A federal appeals court has denied an emergency motion that would have delayed a judge’s order that a jail in northern Maine provide an inmate with medication to treat her substance use disorder.

Last month, U.S. District Court Judge Nancy Torresen ruled in favor of Brenda Smith of Madawaska, who had sued the Aroostook County Jail and Sheriff Shawn Gillen over whether she should be permitted to take Suboxone while in jail. In her decision to grant a preliminary injunction, Torresen concluded that denying Smith her medication would “cause serious and irreparable harm,” and would violate the Americans With Disabilities Act.

The American Civil Liberties Union of Maine, which brought the lawsuit, called it a landmark decision.

“This ruling is a breakthrough in the fight against the opioid crisis,” ACLU attorney Emma Bond said at the time. “The court rightly found that jails must provide necessary medical care for opioid use disorder, just like any other disease. We don’t expect jails to solve the opioid crisis, but the least they can do is not make it worse.”

Peter Marchesi, an attorney representing Aroostook County, immediately filed a notice of appeal and also an emergency motion that sought to stay the preliminary injunction pending the outcome of that appeal.

A three-judge panel of the 1st U.S. Circuit Court of Appeals denied that motion on Monday, but the appeal itself will continue. Attorneys for Aroostook County and for Smith have filed briefs but oral arguments have not been scheduled.

A ruling on the appeal is not likely to happen before Smith is scheduled to report to jail on May 1. ACLU legal director Zachary Heiden said Wednesday he expects that will still happen and that Smith will receive her Suboxone while there, per court order.

Smith, 35, was sentenced last year for stealing $40 in change that another customer had left behind at a grocery store self-checkout terminal in December 2017, according to the court documents. Her sentenced had been stayed pending the outcome of her lawsuit, which was filed in September.

During her trial in February, Smith testified about her struggles with opioids, which began when she was a teenager. She said her addiction led to her being homeless for a time and separated from her children. She’s worked hard to rebuild her life, she said, and being in a medication-assisted treatment program has been a major part of that.

“It makes me feel normal, like before I started using drugs,” she said.

Smith was asked if she worried about relapsing or even overdosing if she had to go 40 days without her medication.

“Absolutely,” she said.

Suboxone has emerged as the gold standard in treating opioid use disorder. Although jails and prisons have been slow to allow its use, things have been shifting. Maine Gov. Janet Mills signed an executive order in February that directed her administration to take a series of immediate steps to address Maine’s opioid crisis. Among them was asking her corrections department to explore ways to expand medication-assisted treatment in state prisons.

County jails, like the one in Aroostook County, are not governed by the state but some facilities, including Cumberland County Jail, are looking at ways to better treat inmates struggling with substance use disorder.

In their brief, attorneys for the county raised security concerns about administering a drug within the jail.

“Suboxone is a potent and highly coveted opiate inside jails. It is easy to divert, and the motivations for diversion are numerous. The risk of simply having the drug inside the jail creates risks of substantial harm to inmates, staff, and even free citizens in the community,” Marchesi wrote.

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