A bill introduced this session (HB 116) would require all jails and prisons in Maryland to provide the full range of FDA approved Medication Assisted Treatment (MAT) for opioid use disorders to inmates and pretrial detainees. These treatments include methadone, buprenorphine, and naltrexone. It would also require the state to fund the screenings, assessments, and treatments.
The bill is part of a growing movement nationally to require MAT be offered in the criminal justice system. This movement is a significant shift from traditional criminal justice operations as most jails and prisons nationwide do not provide any MAT to their inmates due to safety and security concerns. In Maryland opioid use disorder treatment in the criminal justice system ranges from just counseling to one or two medications being offered in certain situations. Neither state nor local facilities provide the full range of treatments to all inmates.
An article by The Marshall Project explores the impetus behind this nationwide movement including litigation arguing that denying MAT to people who are incarcerated is a violation of the American with Disabilities Act and efforts to implement MAT programs on a local and statewide basis. The article also raises the challenges and concerns with requiring such treatment behind the walls:
His is one of at least four cases nationwide in which addicts have claimed that to deny them their medication while they are incarcerated amounts to discrimination on the basis of their disability. That argument is gaining traction among lawyers and advocates who work on behalf of people with addictions, as well as some federal law enforcement officials.
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The landmark Americans with Disabilities Act, signed into law in 1990, bans discrimination against people with disabilities and requires that public places or services be made accessible to all. From its inception, the law included protections for those recovering from alcoholism and drug addiction.
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The ADA does say someone currently using drugs illegally is not considered an “individual with a disability”—that term generally applies to a person in recovery—but the law also says that even current users can’t be denied health care. But much of how the ADA applies in these situations is open to interpretation and hasn’t been tested in the courts.
Read the full article in The Marshall Project to learn more.