The U.S. Department of Justice says Butler County’s courts are among those across the state that discriminated against those suffering with opiate addictions.

The lawsuit claims the Unified Judicial System of Pennsylvania violated the Americans with Disabilities Act by restricting the use of medical-assisted treatment for people with opioid use disorder who are under court supervision.

In a lawsuit filed in federal court in eastern Pennsylvania last week, the DOJ alleges courts discriminated against people with opioid use disorder by requiring they cease taking or forbidding the use of medications designed to treat the disorder.

The suit states that until June 2021, the policy of Butler County Court of Common Pleas Drug Treatment Court forbids the use of methadone or Suboxone to assist those struggling with opioid addiction. The county points out that policy has changed since then, but the treatment court’s updated manual continues to disincentivize certain classes of treatments used to assist opioid addictions.

These drugs include methadone; medications derived from buprenorphine, such as the brand Suboxone; and treatments related to naltrexone, commonly sold as the brand Vivitrol.

At issue is whether people going through the drug treatment court are able to use the medication-assisted treatment of their — and their physicians’ — choosing, rather than one dictated by the county court. While changes in 2021 permitted the use of methadone and buprenorphine, the use of such medications is much more limited than the use of naltrexone. To use the former medications, those going through the court system must receive permission from “a competent physician with expertise in addiction,” while the use of the latter treatment “is permitted.”

All drugs used in medication-assisted treatment work in basically the same way. They ease the symptoms of opiate withdrawal while also blocking opioids from providing a “high.” In essence, they block opioid receptors in the body.

The U.S. Substance Abuse and Mental Health Services Administration says “Buprenorphine is an evidence-based best practice for treating OUD, and it has been shown to be highly effective in promoting long-term recovery.”

“Offering the full range of effective treatments maximizes patient choice and outcomes, because no single approach is universally successful,” they add. The county’s decision to put more restrictions on methadone and buprenorphine is based not on fact or medical research, but rather on stigma.

Butler County’s drug treatment court needs to reexamine: 1) Why it’s made the decision to prioritize naltrexone over methadone and buprenorphine; 2) The body of scientific and medical research on the efficacy of the three classes of drugs; and 3) Whether the decision is based on fact or stigma.

— JGG