By Amy Roe
Nearly 30 years ago, when he was 18 years old, Sy Eubanks had surgery for a knee injury he got while competing on his high school’s wrestling team. His doctor prescribed him opioid painkillers, the dangers of which are now widely known. All Sy knew was that he liked the feelings his prescription gave him, and he wanted more.
After graduation, Sy got a job as a logger. It was then he realized he couldn’t stop taking opioids. Whenever he did, he’d get so sick from withdrawal that he couldn’t work. To support his opioid addiction, Sy resorted to increasingly desperate measures: shoplifting, stealing, and pawning items to get money or drugs. By his mid-20s, Sy was using heroin, too.
Opioids reduce pain, produce euphoria, and are highly addictive. They include prescription painkillers and street drugs heroin and illicit fentanyl. People who are unable to stop using them may have Opioid Use Disorder (OUD), a chronic condition often accompanied by changes to brain chemistry.
Sy kept trying to overcome his OUD, which is a disability protected under the Americans with Disabilities Act (ADA). About 15 years ago, he went to a drug counseling center and received his first dose of methadone, one of three medications now used as part of MAT (Medication Assisted Treatment), a treatment of OUD. MAT limits the euphoric effects of opioids, relieves physiological cravings, and helps normalize body functions — all without the negative effects of having to obtain and use illicit opioids. It is widely regarded by the medical community as a very effective way to treat opioid use disorder and can be an effective way of reducing the risk of death from overdose.
With MAT, Sy has had success controlling his opioid use disorder. When he was booked into the Whatcom County Jail in September of 2017, Sy wanted to continue his treatment. But staff at the jail refused to let him — it only allows MAT to women who are pregnant.
Sy is a plaintiff in a lawsuit filed last week by the ACLU of Washington against Whatcom County. The class-action suit, Kortlever et al v. Whatcom County, could have national implications. It asserts the county’s policy of refusing to provide access to MAT to people with OUD in jail discriminates against them on the basis of their disability and exposes them to grave danger of relapsing and overdosing when they get out.
This is because the jail’s answer to OUD — withdrawal — does nothing to treat the underlying addiction and reduces one’s tolerance to opioids. There is a good chance that people who are forced into withdrawal in jail will start using again upon release, and now that their drug tolerance is lower, they’re more likely to take too much and die.
Utilizing the ADA to assert the right to medication for people with OUD is a novel approach and an essential one. America has long treated drug addiction as if it were a problem of morality rather than a public health concern. This has resulted in the favoring of abstinence-based programs, instead of more effective medical interventions.
Evidence that abstinence alone isn’t working can be found in every community in the country. In 2016, 42,249 people died of opioid overdose deaths in the United States. Washington lost 709 of these people. In 2016, at least 18 people died from heroin-related overdoses in Whatcom County, more than double the number of people killed by motor vehicle accidents. The fact that we possess a powerful tool to greatly reduce or even eliminate such deaths makes the willful refusal to use it all the more inhumane.
To someone with a life-threatening medical condition, treatment isn’t optional — it’s critical. MAT can be as life-saving to a person with OUD as insulin is to a person with diabetes. Withholding necessary medical treatment from one group of people — non-pregnant people with addictions — while giving the very same treatment to a different group of people — pregnant women — is discriminatory and dangerous.
It’s also shortsighted.
When people with OUD get the treatment they need, they are better able to take care of themselves and their families and to contribute to their communities. Whatcom County should be doing all it can to help people with opioid use disorder get access to MAT, instead of obstructing them.
Amy Roe is a Senior Writer with ACLU of Washington