they told her she was faking until 2 days later and they realized she wasn’t. Then they started giving her Tylenol 3s. So how would I handle getting my subutex in jail?
Posted by janaburson on October 19, 2018 at 8:51 pm
You must get your lawyer to help you. Hopefully your physician can work with your lawyer to advocate for your treatment.
Posted by Justin smith on February 1, 2020 at 3:43 am
Hello, My name is Justin. I live in greenup county Kentucky. (unfortunately) This coming Monday I will be going to find a lawyer who can assist me in a aggravated DUI case. What I understand is that I could be facing up to 90 days in jail for aggravated DUI. I have had issues with dependence for almost 12 years. I recently started a Suboxone treatment and I have not had a positive drug test since I started. I do not want to spend time in jail, away from my children, risk losing my job and be denied my medication all for one mistake. This is my first time having any legal issues and the only thing that scares me is going to jail to be placed in freezing cold room, to sleep on the ground for several days while withdrawing from Suboxone.
Posted by Justin smith on February 1, 2020 at 3:45 am
Sorry to reply to my own comment but I was also diagnosed with Hep B and C and I am afraid that withdrawing could be more serious then just “Drying out in a jail cell” in my case.
Posted by janaburson on February 1, 2020 at 2:10 pm
If you don’t have money for a good lawyer, or if you can’t find a lawyer who is familiar with the discriminatory issues at play, I’d recommend contacting the ACLU of Kentucky and see if they will take your case or help you with your case.
Posted by Jamie Wright on July 26, 2020 at 6:49 am
I just want to thank you for aactually. Caring about your patients my be is locked up and i am worrying about him coming off of methadone I have done it its horrable the last time he had to be hospitalized I am afraid if they don’t pay attention what can happen we are both doing great have jobs sober doing everything right and they are locking him up over a trafficc ticket for 30 days because of covid 2 weeks and then they have to call the county to see if he has to do two weeks there because they can’t transfer without corrintine I don’t know what to do we are about to lose everything we have worked the last year and a half building because he forgot about a ticket
Posted by janaburson on July 26, 2020 at 3:21 pm
It’s crazy for a patient with a potentially fatal disease, opioid use disorder, to be forced to undergo withdrawal from methadone because of a traffic ticket. I don’t know if his physician can do anything, but perhaps can provide a letter outlining the physical suffering your husband will endure, and the increased risk of overdose death once he’s released could help.
Surely there are other punishment options for a traffic ticket that don’t involve the risk of death!
Posted by Dana meyer on September 10, 2020 at 6:49 pm
I got addicted to pain medication when I was 37 never did a drug in my life, anyways I was prescribed vicodin for my leg becuz of an accident years prior, and I had severe leg pain and had to work, and then I didn’t know much about opiates and in them for 2 1/2 years
and I did illega and my tolerance growl stuff my mind was so fogged from opiates, anyways I quit on my own and the physical withdrawals were horrible for about 5 days. and then I felt better still didn’t have alot of energy n couldn’t sleep much, after a month I had horrible cravings it was so bad that I got on suboxone, n of course I had to do a few short stays in jail 10 days n 5 days and ve sthey wouldn’t let me suboxone and I could not sleep I was so sick n it was awful and the jail nurse
was rea did not care at all mean and I think its ridiculous n this is in Minnesota, ottertail county and the city is Fergus falls and their were several people also really sick cuz they could not have their medication. N also I was on suboxone to for my leg pain. Jail is bad enough and you also have to be in their sick and can’t sleep and in pain even though my jail were shorter periods of time it w As S hell and I was crying n the jailers treated you like garbage they didn’t care u had withdrawals n it’s not right…
Posted by Jeana on October 28, 2021 at 2:53 am
I know this is an old post but I an still very PASSIONATE on this subject. I am a recovering addict. I am where I need to be to intern as a c-sac substance abuse counselor but I am debating taking the L-SAT toward a law degree. I have been on methadone 12 years and jailed a half dozen times A decade ago, and refused my medication. I was clean and begged to keep on my oath. To make matters worse I couldn’t return to clinic clean… I had to use an opioid to ensure I could return to treatment. I wasn’t stable enough to be completely tapered yet.. Crazy right?
Posted by Robert Hobbs on November 12, 2022 at 7:25 pm
I just done six months in limestone county jail Alabama I’m a addict that had been on Subutex for 3 yrs I’m 100% disabled and was denied my meds I’m currently in a re-entry program an still denied my meds they say I’ll be put back in jail if I go to my doctor I not only take the Subutex for addiction it also makes my pain easier to handle I need a lawyer