Introduction

Statistics about number of people in correction setting with Substance Use Disorder (SUD)

The National Institute on Drug Abuse estimates that at least 65% of the people who are incarcerated in the United States have Substance Use Disorder (SUD). Although another 20% do not meet the official criteria for SUD, they were under the influence of drugs or alcohol when they committed their crime [1].

Statistics about use of Medication-Assisted Treatment (MAT) in correctional facilities

Medication-Assisted Treatment (MAT) is an evidence-based treatment, when combined with counseling and other therapeutic techniques, provides a whole-patient approach to recovery [2]. In 2021, the O’Neill Institute for National and Global Health Law at Georgetown University Law Center conducted a study titled, A National Snapshot: Access to Medication for Opioid Use Disorder in U.S. Jails and Prisons Litigation, Legislation, and Policies. It was a 50-state review of current laws, policies, and court actions related to access to Medications for Opioid Use Disorder (MOUD) in correctional facilities in the United States as of April 2021 [3]. A review of the report found that 34 states and the District of Columbia use at least one form of MAT. Nine states allow the use of all medications approved by the U.S. Food and Drug Administration to treat OUD.

Brief overview of coverage under the Americans with Disabilities Act (ADA) for individuals with Opioid Use Disorder (OUD)

The Americans with Disabilities Act (ADA) ensures that people with disabilities have the same rights and opportunities as everyone else. This includes people who are addicted to alcohol and people in recovery from opioid or other drugs [4]. Title II of the Americans with Disabilities Act (ADA) covers the programs and services provided by state and local governments. This includes correctional facilities [5]. Correctional facilities are required to make reasonable modification to policies and practice to allow inmates with Opioid Use Disorder (OUD) to have access to Medication Assisted Treatment (MAT). Five states, however, do not offer MAT for prisoners and thirty-four states put limits on treatment options. A failure to provide MAT results in painful withdrawal and a high risk of relapse when released from jail. Additionally, former inmates with OUD are 129 times more likely to overdose within the first two weeks of release [6]. The Journal of the American Medical Association states that “not treating a drug-abusing offender is a missed opportunity to simultaneously improve both public health and safety. Integrating treatment into the criminal justice system would provide treatment to individuals who otherwise would not receive it, improving their medical outcomes and decreasing their rates of reincarceration [7].

Materials and Methods

The material in this article was developed based upon the authors’ research, training, education, and knowledge of the Americans with Disabilities Act (ADA).

Results and Discussion

Medication-Assisted Treatment (MAT)

What is MAT?—Medication-Assisted Treatment (MAT) is an evidence-based treatment, when combined with counseling and other therapeutic techniques, to provide a whole-patient approach to recovery. MAT is commonly used for treatment of Opioid Use Disorder (OUD) and relies on medications to normalize brain chemistry and bodily functions, block the euphoric effects of opioids, and relieve physiological cravings. The Food and Drug Administration has approved three drugs to treat OUD: methadone, buprenorphine, and naltrexone [8].

Availability in correctional settings

In 2021, the O’Neill Institute for National and Global Health Law at Georgetown University Law Center conducted a study titled, A National Snapshot Access to Medication for Opioid Use Disorder in U.S. Jails and Prisons Litigation, Legislation, and Policies. It was a 50-state review of current laws, policies, and court actions related to access to Medications for Opioid Use Disorder (MOUD) in correctional facilities in the United States as of April 2021 [9]. A review of the report found that 34 states and the District of Columbia use at least one form of MAT. Nine states allow the use of all medications approved by the U.S. Food and Drug Administration to treat OUD.

ADA Title II coverage of state and local correctional facilities

ADA Title II overview: Title II of the ADA applies to all state and local government departments and agencies including the criminal justice system (e.g., jails, prisons, probation, and courts). The ADA requires that all programs, services, and activities are accessible to and usable by people with disabilities [10].

Court cases

Pennsylvania Department of Corrections v. Yeskey: In 1998, the U.S. Supreme Court held in the Pennsylvania Department of Corrections v. Yeskey (524 U.S. 206, 1998)) [11] that Title II applies to state prisons. In this case, Ronald Yeskey was denied placement in a motivational bootcamp due to a medical history of hypertension. Participation in the bootcamp would have reduced Yeskey’s sentence from 18–36 months to six months. Based on Yeskey, other courts have determined that the ADA applies to medical services as well as other programs and services provided by state and local correctional facilities [12].

Pesce v. Coppinger: In 2018, in Pesce v. Coppinger, Civil Action No. 18–11972 DJC [13], Geoffrey Pesce was sentenced to 60 days in a Massachusetts prison for driving on a suspended license. At the time, he had successfully completed two years of MAT and was considered in recovery. The prison denied Pesce access to MAT, forcing him into painful withdrawal. The denial of medical services by the prison was found to be a violation of both ADA Title II and the 8th Amendment of the U.S. Constitution, cruel and unusual punishment. The court ruled in Pesce’s favor [12].

Smith v. Aroostook County: In a 2019 case, Smith v. Aroostook County (376 F. Supp. 3d 146) [14], plaintiff Brenda Smith was taking buprenorphine prescribed by her doctor to treat her OUD. At the time she was sentenced to a 40-day term in the Aroostook County Maine jail she was ten years in recovery. The jail’s policies denied the use of MAT by inmates, except for those inmates with OUD who were pregnant. Smith sued the jail saying that the jail’s policies violated her rights under the Title II of the ADA “by denying her the benefit of the jail’s health care program because of her disability or by refusing to make reasonable modifications to a policy or practice in order to allow her to access necessary treatment for her disability.”

The jail claimed that inmates were prohibited from using MAT out of security concerns. The court ruled in favor of Ms. Smith, noting that there are several ways in which the jail could safely provide inmates with MAT. In its ruling, the court said that denying Smith’s medication was unjustified and unreasonable “as to raise an inference that the jail denied the Smith’s request because of her disability.” Alternatively, the court found it likely that the Smith would succeed in her case based on the theory that she was denied a reasonable modification by the jail. The court noted the jail already allowed MAT for pregnant inmates, so it was reasonable for the jail to provide the same accommodation to Smith. In April 2019, the U.S. Court of Appeals for the First Circuit affirmed the case, making it the highest court to rule on the issue [2].

Conclusion

Medication Assisted Treatment is a proven effective treatment for Opioid Use Disorders. MAT reduces the number of people who die each year from OUD by fifty percent and ninety percent of individuals in recovery maintain sobriety after two years. Yet misconceptions that MAT is exchanging one addiction for another persist [15]. The Substance Abuse and Mental Health Services Administration (SAMHSA) report that sixty-five percent of people in correctional facilities meet the criteria for SUD and people on parole are three times more likely to have SUD than the general population. Correctional facilities must make reasonable modification to policies and practice to allow inmates in recovery to have access to MAT. Correctional facilities should be a first line of support for those in recovery, making communities safer [16].

Introduction

Statistics about number of people in correction setting with Substance Use Disorder (SUD)

Research indicates that approximately 65% of individuals in United States correctional facilities have Substance Use Disorder (SUD). An additional 20% of incarcerated individuals, while not meeting the full criteria for SUD, were under the influence of drugs or alcohol at the time their offense occurred.

Statistics about use of Medication-Assisted Treatment (MAT) in correctional facilities

Medication-Assisted Treatment (MAT) is recognized as an evidence-based approach that, when combined with counseling and other therapeutic interventions, offers a comprehensive pathway to recovery. A 2021 study by the O’Neill Institute for National and Global Health Law at Georgetown University Law Center, titled "A National Snapshot: Access to Medication for Opioid Use Disorder in U.S. Jails and Prisons Litigation, Legislation, and Policies," reviewed laws, policies, and court actions concerning access to Medications for Opioid Use Disorder (MOUD) in correctional settings across all 50 U.S. states as of April 2021. The review found that 34 states and the District of Columbia utilize at least one form of MAT, with nine states permitting the use of all medications approved by the U.S. Food and Drug Administration for Opioid Use Disorder (OUD) treatment.

Brief overview of coverage under the Americans with Disabilities Act (ADA) for individuals with Opioid Use Disorder (OUD)

The Americans with Disabilities Act (ADA) ensures that individuals with disabilities have equal rights and opportunities. This protection extends to individuals with alcohol addiction and those in recovery from opioid or other drug use. Title II of the ADA specifically covers programs and services provided by state and local governments, including correctional facilities. These facilities are required to implement reasonable modifications to policies and practices to ensure inmates with Opioid Use Disorder (OUD) can access Medication-Assisted Treatment (MAT). However, five states do not offer MAT for prisoners, and 34 states impose restrictions on treatment options. The failure to provide MAT can lead to painful withdrawal symptoms and a high risk of relapse upon release from incarceration. Furthermore, former inmates with OUD are significantly more likely to experience an overdose within the first two weeks post-release. Integrating treatment within the criminal justice system is considered an opportunity to improve both public health and safety, providing necessary care to individuals who might otherwise not receive it, thereby enhancing medical outcomes and reducing reincarceration rates.

Materials and Methods

The information presented in this article is derived from the authors’ research, training, education, and understanding of the Americans with Disabilities Act (ADA).

Results and Discussion

Medication-Assisted Treatment (MAT)

Medication-Assisted Treatment (MAT) is an evidence-based approach that combines medication with counseling and other therapeutic methods to provide comprehensive care for individuals seeking recovery. MAT is frequently employed in the treatment of Opioid Use Disorder (OUD). It uses medications to help normalize brain chemistry and bodily functions, block the euphoric effects of opioids, and alleviate physiological cravings. The Food and Drug Administration has approved three specific medications for OUD treatment: methadone, buprenorphine, and naltrexone.

Availability in correctional settings

In 2021, the O’Neill Institute for National and Global Health Law at Georgetown University Law Center conducted a study titled "A National Snapshot: Access to Medication for Opioid Use Disorder in U.S. Jails and Prisons Litigation, Legislation, and Policies." This research involved a 50-state review of current laws, policies, and court actions related to access to Medications for Opioid Use Disorder (MOUD) within United States correctional facilities as of April 2021. The report indicated that 34 states and the District of Columbia currently use at least one form of MAT. Among these, nine states permit the use of all FDA-approved medications for OUD treatment.

ADA Title II coverage of state and local correctional facilities

Title II of the ADA applies to all state and local government departments and agencies, including the criminal justice system, which encompasses jails, prisons, probation, and courts. The ADA mandates that all programs, services, and activities offered by these entities must be accessible to and usable by individuals with disabilities.

Court cases

In 1998, the U.S. Supreme Court ruled in Pennsylvania Department of Corrections v. Yeskey that Title II of the ADA applies to state prisons. In this case, Ronald Yeskey was denied participation in a motivational bootcamp due to his medical history of hypertension. Participation in the bootcamp would have significantly reduced his sentence. Following the Yeskey precedent, other courts have affirmed that the ADA extends to medical services and other programs and services provided by state and local correctional facilities.

In 2018, in Pesce v. Coppinger, Geoffrey Pesce was sentenced to 60 days in a Massachusetts prison after two years of successful MAT and recovery. The prison denied him access to MAT, which resulted in painful withdrawal. The court determined that the prison's denial of medical services violated both ADA Title II and the Eighth Amendment of the U.S. Constitution, which prohibits cruel and unusual punishment. The court ultimately ruled in Mr. Pesce's favor.

In a 2019 case, Smith v. Aroostook County, Brenda Smith, who had been in recovery for ten years and was prescribed buprenorphine for her OUD, was sentenced to a 40-day term in a Maine jail. The jail's policies prohibited inmates from using MAT, with the sole exception being pregnant inmates with OUD. Ms. Smith filed a lawsuit, asserting that the jail’s policies violated her rights under Title II of the ADA by denying her access to the jail's healthcare program due to her disability or by refusing to make reasonable modifications to allow her necessary treatment.

The jail asserted that security concerns justified the prohibition of MAT for inmates. However, the court ruled in favor of Ms. Smith, noting that various methods exist for safely providing MAT to inmates. The court stated that denying Ms. Smith's medication was unjustified and unreasonable, suggesting that the denial was likely due to her disability. The court also found it probable that Ms. Smith would succeed based on the argument that she was denied a reasonable modification, particularly since the jail already provided MAT to pregnant inmates. In April 2019, the U.S. Court of Appeals for the First Circuit affirmed the case, making it the highest court to rule on this specific issue at that time.

Conclusion

Medication-Assisted Treatment is a proven effective intervention for Opioid Use Disorders. MAT has been shown to reduce mortality rates from OUD by 50%, with 90% of individuals in recovery maintaining sobriety after two years. Despite this evidence, misconceptions that MAT merely substitutes one addiction for another persist. Reports from the Substance Use and Mental Health Services Administration (SAMHSA) indicate that 65% of individuals in correctional facilities meet the criteria for SUD, and people on parole are three times more likely to have SUD than the general population. Correctional facilities are therefore obligated to implement reasonable modifications to policies and practices to ensure inmates in recovery have access to MAT. These facilities should serve as a crucial point of support for those in recovery, contributing to safer communities.

Introduction

Statistics on Substance Use Disorder (SUD) in Correctional Settings

Estimates from the National Institute on Drug Abuse indicate that a significant majority, at least 65%, of individuals incarcerated in the United States experience Substance Use Disorder (SUD). Additionally, 20% of incarcerated individuals, while not meeting formal SUD criteria, were under the influence of drugs or alcohol during the commission of their offenses.

Statistics on Medication-Assisted Treatment (MAT) in Correctional Facilities

Medication-Assisted Treatment (MAT) represents an evidence-based approach that, when integrated with counseling and other therapeutic interventions, supports a comprehensive path to recovery. A 2021 study by the O’Neill Institute for National and Global Health Law at Georgetown University Law Center, which reviewed state laws, policies, and court actions concerning access to medications for Opioid Use Disorder (OUD) in U.S. correctional facilities, revealed varied adoption. The review found that 34 states and the District of Columbia utilize at least one form of MAT, while only nine states permit the use of all medications approved by the U.S. Food and Drug Administration for OUD treatment.

Overview of Americans with Disabilities Act (ADA) Coverage for Opioid Use Disorder (OUD)

The Americans with Disabilities Act (ADA) guarantees equal rights and opportunities for individuals with disabilities, a protection that extends to people with alcohol addiction and those in recovery from opioid or other drug use. Title II of the ADA specifically encompasses programs and services administered by state and local governments, including correctional facilities. These facilities are obligated to implement reasonable modifications to their policies and practices to ensure that incarcerated individuals with Opioid Use Disorder (OUD) can access Medication-Assisted Treatment (MAT).

Despite this mandate, five states do not offer MAT to incarcerated individuals, and 34 states impose restrictions on available treatment options. The absence of MAT can lead to severe withdrawal symptoms and significantly elevate the risk of relapse upon release. Notably, individuals with OUD who have been formerly incarcerated face a 129-fold increased likelihood of overdose within the initial two weeks post-release. Experts suggest that integrating treatment within the criminal justice system represents a crucial opportunity to enhance both public health and safety by providing necessary medical care and potentially reducing rates of reincarceration.

Materials and Methods

The information presented in this article was compiled through comprehensive research, training, education, and a thorough understanding of the Americans with Disabilities Act (ADA).

Results and Discussion

Medication-Assisted Treatment (MAT)

Medication-Assisted Treatment (MAT) is an evidence-based approach that, when combined with counseling and other therapeutic methods, offers a comprehensive path to recovery. This treatment is frequently employed for Opioid Use Disorder (OUD), utilizing medications to help normalize brain chemistry and bodily functions, block the euphoric effects of opioids, and alleviate physiological cravings. The U.S. Food and Drug Administration has approved three medications for OUD treatment: methadone, buprenorphine, and naltrexone.

Availability in Correctional Settings

A 2021 study by the O’Neill Institute for National and Global Health Law at Georgetown University Law Center, which assessed access to medications for Opioid Use Disorder (OUD) across U.S. jails and prisons, revealed that 34 states and the District of Columbia employ at least one form of MAT. However, only nine states permit the use of all FDA-approved medications for OUD treatment within their correctional facilities.

ADA Title II Coverage of State and Local Correctional Facilities

Title II of the ADA mandates that all programs, services, and activities provided by state and local government entities, including the criminal justice system encompassing jails, prisons, probation, and courts, must be accessible to individuals with disabilities.

Court Cases

Pennsylvania Department of Corrections v. Yeskey: In 1998, the U.S. Supreme Court affirmed that Title II of the ADA applies to state prisons. This ruling stemmed from a case where an individual was denied participation in a program that would have reduced their sentence, due to a medical condition. This landmark decision established that the ADA applies broadly to medical services and other programs provided by state and local correctional facilities.

Pesce v. Coppinger: In 2018, a court ruled in favor of Geoffrey Pesce, who was denied access to MAT while incarcerated, despite being in recovery and having successfully used MAT for two years. The prison's denial of this medical treatment resulted in painful withdrawal and was deemed a violation of both ADA Title II and the Eighth Amendment, which prohibits cruel and unusual punishment.

Smith v. Aroostook County: A 2019 case involved Brenda Smith, an individual in recovery from OUD who was using prescribed buprenorphine when incarcerated. The jail's policy denied MAT to inmates, with the sole exception of pregnant individuals with OUD. Smith sued, asserting that the jail's policy violated her ADA Title II rights by denying access to necessary treatment due to her disability or by refusing reasonable modifications. The jail cited security concerns, but the court found such denial unjustified and unreasonable, noting that safe provision methods existed and that the jail already accommodated pregnant inmates. The court inferred that the denial was likely due to her disability and found it probable that Smith would succeed based on the denial of a reasonable modification. This ruling was upheld by the U.S. Court of Appeals for the First Circuit in April 2019, marking a significant higher court decision on the issue.

Conclusion

Medication-Assisted Treatment (MAT) is a demonstrably effective intervention for Opioid Use Disorders. It has been shown to reduce annual OUD-related fatalities by 50% and contributes to 90% of individuals maintaining sobriety after two years in recovery. Despite this evidence, persistent misconceptions incorrectly suggest that MAT merely substitutes one addiction for another. Data from the Substance Use and Mental Health Services Administration (SAMHSA) indicates that 65% of individuals in correctional facilities meet the criteria for SUD, and those on parole are three times more likely to have SUD than the general population. Given these statistics, correctional facilities hold a crucial responsibility to implement reasonable modifications in their policies and practices, thereby ensuring that incarcerated individuals in recovery can access MAT. By acting as a primary support system for individuals in recovery, these facilities can contribute significantly to enhanced community safety.

Introduction

Many people in the United States who are held in correctional facilities have a Substance Use Disorder (SUD). Estimates suggest that at least 65% of incarcerated individuals have SUD. Another 20% were under the influence of drugs or alcohol when they committed their crime, even if they do not fully meet the official definition of SUD. This highlights a significant need for effective treatment within the justice system.

Medication-Assisted Treatment (MAT) is a treatment method supported by scientific evidence. When combined with counseling and other therapies, MAT offers a complete approach to recovery. A 2021 study by the O’Neill Institute for National and Global Health Law at Georgetown University Law Center reviewed laws and policies across all 50 states regarding access to Medications for Opioid Use Disorder (MOUD) in prisons and jails. This review found that 34 states and the District of Columbia use at least one form of MAT. Nine states allow all medications approved by the U.S. Food and Drug Administration to treat Opioid Use Disorder (OUD).

The Americans with Disabilities Act (ADA) ensures that people with disabilities have equal rights and opportunities. This protection extends to individuals with alcohol addiction and those recovering from opioid or other drug addictions. Title II of the ADA specifically covers programs and services provided by state and local governments, including correctional facilities. These facilities are required to make reasonable changes to their policies to allow inmates with OUD to access MAT. However, some states still do not offer MAT for prisoners, and many limit treatment options. Not providing MAT can lead to painful withdrawal and a high risk of relapse upon release. Former inmates with OUD are also much more likely to overdose within the first two weeks of release. Providing treatment within the criminal justice system is seen as an important opportunity to improve public health and safety.

Materials and Methods

The information in this article was developed based on the authors’ research, training, education, and knowledge of the Americans with Disabilities Act (ADA).

Medication-Assisted Treatment

Medication-Assisted Treatment (MAT) is an evidence-based approach that combines medication with counseling and other therapies to support a person's recovery from substance use. MAT is often used to treat Opioid Use Disorder (OUD). It works by helping to normalize brain chemistry and body functions, blocking the pleasurable effects of opioids, and reducing physical cravings. The U.S. Food and Drug Administration has approved three medications for OUD treatment: methadone, buprenorphine, and naltrexone. A 2021 study found that 34 states and the District of Columbia use at least one form of MAT in correctional facilities, and nine states allow all FDA-approved medications for OUD.

ADA Title II in Correctional Facilities

Title II of the Americans with Disabilities Act (ADA) applies to all state and local government agencies and departments, including the criminal justice system, such as jails, prisons, probation, and courts. The ADA requires that all programs, services, and activities provided by these entities are accessible to and usable by people with disabilities.

Court Cases

Several court cases have clarified the application of the ADA to correctional facilities regarding MAT access. In 1998, the U.S. Supreme Court ruled in Pennsylvania Department of Corrections v. Yeskey that Title II of the ADA applies to state prisons. This decision established that the ADA covers medical and other services provided in state and local correctional facilities.

Later, in the 2018 case Pesce v. Coppinger, a Massachusetts prison denied Geoffrey Pesce access to MAT, despite his two years of successful recovery, which led to painful withdrawal. The court found that the prison's denial of medical services violated both ADA Title II and the Eighth Amendment, which prohibits cruel and unusual punishment, and ruled in Pesce’s favor.

In the 2019 case Smith v. Aroostook County, Brenda Smith, who had been in recovery from OUD for ten years and was taking prescribed buprenorphine, was denied MAT at a Maine jail. The jail's policy allowed MAT only for pregnant inmates with OUD, citing security concerns. Smith sued, arguing that the jail's policy violated her ADA rights by denying her necessary treatment because of her disability. The court sided with Smith, stating that denying her medication was unreasonable and that the jail could safely provide MAT. The court also noted that since the jail already allowed MAT for pregnant inmates, providing the same accommodation to Smith was reasonable. In April 2019, the U.S. Court of Appeals for the First Circuit upheld this ruling, making it a significant legal precedent.

Conclusion

Medication-Assisted Treatment is a proven and effective method for treating Opioid Use Disorders. MAT can significantly reduce overdose deaths and help individuals maintain sobriety. Despite its effectiveness, some still hold incorrect beliefs that MAT is simply replacing one addiction with another. Data shows that a large percentage of people in correctional facilities have Substance Use Disorder, and those on parole are more likely to have SUD than the general population. Therefore, correctional facilities must make reasonable changes to their policies to allow inmates in recovery to access MAT. By supporting individuals in recovery, correctional facilities can become a key part of making communities safer.

Introduction

Statistics about number of people in correction setting with Substance Use Disorder (SUD)

Many people in jail or prison have problems with drugs or alcohol. About 65 out of every 100 people in jail or prison have a substance use disorder, or SUD. This means they have a serious problem with drugs or alcohol. Another 20 out of 100 people were using drugs or alcohol when they committed a crime, even if they do not have a full disorder.

Statistics about use of Medication-Assisted Treatment (MAT) in correctional facilities

One way to help people with drug problems is called Medication-Assisted Treatment, or MAT. This treatment uses medicine along with talking to a counselor. It helps people get better in a full way. In 2021, a study looked at how many jails and prisons use MAT. It looked at laws, rules, and court actions about using medicines for opioid problems in jails and prisons. The study found that 34 states and Washington D.C. use at least one type of MAT. Nine states use all the medicines approved by the government to treat opioid problems.

Brief overview of coverage under the Americans with Disabilities Act (ADA) for individuals with Opioid Use Disorder (OUD)

The Americans with Disabilities Act, or ADA, is a law that helps people with disabilities. It makes sure they have the same chances as everyone else. This law also covers people who are getting better from opioid or other drug problems. The ADA law applies to state and local governments. This includes jails and prisons.

Jails and prisons must make changes to their rules and ways of doing things. This allows people with opioid problems to get Medication-Assisted Treatment. But some states do not offer MAT for people in prison. And 34 states limit which treatments are offered. Not giving MAT can cause painful sickness from withdrawal. It also makes people much more likely to use drugs again when they leave jail. People with opioid problems who leave jail are 129 times more likely to die from overdose in the first two weeks. Experts say that not treating a person with a drug problem in jail is a missed chance. Providing treatment in the justice system can help people get better and make communities safer.

Materials and Methods

The information in this article comes from what the writers have learned from research, training, and their knowledge of the Americans with Disabilities Act.

Results and Discussion

Medication-Assisted Treatment (MAT)

Medication-Assisted Treatment, or MAT, uses medicine along with counseling. It helps people recover from drug problems in a full way. MAT is often used for opioid problems. It uses medicines to make the brain and body work normally. It can stop the strong feeling of wanting to use opioids and block their effects. The government has approved three medicines to treat opioid problems: methadone, buprenorphine, and naltrexone.

Availability in correctional settings

In 2021, a study looked at how much Medication-Assisted Treatment is used in jails and prisons across the United States. It looked at laws and rules about getting medicines for opioid problems in these places. The study found that 34 states and Washington D.C. use at least one type of MAT. Nine states allow the use of all the medicines approved by the government for opioid problems.

ADA Title II coverage of state and local correctional facilities

The ADA law applies to all parts of state and local governments. This includes jails, prisons, and courts. The ADA says that all programs, services, and activities must be open to people with disabilities.

Court cases

Pennsylvania Department of Corrections v. Yeskey: In 1998, the U.S. Supreme Court made a ruling. It said that the ADA law applies to state prisons. In this case, a man named Ronald Yeskey could not join a special program in prison because of his health. This program would have shortened his prison time. Because of this case, other courts have said that the ADA law applies to medical care and other programs in state and local prisons and jails.

Pesce v. Coppinger: In 2018, a man named Geoffrey Pesce was sent to a prison in Massachusetts for 60 days. He had been getting MAT for two years and was doing well in his recovery. The prison would not let him have his MAT. This made him feel very sick from withdrawal. The court said that the prison broke the ADA law. It also said the prison treated him cruelly. The court sided with Mr. Pesce.

Smith v. Aroostook County: In a 2019 case, a woman named Brenda Smith was taking medicine for her opioid problem, as prescribed by her doctor. She had been well for ten years. When she was sent to jail for 40 days, the jail would not let her have her medicine. The jail had a rule that said inmates could not use MAT, except for pregnant inmates. Ms. Smith sued the jail. She said the jail broke the ADA law by not letting her get the medical care she needed because of her disability.

The jail said it stopped inmates from using MAT for safety reasons. But the court sided with Ms. Smith. The court said there were many safe ways the jail could give inmates MAT. The court ruled that stopping Ms. Smith's medicine was not fair. It seemed like the jail said no because of her disability. The court also said it was likely Ms. Smith would win because the jail did not make a fair change for her. The jail already allowed MAT for pregnant inmates. So, it was fair for them to let Ms. Smith have it too. In April 2019, a higher court also agreed with this decision.

Conclusion

Medication-Assisted Treatment is a proven way to treat opioid problems. It lowers the number of people who die from opioid problems by half. Also, 90 out of 100 people getting better with MAT stay sober after two years. But some people still wrongly believe that MAT is just trading one drug problem for another. Many people in jail or prison have drug problems. Jails and prisons must change their rules to let people get MAT. Jails and prisons should be a first place of help for people getting better. This makes communities safer.