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Legality of Denying Access to Medication Assisted Treatment In the Criminal Justice System

NCJ Number
Date Published
December 2011
25 pages
This report examines the prevalence of opiate addiction among offenders in the criminal justice system, its adverse consequences, and the widespread denial of access to one of its most effective forms of treatment, i.e. medication-assisted treatment (MAT); the report also analyzes the circumstances in which the denial of MAT violates Federal anti-discrimination laws and the U.S. Constitution.
An estimated 65 percent of individuals in U.S. prisons or jails have a substance-use disorder; and a significant number of these individuals are addicted to opioids. Rates are at least as high in offenders participating in community-based programs. Scientific research has clearly established that treatment of opiate dependence with medications reduces addiction and related criminal activity more effectively and at significantly less cost than incarceration. MAT uses medications such as methadone or buprenorphine to normalize brain chemistry, block the euphoric effects of opioids, relieve physiological cravings, and normalize body functions without the negative effects of short-acting drugs of abuse. Still, many in the criminal justice system prohibit MAT, even when it is prescribed by a treating physician. Some criminal justice agencies have expressed concerns about costs and diversion, but others have declined to permit MAT because of a lack of understanding of the nature of addiction and MAT, including the belief that MAT is substituting one addiction for another. This paper develops the argument that denial of access to MAT violates the Federal American with Disabilities Act and the Rehabilitation Act. Denial of MAT also risks violating the U.S. Constitution's 8th amendment prohibition of cruel and unusual punishment or 14th amendment due process clause when individuals on MAT are forced to detoxify without appropriate medical supervision or delay MAT. 112 notes