Our Stories
Share the power of long-term recovery. If you are in recovery, a family member, friend or ally of someone in recovery, we want to hear your recovery story!
Learn more...
Faces & Voices of Recovery's book page
has information on many of the growing number of recovery-related publications. It’s a work in progress, so please let us know of other books that you think we should include. Check it out!
|
Recovery in the News
Jail's Prohibition of Opiate Addiction Treatment Drugs Comes Under Scrutiny
Susan Sharon
Maine Public Broadcasting
July 7, 2010
It's believed to be the first case of its kind in Maine and one of only a handful around the country: A Falmouth women recently filed a lawsuit against the Cumberland County Sheriff over a jail policy governing treatment of opiate addiction. The case alleges that the jail's policy, which prohibits the use of certain drugs, constitutes cruel and unusual punishment under the Eighth Amendment to the U.S. Constitution. Susan Sharon has the first of a two part series on treating addicts in jail.
Erin Smith was already in trouble when she got caught speeding and driving with a suspended license in February of 2009. She was in her last trimester of pregnancy, and says she was rushing to a pharmacy to pick up some blood pressure medicine before it closed.
Her driving record was already peppered with administrative violations, including one previous conviction for driving with a suspended license. And Smith says the court was prepared to get tough with her. "They appointed me a lawyer because the state wanted me to go to jail for 30 days and give me a $500 fine for the speeding and the driving after license suspension and the accumulation of things that had happened -- unfortunately."
Smith's attorney was able to reduce the number of days in jail to ten, which Smith accepted, until she found out she would not be able to take her Saboxone medication in the Cumberland County Jail. Saboxone is what's known as a partial opiate agonist, which suppresses withdrawl symptoms and blocks opiate receptors that trigger drug cravings.
As an addict in recovery Smith has been prescribed Saboxone as part of an overall treatment plan that includes therapy and behavior modification. She's been through withdrawl before and the thought of going through it again in jail is terrifying.
"It is like you'd just rather die," Smith says. "You are just sweating, and you vomit and your body aches so bad it feels like you want to stretch every muscle in your body and you just cannot get comfortable and it last for days and you don't know when it's going to end. It can take weeks, it can take a long time to fee better, a long time."
Susan Sharon: "Were you surprised when you learned that the jail wasn't going to allow you to take your medication?"
Erin Smith: "I was amazingly shocked, yes. I have a legitimate prescription and they said 'no.'"
Cumberland County Sheriff Mark Dion says there's a reason he doesn't allow opiate addicts in treatment to have access to their prescribed saboxone in jail. "It's the number one substance smuggled into the jail by every orafice that we can describe. Why? Because those who are undeclared addicts need it to get through their detention."
Instead, the jail's policy requires inmates who are prescribed Saboxone or Methadone to detox under medical supervision. The only exception is pregnant women. They are given their medications to protect their health and their babies. Some professionals in the drug treatment community think that limited treatment approach is outdated.
"Denying people effective treatment is cruel from the standpoint of the patient, but it's also an ineffective strategy for society," says Dr. Mark Publicker, an addiction specialist with the Mercy Recovery Center who has treated Erin Smith for the past six years. He says patients who are abruptly taken off saboxone are at risk of relapse, of re-committing crimes and serious physical side effects.
"People with serious medical conditions, from diabetes and heart disease to mental disorders like major depression, will experience complications up to and including potentially potentially life-threatening complications," he says.
Privacy rules prevent Publicker from describing his patient's care. But in her lawsuit, Smith says she is routinely seen by Dr. Publicker and by a psychiatrist because she also has been diagnosed with severe, treatment-resistant depression. She's been hospitalized for complications from depression several times and repeatedly tried rehab. But she kept relapsing.
She says Saboxone is the only thing that works for her. "It's been six years and I'm doing so well and my life is together. I'd probably be dead right now if I had continued to use."
Smith and her doctor say that going to jail even for a short time could unravel everything she's achieved. So with the help of the Maine Civil Liberties Union, Smith filed a lawsuit against Sheriff Dion.
"Depriving prisoners of saboxone causes them serious pain. It makes them sick," says Zach Heiden, an attorney with the MCLU. "In these cases doctors tell their patients: 'You need this medicine.' But jails say: 'Not when you're here.' People with diabetes need insulin. People with asthma need inhalers. And people with drug addictions also need medication to help them lead normal lives and remain sober."
In the case of Erin Smith versus Sheriff Mark Dion, the Cumberland County district attorney and the court eventually agreed to an alternative sentence, one that prevented Smith from having to serve any time in jail and from being forced off her medication.
Heiden says even though this case has a satisfactory outcome, he'll be pressing for policy changes through the courts, if necessary. " Erin got lucky. The court and the prosecutor were willing to agree to a punishment that also took account of her need for medicine. But too many prisoners in Maine's criminal justice system are not so lucky and we really need to do something to address that."
Sheriff Dion estimates that about 70 percent of the people in his custody are addicted to drugs. He says the figure goes higher if you include alcohol. With abuse so prevalent, Dion says he's considered the idea of making drug treatment available at the jail.
But the average inmate's stay is 15 days. That's hardly enough time to break the addiction cycle. And Dion says the cost of doing intervention is prohibitively expensive. He spent more than $3.5 million on medical treatment last year. And he says there's no big push from the community to spend more -- especially on addicts in jail.
"There is no magic bullet because we continue to define what goes on here as crime," Dion says. "Once we've decided this is a public health problem than I think we can shift the strategies."
Tomorrow: a look at how far prisoners go to smuggle drugs into the Cumberland County Jail and why a change in strategy may be needed.