By Madeline Olds, Web Editor
From 1999-2019 nearly 500,000 Americans this past year have died from overdosing on opioids or drugs such as heroin and fentanyl, commonly used by those who are addicted to opioids.[1] With such a drastic number of individuals overdosing, Pennsylvania has implemented ways of helping those struggling with addiction, such as treatment programs using medicinal and non-medicinal measures.[2] Included in those using these measures is the Pennsylvania Courts, who have developed drug courts in most counties to help those that have been incarcerated with addiction get help.[3]However, recently Pennsylvania Courts have been sent a letter by the Department of Justice for discriminating against those with opioid use disorder in not allowing them to use medicinal means to alleviate the struggle of their addiction.[4]
The Opioid Epidemic has been prevalent throughout the United States since the 1990s. The cause for the opioid epidemic has been mostly attributed for the push for new painkillers by pharmaceutical companies.[5] In the creation of these painkillers, the pharmaceutical companies stated to doctors that the drugs were less addictive or non-addictive in comparison to traditional pain killers such as morphine, and stated they saw no repercussions in patients that have taken them.[6] What was then called the opioid business pushed this narrative on doctors and therefore led to the push of distribution of opioids in elevated levels.[7] However, it was found that the prescription opioid painkillers were actually highly addictive and had detrimental effects to this day with United States’ struggle with addiction.[8] Happening in what the CDC constitutes as waves; the first waves of overdose deaths began due to the increased prescribing of opioids with most deaths involving prescription opioids.[9] The second wave began in 2010 with the death rate greatly increasing due to overdose involving heroin.[10] The third wave began in 2013 with a significant increase in overdose involving synthetic opioids, particularly through involving illicitly manufactured fentanyl, with the market for manufactured fentanyl continuing to change and combine with other illicit drugs.[11] As of 2019, there have been 9.7 million Americans that have taken prescription painkillers improperly, with 80% of people suffering from an addiction to heroin started with a prescription opioid addiction.[12] The scale of the opioid epidemic has been so largely significant that it has cost the United States over $78.5 billion a year.[13]
From January 2018 to January 2022, Pennsylvania has had 40,000 ER visits for opioid overdoses and has given 67,561 doses of naloxone, also known as Narcan, a common drug to prevent overdosing from opioids, administered by EMS.[14] Pennsylvania has struggled greatly compared to the other 50 states with the Opioid Epidemic.[15] With this in mind, there have been a variety of measures taken by the Pennsylvania Department of Health to help with prevention measures for opioid addiction along with treatment measures.[16] What is specifically important about Pennsylvania’s approach is the phrase within the website which is “Opioid-use disorder is a disease, not a moral failing. Opioids, prescribed or illegal, can change the brain’s chemistry creating dependence.” (This is important, as many view addiction as a failure or a moral wrong, and by approaching addiction in this manner, the Pennsylvania Department of Health has been able to help many struggling with opioid-use disorder.)[17] Specifically, Pennsylvania has developed a prescription drug monitoring program to collect information on filled prescription for controlled substances.[18] Pennsylvania has also allowed for individuals to receive prescription for Naloxone along with expanding access to treatment facilities which can be connected to through discussing treatment with the established helpline.[19] Treatment programs include therapy, rehab, and medicinal methods of treating opioid use disorder including methadone, naltrexone, and buprenorphine.[20]This all is in conjunction with educating the public on opioid use.[21]
Along with the Pennsylvania Health Department, the Pennsylvania Courts have developed drug court in order to help those that have been convicted of an offense.[22] These programs offer treatment programs that those committed an offense could access during their time incarcerated and following incarceration on probation.[23] The court creates a plan along with parole officers, mental health advocates, and Justice Related Services, to help the individuals within this court work towards being clean.[24]
However, within the drug court system, it has been alleged that the Pennsylvania Courts have discriminated against people with opioid use disorders.[25] A complaint was filed on behalf of three individuals with Opioid Use Disorder against specifically Northercumberland and Jefferson County Court of Common Pleas.[26] The two petitioners in Jefferson County alleged that the probation officers made them stop using prescription medication for their opioid use disorder. The third individual in Northcumberland County alleged that the court required her to stop using her prescribed medication for opioid use disorder to graduate from drug court.[27] After an investigation by the Department of Justice asked to complete by the Disability Rights Section of the Federal District Courts of Pennsylvania, the Department of Justice found evidence that corroborated these allegations and additionally found further evidence that the other UJS Courts in Pennsylvania have policies that discriminated against those with opioid use disorder.[28] The Department of Justice sent a letter to the Pennsylvania Supreme Court and rest of judiciary, also published on the Department of Justice website, asking for a response as to why they have been practicing in this manner.[29] Pennsylvania did respond to that letter on February 23, 2022. In the letter, the Administrative Office of the Pennsylvania Courts wrote that the state office complied by having policies directing courts to abide by the ADA and offer training opportunities for training for lower court officials with plans for more this year.[30]
In response, on February 24, 2022, the DOJ filed a suit against the Unified Judicial System of Pennsylvania for violating the Americans with Disabilities Act.[31] In the suit, the DOJ is asking to declare that the Pennsylvania Unified Judicial System is in violation of the ADA and require the courts to adopt a non-discrimination policy against individuals that take opioid treatment medication.[32] The DOJ also ask that the policy explicitly state that the courts cannot exclude participation or deny access to the medicinal treatment program.[33] Finally, the DOJ wants the court to require the implement of a compliance monitoring system to assure that the court employees are trained on the allowance of medication, develop a better complaint system, and compensate those harmed by the lower court policies.[34] In response to the allegations and the following stated by the DOJ, Pennsylvania officials for the Unified Judicial System replied they have taken steps to “enhance awareness in the few, discrete judicial districts,” and stated that every court has an ADA compliant officer and training as to deal with those struggling with opioid-use disorder.[35]The impact of this suit is significant and is the first of its kind in the continued battle in the opioid epidemic. There have been no states to be sued before by the DOJ for mistreatment of opioid-use disorder and the suit against Pennsylvania may impact how addiction is treated across the country, both in
[1] Drug Overdose: Understanding the Epidemic, Center for Disease Control and Prevention,https://www.cdc.gov/drugoverdose/epidemic/index.html (last visited April 20, 2022).
[2] Opioid Data Dashboard, Commonwealth of Pennsylvania (2022), https://data.pa.gov/stories/s/9q45-nckt/.
[3] Id.
[4] Justice Department Files Suit Against Pennsylvania Court System for Discriminating Against People with Opioid Use Disorder, Dep’t of Just. (Feb. 24, 2022), https://www.justice.gov/opa/pr/justice-department-files-suit-against-pennsylvania-court-system-discriminating-against-people.; Re: The United States’ Findings and Conclusions Based on Its Investigation of Unified Judicial System of Pennsylvania under Title II of the Americans with Disabilities Act, Dep’t of Just. (Feb. 2, 2022), https://www.ada.gov/ujs_lof.pdf.
[5] The Opioid Epidemic, Addiction Center, https://www.addictioncenter.com/opiates/opioid-epidemic/ (last visited April 20, 2022).
[6] Id.
[7] Id.
[8] Id.
[9] Drug Overdose: Understanding the Epidemic, Center for Disease Control and Prevention,https://www.cdc.gov/drugoverdose/epidemic/index.html (last visited April 20, 2022).
[10] Id.
[11] Id.
[12] Id.
[13] Id.
[14] Opioid Data Dashboard, Commonwealth of Pennsylvania (2022), https://data.pa.gov/stories/s/9q45-nckt/.
[15] 2019 Drug Overdose Death Rates, Center for Disease Control and Prevention,https://www.cdc.gov/drugoverdose/deaths/2019.html (last visited April 20, 2022).
[16] Opioid Data, supra note 14.
[17] Id.
[18] Id.
[19] Id.
[20] Id.
[21] Id.
[22] Drug Courts, The Unified Judicial System of Pennsylvania, https://www.pacourts.us/judicial-administration/court-programs/drug-courts (last visited April 20, 2022).
[23] Id.
[24] Id.
[25] Justice Department Files Suit Against Pennsylvania Court System for Discriminating Against People with Opioid Use Disorder, Dep’t of Just. (Feb. 24, 2022), https://www.justice.gov/opa/pr/justice-department-files-suit-against-pennsylvania-court-system-discriminating-against-people.; Re: The United States’ Findings and Conclusions Based on Its Investigation of Unified Judicial System of Pennsylvania under Title II of the Americans with Disabilities Act, Dep’t of Just. (Feb. 2, 2022), https://www.ada.gov/ujs_lof.pdf.
[26] Re: The United States’ Findings and Conclusions, supra note 25.
[27] Id.
[28] Justice Department Files Suit Against Pennsylvania Court System for Discriminating Against People with Opioid Use Disorder, Dep’t of Just. (Feb. 24, 2022), https://www.justice.gov/opa/pr/justice-department-files-suit-against-pennsylvania-court-system-discriminating-against-people.; Re: The United States’ Findings and Conclusions Based on Its Investigation of Unified Judicial System of Pennsylvania under Title II of the Americans with Disabilities Act, Dep’t of Just. (Feb. 2, 2022), https://www.ada.gov/ujs_lof.pdf.
[29] Id.
[30] Claudia Lauer, Feds Sue Pennsylvania Court System Over Bans on Opioid Meds, Associated Press (Feb. 25, 2022), https://www.usnews.com/news/politics/articles/2022-02-25/feds-sue-pennsylvania-court-system-over-bans-on-opioid-meds#:~:text=The%20U.S.%20Department%20of%20Justice,while%20in%20drug%20treatment%20courts.&text=Feb.%2025%2C%202022%2C%20at%205%3A44%20p.m.
[31] Re: The United States’ Findings and Conclusions, supra note 28.
[32] Id.
[33] Lauer, supra note 30.
[34] Id.
[35] Id.
