Judge Orders County to Offer OUD Meds to All Jailed Patients, in US First

May 25, 2022

A New York district judge has ordered upstate Jefferson County to offer medication for opioid use disorder (MOUD) to all people who were taking such medicine at the time of their detention. In his May 16 ruling, Judge David N. Hurd certified the New York Civil Liberty Union’s request for a class action suit against the county over its denial of access to MOUD of people detained in the Jefferson County Correctional Center. The order marks the first time in the United States that a preliminary injunction has been granted for a class, rather than an individual, in litigation related to MOUD access in jails.

The development stems from a lawsuit brought against Jefferson County and sheriff in March, alleging they were violating the Eighth Amendment, Fourteenth Amendment, state civil rights law and state human rights law by denying detainees at the Jefferson County Jail continuing access to MOUD prescribed by a doctor.

“This is the first time that a court has recognized on a class-wide basis the right of people with OUD to receive treatment while in custody.”

As the ACLU has brought suits to ensure that people in states including Massachusetts and Maine could continue receiving MOUD while incarcerated, judges have handed down preliminary injunctions in individual cases. Similarly, prior to the ACLU’s class action in New York, the NYCLU brought a suit against Jefferson County to ensure that an individual plaintiff, referred to in court filings as PG, could continue MOUD treatment while detained in the county jail. As Filter reported in September, this resulted in a preliminary injunction that forced the county to continue providing treatment for PG.

But the new injunction represents a departure from such cases. The order requires the jail to provide the agonists buprenorphine and methadone to all people previously prescribed these medications.

Three medications for opioid use disorder are approved by the Food and Drug Administration. Buprenorphine and methadone are agonists, meaning they activate the brain’s opioid receptors, while the third, naltrexone, attaches to the opioid receptors and blocks the effects of opioids. Despite the federal government’s authorization of these medications, less than 13 percent of all incarceration institutions across the country provide any form of MOUD to detainees, according to the Jail & Prison Opioid Project.

“This is the first time that a court has recognized on a class-wide basis the right of people with OUD to receive treatment for their disability while in custody,” NYCLU Senior Staff Attorney Antony Gemmell said in an email statement to Filter.

“The Court’s decision affords lifesaving relief for class members, and sends a clear message to jails about their obligation to place science before stigma by providing access to MOUD.”

In his ruling, the judge also wrote that he thought the case would succeed in a final decision.

“Plaintiffs argue that they are ‘substantially likely’ to succeed on the merits of their case under Title II of the ADA and Eighth and Fourteenth Amendments. The Court agrees,” he wrote.

A lawyer representing the county in the lawsuit did not respond to Filter’s request for comment.


State Law Soon Due to Take Effect

In October, New York Governor Kathy Hochul signed a bill mandating that jails and prisons around the state provide all three forms of FDA-approved MOUD. The law has not yet taken effect, and the sponsor of the bill, Manhattan Assemblymember Linda Rosenthal, said the ongoing denial of care in Jefferson County proved why her legislation was necessary.

“I am deeply disappointed that Jefferson County would withhold MAT, but this is exactly why my law was needed.”

To deny a person who is sick and suffering access to medication-assisted treatment (MAT) is the epitome of cruel and unusual. What’s more, the law that I passed in 2021 will require every state prison and county jail to provide people who are incarcerated with access to MAT,” Rosenthal, who is Chair of the Assembly Committee on Social Services, wrote in an email statement to Filter.

“The fact that this law will not take effect for another five months (October 2022), should not mean that people have to fight tooth and nail to access these proven lifesaving drugs in court,” she continued. “I am deeply disappointed that Jefferson County would withhold MAT from a person who needs it, but this is exactly why my law was needed.”

Facilities around the state must make significant progress in the next five months to be in compliance with the law.

A spokesperson for New York’s Office of Addiction Services and Supports said 43 locally-managed county jails (approximately three-quarters of those in the state) currently provide at least one form of MOUD.

“We are actively working with counties to provide support and assistance in order to implement MAT services in correctional facilities where they do not already exist, and get these programs up and running as soon as possible,” Evan Frost wrote in an email to Filter.

Meanwhile, 25 of the 44 prisons run by the state’s Department of Corrections and Community Supervision currently offer at least one form of MOUD, an agency spokesperson told Filter, adding that the department plans to have all of them providing medications by the time the law takes effect.

DOCCS strongly believes in the value of medication-assisted treatment programs and has continued to expand available treatment to additional correctional facilities,” the spokesperson said. “As of [May 1], there were 401 individuals under custody receiving MAT. DOCCS accepts individuals on MAT from county jails and continues their medication.”



Photograph via Piqsels/Public Domain

Daniel Moritz-Rabson

Daniel is a freelance reporter whose work has been published in outlets including Fortune, The Appeal and Gothamist. He will FOIA documents related to criminal justice if you ask nicely. He lives in Brooklyn.

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