A look at Whatcom County Jail
A settlement agreement has been proposed in a federal civil rights lawsuit filed by the American Civil Liberties Union last year against the Whatcom County Jail and the Whatcom County Sheriff’s Office, according to a press release sent Tuesday from ACLU’s Washington chapter.
The ACLU lawsuit alleges inmates were denied access to medication to treat opioid addictions, according to court records filed in Seattle with the U.S. District Court for the Western District of Washington.
The Whatcom County Jail now will provide people in the jail with medication-assisted treatment (MAT) services to treat opioid use disorder, according to a press release sent Tuesday from the sheriff’s office.
Opioid use disorder is classified as a disability under the Americans with Disabilities Act, and also is a recognized substance use disorder.
A person qualifies as having opioid use disorder if they meet two or more criteria that reflect impaired health function over a 12-month period. The disorder is a chronic condition and is often accompanied by changes to brain chemistry, the ACLU release stated.
The lawsuit, filed in June 2018, alleged the jail had a policy for giving medication, such as buprenorphine (Suboxone or Subutex) or methadone, to pregnant women suffering from opioid use disorder, but had no policy for non-pregnant individuals, essentially forcing them to go into withdrawal once they were booked, according to court records.
The lawsuit was brought on behalf of two inmates who were receiving medication-assisted treatment before they became incarcerated, according to court records.
The proposed settlement
As part of the proposed settlement, the jail will maintain people on MAT prescriptions they were already using in the community, as well as start qualifying people on medication in the jail before they’re released, the ACLU press release stated.
The medications provided will include Suboxone, Subutex and Vivitrol as options. The medications work by inhibiting the opioid receptors in the brain, counteracting the euphoric effects and physiological cravings.
The jail also has been working with community medication-assisted treatment providers to make sure people will be able to continue treatment once they’re released, the ACLU release stated.
The ACLU and Whatcom County have asked the court to approve the settlement agreement and certify the class. A response from the court takes about 60 days, the ACLU release stated.
“When people who are getting Medication-Assisted Treatment for their opioid use disorder are able to stay on the medicine, the entire community is better off,” Mark Cooke of the ACLU said in a prepared statement. “We’re glad that Whatcom County has taken steps to help people in their efforts to overcome opioid addiction. The policy changes at the jail will save lives.”
Federal judges in Massachusetts and Maine have recently ordered jails to provide medication-assisted treatment for specific individuals with opioid use disorder entering incarceration, but this is the first time class-action litigation has resulted in a jail changing its policy to provide treatment for those who have a medical need for it, the ACLU release states.
“Singling out a group of people because of their disability and denying them access to medical services to which they would otherwise be entitled is prohibited under the Americans with Disabilities Act. Whatcom County’s willingness to change its policies means that the court will not have to decide whether the previous policy was unlawful,” the ACLU release stated.
Treatment program begins
Whatcom County Sheriff Bill Elfo previously told The Bellingham Herald that the sheriff’s office already was developing a plan for medication-assisted treatment in the jail prior to the lawsuit.
The sheriff’s office obtained a small grant from the U.S. Department of Justice National Institute of Corrections to study MAT programs in September 2018 and to work with community partners to develop a safe program reflecting best practices, according to the sheriff’s office release.
The Presidential Commission on Combating Drug Addiction and the Opioid Crisis, and the National Sheriffs’ Association both recommend that MAT programs be adopted in local jails, the sheriff’s release stated.
The grant allowed the sheriff’s office to review existing programs in other states, and over the last two years, policies and protocols appropriate for a jail setting were developed and implemented, the release stated.
Two phases of the MAT protocols have been implemented at the Whatcom County Jail, with the third and final one expected to start within the next two months, Elfo told The Bellingham Herald.
“Whatcom County has been suffering from the opioid epidemic, just like the rest of Washington and our nation. MAT helps people manage their addiction and saves lives,” Elfo said in a prepared statement. “We are proud to be among the first jails in the nation to adopt policies to allow inmates to continue their MAT treatment, as well as to begin MAT treatment.”
The first phase of the jail’s medication-assisted treatment program started in September 2018. It tapers people who are experiencing the physical symptoms of withdrawal off the opioid they were using, and is a more humane way to handle withdrawal, the sheriff’s office release stated.
The second phase allows for people who were on a community-based MAT program, such as the inmates in the ACLU lawsuit, to continue treatment if they become incarcerated. This portion of the jail’s protocols started in February.
The third phase will work with people who are willing to undergo medication-assisted treatment as a means of entering into recovery, the sheriff’s release stated. The jail had a version of this phase available for pregnant women for the past three years, according to the release.
‘A viable reality’
One of the criteria considered for MAT is the concurrent use of other illegal drugs.
Some drugs can interact with opioids in a very dangerous way, and are a serious concern for the medical staff, according to the release. Jail staff are seeing an increase in multiple drug combinations, especially with methamphetamine. Approximately 73% of screened inmates are using meth in combination with opioids, the release stated.
In 2018, there were 7,281 people booked into the jail, some of whom were booked multiple times, according to Whatcom County Jail data. Of those, 204 went through heroin withdrawal, while another 209 reported heroin use, but no withdrawal. And more than 250 people went through meth withdrawal, jail health data shows.
An additional 95 people experienced multiple substance withdrawal, according to the data.
“I am very appreciative of the work of our Corrections Bureau staff and health care professionals, our community-based health care and treatment partners and the National Sheriffs’ Association for the assistance that was provided to make this program a viable reality,” Elfo told The Herald.
The ACLU filed its lawsuit as the program was under development, according to the sheriff’s release.
“The Sheriff’s Office worked with the ACLU in finalizing its MAT protocols. The ACLU and Whatcom County have asked the Court to approve a settlement agreement that reflects the adoption of the MAT protocols,” the release stated.
Facilities nationwide have begun to change their policies to provide MAT, which is recognized by the medical community as the standard of care for opioid use disorders, the ACLU press release stated.
The Department of Justice recently reached settlements with healthcare providers for violating the Americans with Disabilities Act for not allowing patients to use medication-assisted treatment. One was a skilled nursing facility in Massachusetts, and the other was a primary and specialty care clinic in West Virginia, according to the release.