SUMMARY OF THE ARGUMENT

There is consensus within the medical community, locally, nationally and internationally, recognizing SUD as a disease of the brain. The 2016 Surgeon General’s Report on Alcohol, Drugs and Health entitled Facing Addiction in America (“Surgeon General’s Report”), includes the finding that “addiction is a chronic neurological disorder and needs to be treated as other chronic neurological conditions are.” Id. Message from the Secretary, U.S. Department of Health and Human Services. See also American Psychiatric Association Diagnostic and statistical manual of mental disorders (5th ed.) at 483 (2013) (“DSM-5”) ("[a]n important characteristic of substance use disorders is an underlying change in brain circuits") and Volkow et al., Neurobiological Advances from the Brain Disease Model of Addiction, 374 N. Eng. J. Med. 363-71 (2016) (“Volkow”).

Punishing relapse without considering the clinical course of SUD, which is characterized by repeated substance use despite destructive consequences, physical dependence, and difficulty abstaining notwithstanding the user’s resolution to do so, will not effectively accomplish the intended goal of deterrence. Relapse is a feature of SUD, and the risk of relapse continues throughout the course of active treatment. Factors such as comorbid mental health disorders and stress may increase or aggravate the risk of relapse.

The District Court’s decision to incarcerate Ms. Eldred for testing positive for fentanyl does not reflect consideration of the substantial evidence regarding effective treatment of SUD or consideration of the scientific knowledge regarding her ongoing risk of relapse. The punitive approach employed in this case has been shown to decrease the likelihood that people with SUD will seek out care. It can also have a detrimental effect on the quality of care received. Thus, it is Amici’s position that the approach taken by the District Court in this case undermines both individual and public health.

SUMMARY OF THE ARGUMENT

Medical professionals widely agree that substance use disorder (SUD) is a disease affecting the brain. Major reports and clinical guidelines support this view. For instance, the 2016 Surgeon General’s Report on Alcohol, Drugs, and Health describes addiction as a chronic neurological disorder. This report suggests treating addiction in the same way other long-term neurological conditions are managed. Clinical manuals also note that changes in brain circuits are a key feature of substance use disorders, and scientific research continues to highlight these neurobiological aspects.

Relapse is a common characteristic of substance use disorder. It involves returning to substance use despite efforts to stop and understanding of negative consequences. Punishing relapse does not effectively stop it because it is part of the illness itself. The risk of relapse continues throughout treatment. Other mental health conditions and stress can increase this risk.

The District Court's decision to incarcerate an individual for a positive fentanyl test did not account for effective SUD treatment methods or the scientific understanding of relapse risk. A punitive approach has been shown to reduce the likelihood of people seeking help for SUD. It can also worsen the quality of care they receive. Therefore, this approach works against both individual and public health goals.

SUMMARY OF THE ARGUMENT

Medical professionals worldwide agree that Substance Use Disorder (SUD) is a disease affecting the brain. Major reports, such as the 2016 Surgeon General’s Report on Alcohol, Drugs, and Health, confirm that addiction is a long-lasting neurological condition. This means it should be managed similarly to other chronic brain disorders. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) also notes that significant changes in brain function are a key feature of SUD.

Relapse, or the return to substance use, is a common and expected part of Substance Use Disorder. Individuals with SUD often continue using substances despite harmful outcomes, develop physical dependence, and struggle to stop even when determined to do so. Therefore, simply punishing a relapse without understanding how SUD progresses will not prevent future substance use. The risk of relapse remains present throughout an individual's treatment. Other mental health conditions and high stress levels can significantly increase this risk.

The District Court's choice to jail Ms. Eldred for a positive fentanyl test did not account for the extensive research on effective SUD treatment or the scientific understanding of relapse risk. Using punishment in such cases typically makes individuals with SUD less likely to seek professional help. It can also reduce the overall quality of care they receive. Consequently, this punitive method harms both the individual's health and the broader public health.

Summary of the Argument

The medical community, both nationally and internationally, generally agrees that Substance Use Disorder (SUD) is a disease of the brain. A 2016 Surgeon General’s Report on Alcohol, Drugs, and Health stated that addiction is a chronic neurological disorder, meaning it is a long-term brain condition that requires treatment similar to other such conditions. Other medical texts also highlight that SUD involves changes in brain circuits.

Punishing someone for relapsing, without considering the typical course of SUD, does not effectively prevent future substance use. SUD often involves repeated use despite harmful consequences, physical dependence, and difficulty stopping even when a person intends to. Relapse is a common characteristic of SUD, and the risk of it continues throughout active treatment. Factors like co-occurring mental health disorders and stress can increase or worsen the risk of relapse.

The District Court's decision to incarcerate Ms. Eldred for testing positive for fentanyl did not account for the extensive evidence on effective SUD treatment or the scientific understanding of her ongoing risk of relapse. This type of punitive approach has been shown to decrease the likelihood that people with SUD will seek necessary care. It can also negatively affect the quality of care they receive. Therefore, this approach undermines the health of both individuals and the wider public.

Summary

Health experts and doctors all over the world agree that addiction is a disease of the brain. It is seen as a long-term problem with the brain, much like other long-term health conditions.

People who have addiction often go back to using drugs or alcohol, even when they know it is harmful. This is called a relapse. Relapse is a common part of addiction, and the chance of it happening can last through treatment. Things like other mental health problems or stress can make a relapse more likely. Punishing someone for a relapse does not usually help them get better.

The court's decision to put Ms. Eldred in jail for relapsing on fentanyl did not consider what is known about treating addiction or why relapses happen. This kind of punishment can make people with addiction less likely to seek help. It can also hurt the quality of care they receive. Therefore, this approach hurts both the person and the health of the community.