Why We’re Suing to Ensure People Held at Grand Traverse County’s Jail will be Provided with Prescription Medication for Treatment of Opioid Use Disorder 
By Syeda Davidson 

Imagine being in excruciating pain, forced to endure needless agony as the people responsible for your care cruelly block access to desperately needed medication that would relieve your suffering.  

Cyrus Patson doesn’t need to imagine that nightmare scenario. He experienced it firsthand earlier this year while being held in Michigan’s Grand Traverse County Jail. And he – along with others in similar circumstances -- will be forced to endure it again unless the jail immediately changes its policies. 

The affliction plaguing Mr. Patson, a 21-year-old white man, is clinically referred to as “opioid use disorder (OUD),” a chronic brain disease characterized by the persistent use of opioids despite their harmful consequences. To treat Mr. Patson, his personal physician prescribed Suboxone, a medicine widely used to prevent the painful withdrawal symptoms associated with opioid addiction. Despite repeated entreaties from Mr. Patson’s physician to provide him with desperately needed medication, jail officials chose to let him suffer in agony. 

With the potential of another stint in jail looming, Mr. Patson is again facing the prospect of being forced to endure the life-threatening torture of withdrawal and the increased likelihood of a potentially fatal relapse if jail officials continue to refuse to provide people like him with Suboxone. Healthcare experts widely agree that it and other medications are the only appropriate way to treat OUD. 

Mr. Patson is far from alone in fearing what will happen if he’s again denied the medication he so desperately needs. 

Stephen Rich, who is also facing the possibility of serving time in the Grand Traverse County Jail, is another one of the millions of Americans afflicted with OUD. Now 51, he became addicted to opioids while in his 20s after being prescribed powerful pain medication when he broke his back in a work-related accident. When the prescriptions stopped, he was already addicted and turned to heroin. Addiction cast a pall over his life for decades. A pipefitter by trade, his drug use made it impossible to remain steadily employed. Relations with his family suffered. 

Then, two years ago, he began taking Suboxone under the care of a physician. The medication was transformative. 

“For me, Suboxone has been a miracle,” he says. “It changed the way my mind works. I’m no longer always thinking about getting the next high. It allowed me to finally start living a normal life again.”  

Awaiting sentencing on charges unrelated to drug use, he’s terrified of what will happen if, like Mr. Patson, jail officials refuse to provide the Suboxone he’s been prescribed. The inevitability of being forced to go through withdrawals if that happens haunts him. Even worse, he says, is the likelihood of relapse once he’s out of jail. 

“If the jail forces me to go off Suboxone, I think, without a doubt, I will be looking to get high again as soon as I’m released,” he says.  

Which means the possibility of an overdose looms, as people who have recently endured cold turkey withdrawal from OUD medication like Suboxone are particularly vulnerable to overdosing due to the reduced tolerance to opioids that results from being on the medication. On the other hand, it has been shown that providing incarcerated people with Suboxone and other medications designed to treat OUD greatly reduces the chances of that happening.  

 “A recent Rhode Island Department of Corrections study examined the effect that providing medications for OUD during incarceration had on overdose deaths post release. After the program’s implementation, post-incarceration deaths decreased 61% compared with the previous year,” The Pew Charitable Trusts noted in a report about the issue released last year. “Indeed, the reduction in deaths post-release among incarcerated persons accounted for much of the state’s 12% reduction overall in overdose deaths.” 

Using Suboxone and similar medications to treat incarcerated people with OUD is far from novel.  

The New York City Department of Correction has provided medications for treatment of the disorder since 1987. California, Vermont, New Jersey, Pennsylvania and Washington, along with Rhode Island, have all successfully launched similar programs. 

As reported in the Detroit Free Press, the Michigan Department of Corrections began using Suboxone and similar medications in 2019. 

“In an important move that reinforces addiction as an illness — not a moral failing — for which everyone deserves treatment, Michigan is joining the national trend of offering medication-assisted treatment (MAT) to prison inmates. …. The medications reduce cravings and soften withdrawal symptoms and are considered the gold standard in opioid addiction treatment,” the paper noted. 

Denying effective treatment to people such as Mr. Patson and Mr. Rich isn’t just dangerous. It is also illegal. Like numerous other courts, a federal appeals court ruled in 2019 that a person incarcerated in a Maine jail was entitled to MAT, and withholding it was a violation of the Americans with Disabilities Act. 

That same assertion is made in a lawsuit the ACLU of Michigan and the law firm Goodwin Procter have filed in federal court on Mr. Patson’s behalf. The lawsuit also contends that denial of the medication needed to treat Mr. Patson’s disorder is a violation of his Eighth Amendment protections against cruel and unusual punishment.  

The need to make effective treatment available to people being held in Michigan’s jails is abundantly clear. As pointed out in the lawsuit: 

“The opioid epidemic has been devastating communities for decades, and its reach continues to grow at an exponential rate. In 1999, 118 people in Michigan died from opioid overdoses. By 2018, that number had grown to 2,036. Nationally, opioid overdoses are the leading cause of death for Americans under 50 years old. In 2019, 70,630 people died from drug overdoses—and 70% of those deaths involved an opioid. Every day, 136 people die from an opioid overdose—equivalent to one person every 10.5 minutes.” 

The terrible consequences of denying effective treatment are also clear. In one particularly horrifying incident, video from Macomb County Jail shows the death throes of David Stojcevski, jailed for failing to pay $700 in traffic fines. In the video, Mr. Stojcevski can be seen sprawled naked on the floor of his cell, convulsing for days as he went through withdrawals from medicine prescribed by his physician to treat his opioid use disorder, which his jailers refused to provide. As a consequence, 17 days after being locked up, Mr. Stojcevski was dead. 

Although no organization tracks how many people die from drug withdrawal in jail Mother Jones magazine in 2017 magazine found 20 lawsuits, filed during the previous two years, alleging that an incarcerated person had died from opiate withdrawal complications. That number likely represents just a fraction of all jail withdrawal deaths, the magazine reported. 

Fortunately, Mr. Patson survived his ordeal this past summer, but there is no guarantee he will survive if forced to undergo cold turkey withdrawal again. Mr. Patson described his experience this summer to the Traverse City Record-Eagle newspaper this way: 

“Your bones – it’s like they’re bruised. You’re sweating and freezing at the same time. You can’t sleep. Your anxiety is just insane. You have no appetite, just diarrhea and vomiting. It kills.” 

No one should be subjected to that kind of torture. A victory in Grand Traverse County will put jail officials across the state on notice that the time has finally come for them to recognize the many benefits of providing medication to people with opioid use disorder and put an end to this senseless cruelty.