Drug Users on Probation Can Be Required to Remain Drug-Free, Court Rules

The Massachusetts Supreme Judicial Court has ruled that a person on probation with a condition to remain drug-free may be put in jail after one positive drug test. This case has been watched closely by many who work with people struggling with substance use disorder, from health care professionals to law enforcement. The case has pitted drug experts against each other and challenges the very notion of what addiction is and what role the courts should play in it.

The ruling centered around the case of Julie Eldred, a 30-year-old woman diagnosed with a severe substance use disorder. Eldred was originally charged with stealing from an employer to pay for drugs to support her addiction. She was given probation on the condition of remaining drug-free. An outpatient program and medication-assisted treatment helped Eldred to stay sober. However, 12 days after she received probation, a court-ordered drug test detected fentanyl, and she was subsequently sent back to jail by the judge.

Lisa Newman-Polk, the attorney representing Eldred and a certified social worker with clinical experience treating addiction and other mental health disorders, argued that the requirement that Eldred remain drug-free to avoid jail was unconstitutional because, in part, “continued use of substances despite negative consequences is a symptom of that [substance use] disorder.”  Many experts agree that addiction is a “disease that affects both the brain and behavior,” according to the National Institutes of Health. Brain images show that substance use disorder physically changes areas that are essential for behavior control and decision-making, making it difficult to fight the impulse to take drugs, even if a court threatens punishment.

Eldred was placed in jail for 10 days without treatment until a spot became available at a rehab facility. Newman-Polk argued that was cruel and unusual punishment and interfered with Eldred’s treatment.

The commonwealth, on the other hand, argued in court that the detention was not only permissible, it “may have helped to save her life, given the dangerous nature of fentanyl.” It also argued that “brain disease” science is still controversial and “not sufficiently developed” enough for the courts to rely on it in this constitutional question. The court agreed.

Legal experts believe this won’t be the last time a case of this kind comes up. As the opioid epidemic continues and cases involving substance use disorder become more prevalent in the courts, the debate about how to balance responsibility for crimes and assign appropriate punishment with compassion and treatment for the underlying cause is ongoing.

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https://www.cnn.com/2018/07/16/health/massachusetts-court-opioid-addiction-eldred/index.html