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.
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:
- Contact the agency in your State that regulates substance use programs. You can find a list of SAMHSA listed substance abuse programs here. Ask if they will contact the court or agency forcing you off MAT.
- File a grievance report with the National Alliance for Medication Assisted Recovery (NAMA-R)
- If you are pregnant or experiencing a MAT-related custody issue, you may want to contact National Advocates for Pregnant Women.
- Contact your elected representatives and ask them to intervene.
- File a complaint with the U.S. Department of Justice, for a violation of the Americans with Disabilities Act.
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!