Lawsuit may compel opioid treatment in NM prisons - Albuquerque Journal

Lawsuit may compel opioid treatment in NM prisons

FILE – In this March 7, 2017, file photo, the CEO of a methadone clinic holds a 35 mg liquid dose of methadone in Rossville, Ga. The drug is the oldest and most effective of approved medications used to treat opioid addiction, but Medicare doesn’t cover it. (AP Photo/Kevin D. Liles, File)

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When people who are addicted to fentanyl or heroin are sent to prison in New Mexico they are often forced to quit using the medication treating their opioid use disorder “cold turkey” – meaning intense and deeply unpleasant withdrawal symptoms and a higher likelihood for relapsing.

That’s because the New Mexico Corrections Department doesn’t provide the medication in its facilities, except for those who are pregnant. Some inmates are allowed to taper off their medication in a county jail – which they also described as agonizing.

Disability Rights New Mexico and the American Civil Liberties Union of New Mexico have filed a federal lawsuit trying to change that.

The suit asks for a judge to require the Corrections Department to provide the medication for opioid use disorder and declare its current practices unlawful and in violation of the Eighth Amendment’s prohibition on cruel and unusual punishment.

The lawsuit was filed on behalf of all people who are addicted to opioids in prison and was filed against the Corrections Department, Secretary Alisha Tafoya Lucero and Health Services Administrator Wence Asonganyi in the U.S. District Court for New Mexico last week.

Max Kauffman, an attorney with Disability Rights New Mexico, said that one of the most common obstacles facing those with an opioid use disorder within the criminal justice system is a lack of adequate treatment.

“When someone with opioid use disorder has taken steps to address their substance use issues the prisons ought to be supporting that effort and not denying them treatment,” Kauffman said. “So we see that as having a discriminatory impact in preventing them from not only accessing recovery but at high risk of overdose relapse and death.”

Carmelina Hart, a spokeswoman for the Corrections Department, said she is not able to comment on pending litigation.

However, she said the department works with the University of New Mexico’s Milagro program to support pregnant inmates who are already on a (medication-assisted treatment) program and it recently got a grant to start a medication pilot program next year.

Opioid use disorder

Opioid use disorder is characterized by “compulsive use of opioids despite negative consequences,” and those who suffer from it often have uncontrollable cravings, decreased sensitivity to opioids and excruciating withdrawal symptoms when they are not using, according to the lawsuit.

However, it can be managed with regular medication and psychological support.

“In essence, OUD can be treated like other incurable but controllable medical conditions, such as diabetes and high blood pressure,” the suit states. “As with other chronic conditions, discontinuation of medication almost always results in the return of symptoms.”

According to the lawsuit, in July 2022 Asonganyi testified before the New Mexico Legislature’s Courts, Corrections and Justice interim committee about the impact of drug use in prison and said that over the period of about six months last year there had been about 188 serious drug-related incidents in the department’s facilities. He said that “any effort to curb that trend is very much welcome.”

“Yet Defendants do not provide continuity of the only effective medical care for (opioid use disorder) to those entering NMCD custody,” the lawsuit states. “Instead, people are forced to withdraw from their physician prescribed medication, placing them at unreasonable risk of harm.”

The denial of medication for opioid use disorder violates the standard of care, according to the lawsuit, and in recent years the Department of Justice has taken the position that it is required in carceral settings and court programs.

Medications matter

In her statement, Hart – the corrections spokeswoman – said the Substance Abuse Mental Health Services Administration had recently awarded the department a $235,000 grant to run a pilot program through 2023 in collaboration with the state’s Human Services Department.

“With these funds we will start a pilot program at the Western New Mexico Correctional Facility in Grants,” Hart said. “The pilot should result in the development of a well-informed, responsible, and sustainable system-wide MAT/MOUD program and help to identify necessary community resources.”

However Kate Loewe, an attorney who assisted with the lawsuit, said the pilot program as she understands it does not provide for continuity of care. She said she has heard the program will use the medication naltrexone, rather than methadone or suboxone.

“Unlike suboxone and methadone, when people are on naltrexone they lose their tolerance for opioids and so are at increased risk of overdose too,” Loewe said. “You can’t simply substitute naltrexone for suboxone or methadone. It requires seven to 10-day period of abstinence from all opioids, thus requiring people on suboxone or methadone to unnecessarily go through withdrawal.”

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