In what appears to be a first in the nation ruling, methadone must be provided to a man potentially facing time behind bars who is recovering from opioid addiction. That's the ruling from a federal judge in Boston, regarding the Essex County House of Correction. WGBH legal analyst Daniel Medwed is a law professor at Northeastern University. He spoke with WGBH All Things Considered host Barbara Howard about the ruling. This transcript has been edited for clarity.
Barbara Howard: So the man in question’s name is Geoffrey Pesce, and he is facing the possibility of a jail sentence in the Essex County House of Correction for driving on a suspended license, in violation of his probation. But that's not really the issue. The issue is that the House of Correction has a policy of not providing methadone to recovering opioid addicts. Now the ACLU did represent Pesce. What were the grounds for bringing this suit?
Daniel Medwed: Well the principal basis revolved around the Americans with Disabilities Act, because addiction is considered a disability under that law, so failure to accommodate a person's disability in turn can violate the provision. So the judge here issued an injunction effectively ordering the house of detention in Essex County to provide methadone to Mr. Pesce as a way of treating his addiction.
Howard: My understanding is also the Eighth Amendment to the Constitution comes into play here?
Medwed: To some extent there is the cruel and unusual punishment argument, as well: that if you're allowing someone to wallow in a very painful state when there is a treatment out there that is possibly beneficial, that that could in fact violate the Eighth Amendment.
Howard: The judge's ruling is preliminary. So when can we expect a final ruling? What does this all mean? Where do things stand right now?
Medwed: To some extent, it depends on whether the House of Correction wants to file an appeal. Preliminary injunctions like this are notable for a number of reasons. For example, this is telling the House of Correction to do something affirmatively. Most injunctions basically stop the government from doing something. So it's actually a very proactive measure.
Howard: This preliminary ruling from the judge is being considered a first in the nation type of ruling. Could this reverberate well beyond Essex County, even beyond Massachusetts?
Medwed: I think it could reverberate nationwide, and here's why: Even though methadone treatment is gaining traction as a way to grapple with addiction, not every jail and state prison across the country has fallen in line and believes that it's appropriate. So this is a way for inmates to push the issue even if jails and prisons and legislatures aren't doing it on their own. In Massachusetts, starting in April, the state prisons are going to be required to provide methadone to inmates. There’s also a pilot program in our county jails, where I believe five county jails are about to start this program as well. So I think we're going to get there eventually. This is a mechanism to speed up the process, both locally and nationally.
Howard: But if it's going to go into effect in April, does that make this case moot?
Medwed: It doesn't, and here's why. This case concerns county jails, which are especially important when it comes to withdrawal from opioids, because it's where most people go post-arrest. Even if they're eventually sent to state prison, they often spend a great deal of time in jail beforehand. So even though state prisons will be required to provide methadone, the greatest problem is in our county jails. That's where people are going to be going through withdrawal, because they're taken immediately off the streets, they're housed in the county jails, and that's when they're going to need the methadone. So this case will apply to jails, and that's where the rubber meets the road.
Howard: Many people who end up in a jail haven't been convicted yet, of anything.
Medwed: That's a great point. You often are waiting in lockup to even go to trial, and the presumption of innocence is still intact.
Howard: That's WGBH legal analyst and Northeastern University law professor Daniel Medwed, speaking with us about the case of Geoffrey Pesce, who is facing the prospect of being incarcerated at the Essex County House of Correction while recovering from opioid addiction. He is suing for access to the addiction treatment drug methadone. This is WGBH’s All Things Considered.
