Should courts jail people for having the disease of addiction?

Dec 01 2017

Should courts jail people for having the disease of addiction?

Is it unconstitutional to put an addict in jail for using drugs?

The Massachusetts Supreme Judicial Court is considering that question, in the case of an Acton, Mass. woman whose decade-long struggle with opiate addiction led to relapse – a violation of her probation on a 2016 theft charge.

Julie Eldred, who makes a living as a part-time pet caretaker, says she complied with her probation requirements by undergoing outpatient, medication-assisted treatment. Eldred failed a drug test, soon after starting treatment, but told her probation officer she had re-started her effort to get clean, by contacting her doctor to increase her Suboxone dosage.

Eldred was sent back to jail for violating her probation. Ten days later, she was released, after her attorney found her a spot in an inpatient treatment program. The lawyer, Lisa-Newman Polk of Lowell, Mass., brought Eldred’s case to the Supreme Court, contending that courts should not have the right to punish people because they have the disease of addiction.

“I was in the midst of active addiction, so I was actively using. But you’re forced to go into this saying ‘I’ll be drug-free,’ or you go to jail,” Eldred told radio station WBUR. She says her parole officer didn’t consider that “I had just gotten started getting everything in order. She just saw that I had a ‘dirty urine,’ and she just sent me in front of the judge to go to jail.”

The judge sentenced Eldred to jail for the probation violation; Eldred says she received no treatment.

“This idea that a court can order a person to stop using — with the threat of punishment — is not grounded in reality,” Newman-Polk says. “If it worked to punish people for addiction and relapse we would have a cured nation.”

Newman-Polk argues that courts should take into account scientific research about addiction, and apply it to defendants. She says it’s unconstitutional to incarcerate someone for relapsing, because relapse is part of the disease, and the recovery process. 

“An order to be drug-free is an order that a person with a substance use disorder needs to be in remission or cured of addiction. It’s not practical or reasonable, in view of what we know about the brain science and what we know about addiction,” Newman-Polk told NPR.

Legal briefs citing the science of addiction have been filed for both sides in the case. The Massachusetts Medical Society filed one supporting the defendant’s argument, pointing out that relapse is a symptom of addiction that needs to be treated, not punished.

“Even Lindbergh bounced down the runway a couple of times before he became airborne,” says Massachusetts Medical Society President Henry Dorkin, M.D., “and we would not want to incarcerate people at the first sign of relapse if we’re treating this as a chronic disease.”

Briefs have been filed in opposition contending that there is not a scientific consensus supporting the brain disease view of addiction.  The National Association of Drug Court Professionals offered an endorsement of specialty drugs as an effective way to divert addicted defendants into treatment, rather than jail. The NADC brief asks the court not to let “any particular theory of addiction to influence its decision.” 

During the state’s supreme court hearing on the case in November, Justice Barbara Lenk asked Newman-Polk how an addict who can’t stop using drugs could resist the urge to commit crimes to support their habit. Newman-Polk responded that, while criminals should be punished, committing crimes is not a symptom of addiction.

The Massachusetts Bar Association says the high court’s ruling will set a precedent, causing state legislators to provide more funding for addiction treatment.

“It is probably going to be one of the most important cases that our court will bring down — over the last decade,” Martin Healy, the MBA’s chief counsel and chief operating officer, told NPR. “And I think it will result in some dramatic changes to the way that society treats addiction.”

The high court is expected to issue a ruling by spring.