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Courts and medication assisted treatment: Your legal rights

By Sally Friedman, Legal Director of the Legal Action Center

Kicked off medication assisted treatment by a court?
Here’s how to fight for your legal rights.

The evidence is overwhelming: Medication assisted treatment (“MAT” for short) for opioid addiction is highly effective in decreasing illicit drug use, overdose, infectious disease transmission, and crime. MAT – the use of medications, such as methadone, buprenorphine-naloxone (Suboxone), and injectable naltrexone (Vivitrol), in combination with counseling and behavioral therapies – provides a whole-patient approach to treatment.

Despite the overwhelming evidence of MAT’s effectiveness, courts and other criminal justice and child welfare agencies often force people off their MAT medication. Typical reasons people are forced off MAT include:

  • the mistaken belief that MAT is “substituting one addiction for another”
  • the mistaken belief that people in MAT are not truly in recovery
  • concern about illicit sale of MAT medications

What can you do if this Catch 22 happens to you? Get off medications and risk relapse? Stay on the medications and likely face incarceration or the lost custody of your children?

Learn how to advocate

The first thing you should do is advocate. Orders to “taper off” MAT medications often result from a lack of understanding about the nature of opioid addiction. In addition, judges and others generally do not realize that policies prohibiting MAT can violate anti-discrimination laws. Education can make a difference. Below are suggestions for how to advocate to stay on life-saving MAT.*

Tip #1: Get a lawyer who will fight for you to stay on MAT.  Then, educate your lawyer.

Having a lawyer who can effectively advocate for you to stay on MAT is critical. But do not assume your lawyer will be educated about MAT. Many lawyers share the same negative attitudes about MAT as the court or other agencies that order people off. Give your attorney a copy of “Advocating for Your Recovery: What to Do When Forced off Addiction Medication,” which you can find on the Legal Action Center’s MAT resource page by clicking on “publications.” This guide has detailed advocacy suggestions and resources your lawyer will need.

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Also suggest that your attorney call the Legal Action Center at (212) 243-1313 for advice about challenging a requirement to stop MAT. Depending on where you live, the Legal Action Center may be able to help you. You can learn more about LAC’s legal services in this area here.

Tip #2: Educate the court or agency forcing you off MAT.

Give educational materials to whomever is denying your rights. Great resources, including sample letter that you (or your advocate) can send to whomever is requiring you to get off MAT, are available in “Advocating for Your Recovery.” The sample letter explains why MAT is effective and why forcing you off can violate anti-discrimination laws.

Tip #3: Get help from your prescribing/treating doctor and counselor.

Treatment professionals often want to help their patients fight to stay on MAT. Here are some ways that your medical doctor or psychologist can help.

  • Ask your treatment providers to write a letter. If you have a prescribing doctor and counselor, get letters from both. It is very important that the letters be detailed and address the concerns of whomever is forcing you off MAT. Give your provider the list of suggested topics to include in a letter, which you will find in “Advocating for Your Recovery.”
  • Ask your doctor to testify in court.
  • Follow up with phone calls, where appropriate.

Tip #4: Reach out to others who may be able to advocate for you.

Here are some people you can ask for help:

More questions about advocacy and medication assisted treatment?

Do you still have questions about advocacy issues and MAT? Please leave your questions in the comments section below. Please leave us a message. We will do our best to reply to you personally and promptly!

About the author: Sally Friedman is the Legal Director of the Legal Action Center, a non-profit law and policy organization that fights discrimination against people with criminal justice histories, substance use disorders, and HIV/AIDS. Ms. Friedman has successfully litigated cases challenging such discrimination, including winning Innovative Health Systems v. City of White Plains, the landmark case establishing that the Americans with Disabilities Act (ADA) prohibits cities from using their zoning laws to exclude programs serving individuals with disabilities. In 2011, Ms. Friedman authored the report, “Legality of Denying Access to Medication Assisted Treatment in the Criminal Justice System.” Prior to joining the Legal Action Center, Ms. Friedman worked as a litigation associate at the New York law firm of Kramer, Levin, Naftalis, Nessen, Kamin and Frankel. She is a graduate of New York University School of Law and Brown University.
* The suggestions in this article are legal information, not legal advice. For legal advice, please speak to a lawyer.

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11 Responses to “Courts and medication assisted treatment: Your legal rights
Anna
5:08 pm July 24th, 2015

I am interested in being an advocate of those that have issues with addiction and need MAT in order to withdraw from the drugs without going “cold turkey”.

Laney
7:46 am July 28th, 2015

If anyone can help me through a custody issue while I’m on suboxone, I really need your help! I had my visitation “abated” because I was in fentanyl last summer, even though I had already begged my Dr to take me off and he did. Just happened to be a few days before I got the court letter, so looks even better for me. Even though I haven’t been on narcotics since March, I am currently now on suboxone ( two weeks today) and I KNOW that my daughters father and lawyer will make a big deal out of this and deny me seeing my daughter. I have not seen her since last August because of this btw, and NO, no one gave me a chance to defend myself last August, he just too the judge some BS and he immediately took away my rights. Even tho no one ever spoke to me nor did her father have ANY proof that I was doing anything wrong! He lied and told the judge I found out later, that I was asking the fentanyl patches , when in reality, I was already off of them before he told the judge. They want me to come to court and do a drug test, which is fine, I have one every month at my pain Dr visits, so my insurance will cover the subs. BUT, I do not want him knowing I’m on subs, so how do I go about taking a court ordered drug test, without him knowing I’m in subs? I’m pretty sure they will do the 13 panel test, which will show subs. It’s not his business and I’m fully capable of taking care of myself and my daughter ! Help!

Chris
8:32 am August 17th, 2015

Does the nurse practionor go in the bathroom with u when u take a drug screen for mental health

10:52 am August 17th, 2015

Hello Chris. Different mental health facilities have different protocols and rules. I don’t know if she’ll monitor you or not.

Toni
10:50 pm March 29th, 2016

I need a advocate to get a court order signed by a judge so I can continue treatment

Lydia @ Addiction Blog
4:41 pm April 7th, 2016

Hi Tony. I suggest you try a search on Google using these key words: site:.gov find a lawyer in [STATE].

Amanda
3:53 am May 3rd, 2017

If you expect anyone but someone trying to justify it to believe that Suboxone is the same thing as true recovery…good luck. There may br more invol, it may not be as strong, it may “prevent” use of illicit opioids but it’s still an opioid which means it still changes the way you feel chemically. My child’s father admits it keeps him feeling even keeled. That’s not true sobriety and as someone who’s been clean and sober for a decade doing the hard work and learning to sit with the way I feel instead of dumping chemicals into my body…it’s an insult to call those ppl 100% sober. What makes them so special they deserve chemical assistance to get thru life and not Rob ppl? Ppl like you only help ppl like my ex continue to inflict extreme psychological damage on children all in the name of addicts deserve their children too. Yeah maybe if they’re actually good parents who actually do something hard beyond micromanaging the mother in the name of good coparenting every time they show back up demanding their rights nd calling themselves exceptional parents and hero’s for coming back again and again. The courts protect abusers, addicts and the mentally ill in custody disputes. Not children. Look at the actual statistics about children growing up with these ppl. Do you know there’s nothing preventing a parent with narcissism or sociopathy from having custody of their children. Those ppl are usually drug addicts. Often because of their issues even taking the custody away from the healthy parent. I know addiction is a disease. Serial killers have a disease too. We are our actions. Period. Stop protecting those who make bad choices and protect their victims from court systems who praise a penis who wants contact with his kids regardless of who he is or why he actually wants it. All you do is create more sick adults. Bravo for your amazing advocacy.

Jesse
11:16 pm June 20th, 2017

I was recently accepted into a Nursing Program, but once they found out that I am taking suboxone (from a dr. along with counseling), they dismissed me from the program, for that reason alone. Now, they are saying I absolutely have to come off my medicine before entering the program. I live in WV. I would appreciate any information you could give me. Thank you!

Lydia @ Addiction Blog
11:44 am June 29th, 2017

Hi Jesse. I suggest that you consult with your doctor and a lawyer about your rights. Maybe that Nursing Program has different policy regarding suboxone. Also, you may consider finding new program.

Alyssa
3:09 am September 21st, 2017

Hi I am trying to get custody of my daughter back from the state. I’m currently on methadone and the state will not give me more visits n my worker says she will take my daughter from me in court. She doesn’t see it as recovery and is always putting me down. I don’t want to relapse I almost have six months clean and I really want my daughter. Pls help thank u I live in California too.

Lydia @ Addiction Blog
4:15 pm September 27th, 2017

Hi Alyssa. I suggest that you consult with a lawyer about this.

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