Pennsylvania courts will pay $100,000 to settle a federal lawsuit alleging that people with opioid use disorder under court supervision were prevented from taking prescribed medicine, the U.S. Department of Justice announced Thursday.

Experts say the lawsuit represents a nationwide issue where people with substance use disorders seeking jail alternative programs such as drug court, probation or parole are restricted from using federally approved addiction treatments that contain opioids.

Sally Friedman, senior vice president of legal advocacy at the Legal Action Center, said the lawsuit in Pennsylvania was the first of its kind, noting she has seen similar issues arise in courts across Ohio, South Carolina, Louisiana, New York, Florida and other states. 

More than 10 million people in the United States struggle with opioid use, according to the National Center for Drug Abuse Statistics, and opioids are a factor in 72% of all overdose deaths.

“All too often, people taking medication to treat their OUD (opioid use disorder) are subjected to discrimination based on unfounded stigma associated with these medications,” said Jacqueline C. Romero, U.S. attorney for the Eastern District of Pennsylvania. “It is a violation of the ADA (Americans with Disabilities Act) to deny someone access to programs and services simply because they are taking medication their doctors have prescribed to get and keep their OUD in remission.”

Under the settlement, Pennsylvania state courts were ordered to pay $100,000 to six people in the lawsuit. The agreement also said state court criminal judges and treatment court professionals will receive training on the Americans with Disabilities Act and opioid use disorder medication.

Years-long legal battle concludes

The settlement concluded a years-long legal battle stemming from a 2018 complaint to the Justice Department by the Legal Action Center, a nonprofit law and policy organization based in New York. Friedman said a woman in Jefferson County, Sonya Mosey, called the center after she was ordered to stop taking a federally approved addiction treatment.

Mosey was on probation in Jefferson County and using an opioid-based medicine approved by the Food and Drug Administration, Friedman said. Suffering withdrawals, Mosey called the center and said she wasn’t sure she would survive, Friedman told USA TODAY.

The Justice Department received more complaints from people in other Pennsylvania counties and sued the state’s courts on behalf of six people, including Mosey.

The lawsuit – filed in 2022 against the Unified Judicial System of Pennsylvania and Supreme Court of Pennsylvania, as well as courts in Blair County, Lackawanna County, Jefferson County and Northumberland County – alleges violations of the American Disabilities Act. 

The lawsuit said at least 11 Pennsylvania courts stopped people from taking prescribed opioid use disorder medication.

“In so doing, Defendants have put these individuals to an untenable choice: take their medication and face incarceration or termination from their treatment court program, or forgo their medication and suffer painful withdrawal symptoms while risking relapse, overdose, and death,” the lawsuit said.

Stacey Witalec, a spokesperson for the Administrative Office of Pennsylvania Courts, confirmed the settlement to USA TODAY on Thursday.

“The DOJ found no systemic ADA violations and there is no admission of liability on the part of the court system. This resolution will alleviate the burden of the ongoing litigation on the courts, who continue to deny the DOJ’s claims,” Witalec told USA TODAY.

Pennsylvania’s first problem-solving court, an adult drug court in Philadelphia, opened in 1997, Witalec said, and the success of that program “solidified the treatment court model as a critical component within the Pennsylvania court system.”

Treatment restrictions ended in relapse, lawsuit says

One man, identified in the lawsuit as Complainant E, developed an addiction to painkillers after several injuries at work. After he stopped receiving prescriptions, the lawsuit said he got painkillers illegally. He sought treatment in 2018, which included a prescription for buprenorphine, a synthetic opioid used to treat addiction.

But the following year, the man pleaded guilty to a drug crime committed before recovery, and was sent to Blair County Drug Court, where he was ordered off of buprenorphine, according to the complaint. The man suffered depression, body aches, nausea and sleeplessness, eventually relapsing, which resulted in jail time and prolonged treatment, the lawsuit said. The man has been in the drug court program for nearly four years and still hasn't graduated.

"Complainant E’s forced withdrawal from medication — which resulted in hisrelapses, subsequent incarceration, inpatient treatment, halfway house residency, and intensiveoutpatient treatment — caused him significant financial harm and has significantly extended histime in the Blair County Drug Court," the lawsuit said.

Stigma around substance use disorders

Friedman attributed the barriers to medicine to a stigma against substance use disorders, noting people often view it as a “moral failing” rather than an illness requiring treatment. 

Also, the opioid-based treatments approved by the FDA can be difficult to get due to insurance barriers or other issues, meaning some people get the medicine off the black market, Friedman said. Judges then see the medicine in drug cases in their courtrooms as an illicitly obtained substance rather than a scientifically backed treatment.

The Americans with Disabilities Act protects people with opioid use disorder, an illness that can involve the use of legal opioids, such as prescribed oxycodone, or illegal opioids such as heroin.

“For courts to be telling people that they cannot use a scientifically appropriate medication for a very serious medical condition that can result in death is just outrageous,” Sara Rose, deputy legal director for the American Civil Liberties Union of Pennsylvania, told USA TODAY.

Despite federal approval and scientific backing, Rose said there are widespread misconceptions around treatment involving opioid-based medications.  

While drugs like heroin or oxycodone create a high and cause withdrawal symptoms within hours of a dose, Friedman said opioid-based medicine stabilizes brain chemistry and enables a person to function.