Landmark Settlement Ends Forced Withdrawal from Medical Treatment for Opioid Addiction in NY County Jail

NEW YORK – Today, the New York Civil Liberties Union reached a settlement in its class action lawsuit in the Northern District of New York over Jefferson County’s discriminatory and life-endangering policy of denying treatment to people with opioid use disorder in the County’s custody.

Opioid use disorder is a serious and chronic medical condition for which medication for opioid use disorder (MOUD), sometimes called medication-assisted treatment (MAT), is often the only effective treatment. Without these doctor-prescribed medications, people with opioid use disorder suffer painful withdrawal and face an increased risk of relapse, overdose, and death.

In the first class settlement of its kind in New York, Jefferson County has agreed to a new policy ensuring access to MOUD to any eligible individual within its custody. Under the settlement, individuals entering Jefferson County Jail with a current MOUD prescription must be able to continue their treatment, and individuals without a current prescription will be able to request evaluation for treatment at intake or thereafter. Patients cannot be withdrawn from MOUD unless medically necessary, and discharge planning must be provided to individuals exiting the jail to ensure continuity of care. The NYCLU will receive detailed data on the jail’s compliance with the agreement for three years.

“No jail can deny life-sustaining medical care to people in its custody,” said Antony Gemmell, Director of Detention Litigation at the New York Civil Liberties Union. “That’s as true for people with opioid use disorder as for those living with any other disability. Jefferson County’s discriminatory ban on MOUD prioritized stigma over science, endangering our clients and countless other class members whose safety depends on access to treatment. This settlement requires that Jefferson County give incarcerated people the tools they need to maintain recovery from opioid addiction. We’ll be watching closely to ensure the jail lives up to that commitment.”

The lawsuit names plaintiffs M.C. and T.G., representing a class of individuals currently incarcerated at Jefferson County Jail who had already been stripped of their life-saving treatment and experienced excruciating withdrawal, as well as an untold number of class members who will enter the jail in the future and would have been subject to the same arbitrary withholding of treatment.

“My life fell apart as I became addicted to opioids, and it was my methadone prescription that allowed me to feel optimistic about breaking the cycle of relapse,” said plaintiff T.G. “I have worked so hard to get this far in my recovery, find employment, and return to school. I know there are many others who have had similar struggles, and with this settlement, no one else will have Jefferson County Jail’s absurd and cruel bans in the way of their progress and future.”

Forcibly ending MOUD treatment subjects people with opioid use disorder to excruciating withdrawal symptoms, as well as a significantly heightened risk of relapse, overdose, and death. Over 82 percent of patients who leave methadone treatment relapse within a year. These harms are even more acute for individuals recovering from opioid use disorder in jail. Incarcerated people are 129 times more likely to die of a drug overdose in their first two weeks after release, compared to the general population.

There is widespread scientific consensus that “agonist” MOUD, including methadone and buprenorphine, is the standard of care to address opioid use disorder. Access to MOUD has been the subject of litigation across the country, including in New York,  Maine, Massachusetts, and Washington State.

In May 2022, the court issued an order preliminarily blocking the Jefferson County Correctional Facility from denying prescribed treatment for opioid use disorder and certifying the lawsuit to proceed as a class action. This was the first class-wide preliminary injunction in the nation granting access to medication for OUD, such as methadone or buprenorphine, at a jail. In September 2021, a federal court blocked Jefferson County jail from denying life-sustaining MOUD to NYCLU client P.G. after having sought a preliminary injunction when jail officials refused to confirm that his methadone treatment would continue.

For decades, the opioid epidemic has impacted communities across the country. More than half a million people have died of opioid use disorder in 20 years, worsening during the coronavirus pandemic. Opioid addiction took the lives of 5,388 New Yorkers in 2022, including 824 in the Northern District alone. Today, one person in the United States dies of opioid overdose every five minutes.

In addition to Gemmell, NYCLU counsel on the case includes staff attorneys Terry Ding and Gabriella Larios and associate legal director Molly Biklen.