Prisoners as patients: The opioid epidemic, medication-assisted treatment, and the eighth amendment

Abstract

In 2016, an estimated 42,000 people died from opioid overdoses, 28 percent more than the year prior. This epidemic is particularly acute in American prisons and jails, where more than half the population meets the criteria for drug abuse or dependence. Drug use in correctional institutions leads to a series of negative consequences during and after incarceration — not only deadly overdoses, but also the transmission of dangerous diseases like hepatitis C and HIV through injection drug use, and other long-term health consequences like pulmonary and heart infections. Yet in the face of such great need, only a small percentage of incarcerated people with opioid addictions have access to what leading medical organizations take to be the standard of care: medication-assisted treatment (MAT). This article argues that correctional institutions violate the Eighth Amendment when they refuse to establish MAT programs and prevent doctors from exercising medical judgment to properly treat incarcerated people with OUD.