The ACLU has filed a lawsuit on behalf of a young, pregnant woman in Montana who was jailed and denied her prescribed buprenorphine (Suboxone, Subutex) putting her health and pregnancy at serious risk.  See a video interview of the young woman, her name is Bethany Cajune, and her lawyers below.

I think it’s interesting that the ACLU chose to frame this as a reproductive freedom issue.  I agree that the denial of the pregnant woman’s medication put her pregnancy at risk.  But I don’t think the denial of medication would have been appropriate even if she didn’t happen to be pregnant.

I think the reproductive freedom argument is a strong one.  I just hope the ACLU will follow up this case with future cases brought on behalf of people who are not pregnant, but who are participating in medication-assisted treatment for opiate dependence, and are denied their medication in jail.

I know many people who have been forced to undergo severe and protracted withdrawal from prescribed medication in jail without even a medication taper.  It is inhumane, unnecessary, and unjustifiable.  From a recovery perspective, it is very destructive.

Consider a common scenario:  Jill is addicted to opiates.  She commits a series of crimes including shoplifting and bad checks.  She gets caught.  She decides to try one more time to stop using.

She’s heard about medication-assisted treatment with buprenorphine.  Up until now, she had rejected the option.  In the back of her mind, she knew that what she really wanted was to not have to rely on any medication, illicit or prescribed.  And she had talked to her mother once about a friend who was prescribed Suboxone, and her mother had said that her friend was just trading one drug for another.

While her charges are pending, Jill goes to a short term residential treatment program.  She completes the program, but relapses within a week of being home.

This isn’t the first time she’s been in trouble.  She knows she may not get court diversion this time, and might go to jail.  She finds a doctor who prescribes Suboxone.

She can’t believe it.  To her, it seems like a miracle drug.  She stops using other opiates, she doesn’t go into withdrawal, and the few cravings she has are manageable.

Weeks go by, and then months.  She’s doing great.  She goes to court, and takes a plea deal.  Thirty days in jail.

She goes to jail.  To her surprise, they deny her the medication prescribed by her doctor.  She goes into severe withdrawal.

Far from the comforts of home, she endures days and nights of severe sickness.  A fellow inmate offers her some Oxycontin, and desperate for some relief, she relapses.

Weeks later, she doesn’t feel as sick, but she still is having trouble sleeping.  She starts to wonder if she even wants to go back on a medication that has caused her so much pain.  She knows she will be on probation when she leaves jail.  What if a minor probation violation lands her back in jail for a short sanction?  Can she face going through this agony again?

Lack of appropriate medical care in jail has caused massive suffering.  She leaves jail having relapsed, and feeling ambivalent about a treatment that had worked for her well prior to incarceration.  Her recovery is destabilized, and she is vulnerable.

Lack of appropriate medical care has put her, her family and her community at unnecessary risk.

And jail and prisons across the country get away with it every day.

Read more about the ACLU case here.

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