It’s time for Pennsylvania courts to stop discriminating against people with opioid use disorder | Opinion

Nobody should be at risk of overdose because they are denied access to medication for opioid use disorder. And yet, amid a growing overdose crisis that cost 100,000 lives in the U.S. just last year, that is exactly what is happening.

Earlier this month, the U.S. Department of Justice released a letter on how Pennsylvania state courts systematically discriminated against individuals with opioid use disorder and violated the Americans with Disabilities Act.

In an investigation sparked by the experiences of individuals assisted by Legal Action Center and the American Civil Liberties Union of Pennsylvania, the Department of Justice describes that people under court supervision, such as probation or drug court, had limited or no access to medications for opioid use disorder. In its letter, the Department of Justice demands that Pennsylvania adopt policies to ensure that discrimination against individuals who have opioid use disorder ends, as well as appropriately train and educate court staff about opioid use disorder and the nondiscrimination requirements of the Americans with Disabilities Act.

The Department of Justice’s findings should be a wake-up call in a state that is estimated to have experienced over 5,000 overdose deaths in 2020. Everyone should have access to medications that help block cravings, buprenorphine and methadone — the gold standard of care — yet they continue to be barred or restricted in many Pennsylvania communities. We can’t end the overdose crisis by ignoring the best evidence for what works or leaving behind those caught up in the criminal legal system.

The intersection between criminal justice supervision and overdose, while often overlooked, is demonstrated by data from Allegheny County on fatal overdoses between January 2016 and June 2020. Among the more than 2,600 overdose deaths during that time period, nearly a quarter (23%) of those who died had probation involvement in the month preceding their death.

At the end of 2018, there were over 178,000 people on probation in Pennsylvania. It is critical that overdose prevention and harm reduction efforts reach those under all types of court supervision.

The Department of Justice’s letter outlines how court attitudes and practices toward those with opioid use disorder were “rooted in stereotypes and myths about medications for opioid use disorder rather than in science.” Stigma against those who use drugs remains a potent and deeply entrenched driver of harmful policy in the U.S. The decision to withhold or restrict the use of lifesaving medications for those under court supervision is symptomatic of this stigma. Such decisions not only imperil peoples’ lives from increased risk of fatal overdose but also clearly violate federal antidiscrimination protections.

Ensuring access to evidence-based medication treatment for individuals under court supervision, including probation and drug court, is not only the right thing to do but also the bare minimum of what’s required under federal civil rights laws. In the face of so many preventable deaths from overdose, Pennsylvania courts urgently need to change course to reduce stigma, promote health, and save lives.

Kate Boulton is senior legal technical adviser at Vital Strategies’ Overdose Prevention Program. Working in Pennsylvania since 2018, Vital Strategies supports comprehensive strategies to reduce overdose across the commonwealth.