Suboxone Patient Wins Lawsuit

 

 

 

 

In Maine, as in most other states in the U.S., patients on medication-assisted treatment for opioid use disorder weren’t allowed to take their life-saving medications while incarcerated.

All that changed in October of this year, when the American Civil Liberties Union settled a lawsuit with the Maine Department of Corrections. The ACLU sued on behalf of Zach Smith, who has been on Suboxone for five years as treatment for opioid use disorder. He was told he would have to stop taking Suboxone during his incarceration. I wrote of the pending case in my blog on August 12, 2018.

We know that if denied his medication, he would go through physical opioid withdrawal and would be at higher risk for overdose death, particularly immediately after release from incarceration.

The ACLU took his case and settled a lawsuit with the Maine Department of Corrections, which ultimately agreed to allow him to continue on his medication. Jailers warn that this was a “special case” and that they would not necessarily allow other prisoners to take buprenorphine as prescribed by a physician. However, this appears to be a clear precedent for other patients and other lawsuits.

I think this is a landmark case for our patients. MAT is the standard of care, and it should be illegal to refuse to provide this treatment to people who are sentenced to incarceration. The diversion of Suboxone films has been an issue for many years because patients in opioid withdrawal can’t access suboxone through any legal channel. This creates a black market for suboxone, and jailers across the country have complained loudly about this situation – that is of their own creation.

The ACLU is supporting patients in their fight to continue medication-assisted treatments during incarceration is other states, too. According to the ACLU website, a similar case is pending in Washington state.

If you are a patient – or know a patient – who is being denied medication-assisted treatment during incarceration, I hope you have a lawyer who is willing for fight for your rights. If you do not, consider reaching out to the ACLU in your state:

For North Carolina: https://www.acluofnorthcarolina.org/

 

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6 responses to this post.

  1. Posted by Britney Lipsett on December 1, 2018 at 10:26 pm

    I have a serious situation I need help please will you respond

    Sent from my iPhone

    >

    Reply

  2. Posted by Rocky Hill on December 3, 2018 at 2:11 am

    Good news, but jails and prisons are still reluctant to embrace MAT. I received a call two months ago from an attorney wanting consultation on a case that he had filed against a California county jail for $2.8 million. He was terrified as he had little understanding of psychoactive substances or dependence. His client had been arrested, first offense on a DUI of .09 and incarcerated. He had been treated by Psychiatrist for bi-polar disorder with seroquel, paxil and Xanax for ten years. The patient, his Psychiatrist, family and family doctor, all, begged the jail to allow him to stay on his treatment regimen. By the time he called me, he inmate had experienced a seizure at day 3 that the attending nurse referred to him “falling down”. He was delusional, hallucinating and in extreme discomfort. On the eighth day, the physician saw him, assessed his situation and determined that he had detoxed off of the Xanax and that he would see him in seven days. The jail staff placed him in solitary, but forgot that there was a pencil in the cell. He was so desperate to stop the withdrawal that he stuck the pencil in his eye, hoping to reach his brain and kill himself. When he couldn’t reach his brain, he took it out, stuck it into his other eye and slammed his face into the concrete wall. The pencil, fortunately, angled to the inside of his skull and he was taken to the hospital with the pencil well into his eye but not into any brain tissue.
    The attorney asked me to write a statement, as to what I would testify to, at trial. It’s unnecessary to repeat the five page declaration, however, the attorney called to inform me that the county counsel had asked to meet but that he had no confidence that they would be willing to settle. Two days later, he called to thank me and let me know that they had elected to settle the case for a figure close to the demand. This is not the first time this has happened to me. Another incident, in which, one of our patient’s was delusional and took her daughter to the local police dept. after her friends flushed her prescribed valium down the toilet. I went to the station to inform the officer that she was not delusional due to methamphetamine, but rather could die from her friend’s mis guided actions. They, too, incarcerated her, gave her daughter to cps. She became increasingly delusional but multiple calls to the nurse advising her that the parents were prepared to sue the county if she died, fell on deaf ears. I called with my own threats to assist the parents in any litigation were ignored as were pleas for her well being. Finally, I called the nurse on duty and informed her that I would be contacting the nursing board with a complaint should anything happen to this 20 year old. That change in tactic prompted a call, by the nurse, to the hospital. An ambulance took her to the hospital and she was placed in ICU for five days.
    Our local Sheriff’s have refused to provide their deputies with naloxone, despite many incidents in which it would have saved lives as they were the first responders.
    It is time for the public to demand that their governmental leaders insist that MAT be integrated into their protocol and that the culture of seeing substance abusers as not deserving of care are challenged and changed.

    Reply

  3. Posted by Martin on December 3, 2018 at 9:54 am

    While MAT is superior to abstinence based treatments in most treatment settings, wouldn’t incarceration without access to drugs be one of the rare treatment settings where abstinence would have comparably good prerequisites to work?

    I acknowledge that abruptly withdrawing a prescribed medication is not acceptable patient care, however could not a medical taper followed by abstinence be an acceptable option to institutions that do not wish to handle large amounts of scheduled substances? When indicated, they could then be reinstated on MAT for protection against overdose upon release.

    Reply

  4. Posted by Charlene Jordan on December 3, 2018 at 3:00 pm

    Testing

    Reply

  5. Posted by Charlene Jordan on December 3, 2018 at 3:54 pm

    Goodmorning doctor, and everyone else, I’m a buprenorphine patient since 2005, I can’t tolerate the naloxone so I take subutex. I happened to be withdrawing one weekend. I had ran of of my pain pills, I looked all week to get an appointment to get them with no luck..I didn’t have any resources to buy on the streets I was a doctor hopper here in southwest Florida where this opoid crisis mostly happened. So I was flipping through a magazine and it was an advertisement for suboxone treatment. Someone must have been looking out for me from above. I read the article and ran to my husband.i said to him could this be my answer to get help? I got the telephone book out and started to search. It was hard because withdrawing I had the symptoms of bad withdrawals. Anyway I made several calls and no luck finding a doctor in the area because the treatment was so very new. After several calls that day..one doctor almost 2 hours away said I could have a appointment and they even took my insurance..the lady said u can have a appointment in like 3 weeks..I was almost crying telling I’m in great pain now are u sure I cannot come today. Lol..like that’s going to happen right?.. shel then said can u be here in 3 hours? I said oh yes,yes, yes…I ran to my husband in tears and said come on let’s get dressed and ready I have a appointment today in a few hours and its q few hours from our home. Fast forward the doctor most definitely noticed I was in withdrawals. Back then they prescribed much different than today..I only know it because doctors come and go..or u just might need to find a different one for several other reasons. Back then they would ask what pulls u have taken, how long have u been abusing. Just much different. So he gives me 4 8mg buprenorphine a day..so anyway since the I have been on different doses because nowadays its different most doctors around here and insurance wise the most is 3 8mgs/day. Now I eventually had a different doctor at this time. My newly dose of buprenorphine was back up to 4 8mg/day..along with xanax 2mg x 4/ daily..valium 10mg x1/nightly. Along with my depression meds.i was on those meds for a long time. No one in my family or friends could possibly imagine me of all people in JAIL?? YES I Was.. A FEW TIMES ON AND OFF FOR Stupid things I did.its embarrassing I never shop lifted in my life and if I was never under the influence of xanax it would have never happened..I felt invisible as if nobody can see what I’m doing. I stole only a couple times. By the 3rd time I have created a record for myself with the police department. I was cought not only did I shoplift this time again but I decided I would probably be out of the house longer than normal I took a little pills case with my xanax and buprenorphine. Get this I had no idea if u are going to carry pills even if they are your prescription and not bought off the street, u better halve proof some where on u or in your car..I had nothing. So arrested for shoplifting plus pills a few of each that looks like I’m selling..however I would never sell my pills I LOVED THEM TO MUCH ..♡♡♡ my husband got a lawyer for me. They got the proof the pills are mine..but because of being arrested before I had no bond..I couldn’t believe it and the shame I felt was terrible.. because of different loop holes I spent almost 3 to 4 months..and for the first two months of withdrawaling was omg just something I had never experienced before. I mean not even tylenol do u get..I was labeled the crazy lady, by everyone except a few because I guess I had crazy dreams and illusions that were not real…so yes, I was crazy I suppose. My husband would visit me after working 9 hours only to come home, shower take care of my 2 baby dogs I love so much. On top of daily chores and a disabled son of 25 years old. I do have 2 daughters who have been a great help to him by taking turns to help around the house….OK IM GOING TO END MY LONG SAD STORY AND SAY THANKS TO ANYONE WHO ACTUALLY READ THIS..I HAVE NEVER WRITTEN ABOUT THIS BEFORE I DON’T KNOW WHAT MADE ME FEEL TO DO THIS TODAY..OTHER THAN MY STORY IN JAIL WAS JUST LIKE THIS EXCEPT I DIDN’T DIE..ITS BEEN 7 YEARS NOW THE FIRST YEAR OUT I ATTENDED WHATS CALLED DRUG COURT. I ENDED UP BEING THE BEST THING I EVER DID AND STILL MISS IT TODAY. IM STILL ON BUPRENORPHINE TREATMENT AND DOING BETTER THAN EVER. I HAVE 2 SISTERS ON METHADONE TREATMENT WHO CLAIM THEY STILL CRAVE..FROM MY FIRST 4 8MG OF BUPRENORPHINE THAT DAY ON THE DRIVE HOME I NEVER CRAVED OR LOOKED BACK..THE ONLY THING I EVER THOUGHT OF IS WHAT DOES METHADONE TREATMENT FEEL LIKE. MY LITTLE SISTER WELL SEEMS TO RUB INTO ME HOW GREAT IT IS COMPARED TO MY TREATMENT. AND I WILL ADMIT SOMETIMES I FEEL JEALOUS OF THE HIGH SHE GETS..IM NOT REALLY LOOKING FOR A HIGH..MAYBE AN EXTRA LITTLE FEEL GOOD..I DONT KNOW THE FIRST THING ABOUT METHADONE EXCEPT I HAVE BEEN TOLD IM BETTER OFF ON BUPRENORPHINE BECAUSE A HIGH DOSE OF MEDICATION IS VERY HARD TO DEROX..MY SISTER SAYS WHO CARES ABOUT THAT I PLAN ON GETTING THIS FOR LIFE. SHE GETS TWO DOSES A DAY CALLED SPLIT DOSE..AROUND 115 X 2 DOSES ??. OK THX CHARLENE

    Reply

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