“I got to that point where I didn’t wake up thinking about using. I didn’t go to bed thinking about using. I wasn’t scared to wake up in the morning and be sick. I was actually okay.”
When a doctor prescribed S.B.* Methadone two years ago, her life changed for the better. For the first time in twenty years, she was able to stop using heroin, a highly addictive opiod that kills thousands of Americans every year. Although S.B. grew up surrounded by drugs, and has suffered from the trauma of sexual abuse and incarceration, she began to imagine a stable future for herself.
"'Hey, where did that thought go?' I never acted on it. This is amazing to me and would not be possible without my methadone."
Then, in the spring of 2020, while S.B. was participating in the Metropolitan Detention Center’s (MDC) community corrections program and undergoing treatment for her addiction, she found out her mother, who lives in Colorado, contracted Covid-19. Concerned for her parents’ health, she made the difficult decision to travel to see them, even though it violated the conditions of her probation.
After arriving, she visited a local methadone clinic and resumed treatment. Methadone helped her to stay off of heroin when, in the fall, S.B’s worst fear came true: her father contracted Covid-19 and passed away.
“When my dad died, I didn’t think I could handle that without using heroin,” S.B. said. “But then I would have a thought about using, and wake up the next day and think, hey, where did that thought go? I never acted on it. This is amazing to me and would not be possible without my methadone.”
Shortly after her dad passed away, S.B. suffered another blow. She was arrested for absconding from probation and taken to a Colorado jail, before she was ultimately sent back to New Mexico.
At her hearing, the judge sentenced S.B. to time in New Mexico Corrections Department custody, which does not allow the use of methadone, or any other medication treatment for opioid use disorder (OUD), except for pregnant people suffering from addiction.
S.B.’s criminal defense attorney successfully petitioned the judge to allow her to first go to MDC, which allows the use of methadone, so she could slowly withdraw prior to her transfer to NMCD. Though S.B. was relieved that she would have some time to taper off her medication, she was still terrified at the prospect of losing her lifeline.
Cycles of addiction and incarceration
Like millions of other Americans and thousands of others in New Mexico, S.B. is diagnosed with severe opioid use disorder (OUD), a chronic relapsing brain disease. OUD, like diabetes or high blood pressure, requires medical intervention for years or even a lifetime.
Recognizing the severity of the disease and that medication for addiction treatment (MAT) is the standard of care, MDC has allowed people who enter the jail while on methadone to continue treatment since 2005. In 2017, the jail also began allowing people suffering from addiction who were not already on medication to enroll behind bars. In doing so, they hoped to reduce suffering, recidivism, and crime rates. Many other jails and corrections departments across the country have followed suit in an effort to end cycles of addiction and incarceration.
"I don’t want to die in here or when I am released, but as my dose gets lower I have to remind myself of this."
In refusing to treat OUD like any other chronic disease that requires care, NMCD subjects people to needless suffering. As S.B. dropped below a therapeutic dose while awaiting transfer to NMCD custody, she began to experience brutal withdrawal symptoms such as body pain, opioid cravings, loss of sleep, impulses for self harm, depression, and extreme anxiety about her ability to stay free from heroin use while incarcerated.
“Being forced to withdraw from methadone makes my depression and anxiety very bad,” S.B. said. “I have a lot of family members who were my age who killed themselves either on purpose or accidentally overdosed. This scares me. I don’t want to do that. I don’t want to die in here or when I am released, but as my dose gets lower I have to remind myself of this.”
NMCD’s refusal to provide MAT, which is the well-recognized standard of care, also puts people at risk for relapse and reentry into prison. A 2018 report by the New Mexico Legislative Finance Committee found that one-half of the recidivism rate in New Mexico was attributed to parole revocations for technical violations related to drug use and about one-third of the people admitted to NMCD prisons were there as the result of failed drug tests and missed appointments.
“NMCD could help prevent people suffering from addiction from winding up back in custody by providing them medication that has been proven to effectively treat OUD,” said ACLU of New Mexico staff attorney Lalita Moskowitz. “Instead, they needlessly subject people to suffering and jeopardize their chances of breaking the cycle of addiction and incarceration.”
"The Corrections Department’s blanket refusal to provide MAT amounts to deliberate indifference to a serious medical need."
Once they leave prison, formerly incarcerated people are also at an increased risk for fatal overdose. A 2007 study published in the New England Journal of Medicine found that during the two weeks following their release from prison, formerly incarcerated people are 12,900% as likely as non-incarcerated people to die of an overdose. A 2017 study published in Addiction found that, in contrast, people who receive MAT while incarcerated are 85% less likely to die of a drug overdose within a month of their release.
In May, The ACLU of New Mexico and the Law Office of Ryan J. Villa intervened to prevent further threat to S.B.’s health and life, filing an emergency motion in a lawsuit to demand she be provided her prescribed medication for addiction treatment when transferred to NMCD. The lawsuit also asks the Court to find that NMCD’s blanket ban on MAT is a violation of the American with Disabilities Act and the Eighth Amendment prohibition on cruel and unusual punishment.
“The Corrections Department’s blanket refusal to provide MAT amounts to deliberate indifference to a serious medical need,” said Moskowitz. “NMCD has a constitutional, legal, and moral duty to provide adequate medical care to our client.”
Through her lawsuit, S.B. not only hopes that she will soon be able to resume a therapeutic dose of methadone, but that other people like her who are struggling to stay off drugs will be able to receive the treatment they need.
“They just want to lock people up and throw away the key,” S.B. said. “Just like there are shots for Covid, there is medication for people with addiction. I think they’re just as important and I don’t understand how come they don’t see it like that.”
*Initials have been used to protect S.B.’s identity