The Justice Department announced last week that it reached an agreement with the Unified Judicial System of Pennsylvania (UJS) and county courts to resolve allegations that courts violated the Americans with Disabilities Act by preventing people under court supervision from taking lawfully prescribed medication to treat opioid use disorder (OUD).
The case started in 2018 with a complaint from a Jefferson County woman who was ordered to stop taking a federally approved addiction medication while she was on probation. She was experiencing withdrawal symptoms and said she wasn’t sure she’d survive, Sally Friedman of the Legal Action Center told USA TODAY.
More complaints from other Pennsylvania counties followed, prompting the Justice Department to investigate whether state courts violated the ADA by preventing people in drug court or on probation or parole from taking methadone, naltrexone, and buprenorphine (including Subutex and Suboxone) to treat OUD.
More than 10 million people in the U.S. struggle with opioid use, USA TODAY reports, and nearly three-quarters of overdose deaths involve opioids.
The problem is especially acute in Pennsylvania, which had the fourth highest number of drug overdose deaths in the nation from May 2020 to April 2021, according to the Pennsylvania Capital-Star.
Of the more than 100,000 drug overdose deaths nationwide in 2022, more than 5,000 died in Pennsylvania, the Justice Department asserted.
As the opioid epidemic continues to worsen, federal prosecutors wrote, there is an “urgent need for effective, evidence-based treatment”—like the medications approved by the U.S. Food and Drug Administration as safe and effective for treating OUD.
Research shows that medication and therapy can successfully treat OUD, and for some patients medications can help sustain recovery, according to the U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (SAMHSA). Medications can also help prevent or reduce opioid overdose.
These medications are safe to use for extended periods of time, SAMHSA says, and it can be dangerous to abruptly stop taking them. SAMHSA warns that “patients who discontinue OUD medication generally return to illicit opioid use.”
Despite the benefits of OUD medications and the risks of stopping them, Justice Department investigators found that Pennsylvania courts were ordering people in drug, mental health, and DUI court, as well as those under probation and parole supervision, to stop taking their OUD medications—or be kicked out of “treatment court,” as these diversionary programs are called in Pennsylvania.
People under court supervision “were put to an agonizing choice: take their medication and face incarceration or termination from their treatment court program or forgo their medication and suffer painful withdrawal symptoms while risking relapse, overdose and death.”
In 2022, the department informed the state judicial system that this violated the ADA’s anti-discrimination protections.
When state officials failed to address the alleged violations, federal prosecutors filed a lawsuit alleging that at least 11 Pennsylvania courts had violated the ADA by stopping people from taking prescribed OUD medication.
To settle the lawsuit, Pennsylvania courts agreed last week to pay $100,000 to the victims identified in the complaint and to train all state criminal court judges and treatment court professionals on the ADA’s requirements regarding OUD medication, the Justice Department said in a statement.
“My office is dedicated to fighting the opioid epidemic with every tool that we have,” said U.S. Attorney Jacqueline C. Romero. “That includes enforcing the ADA to remove discriminatory barriers to treatment for OUD. All too often, people taking medication to treat their OUD are subjected to discrimination based on unfounded stigma associated with these medications. It is a violation of the ADA to deny someone access to programs and services simply because they are taking medication their doctors have prescribed to get and keep their OUD in remission.”