Federal lawsuit: Ky. courts discriminate against addicts

Stephanie Watson, an opiate addict, isn't allowed to take medicine for her addiction – if she wants to stay out of jail.

That's because Kentucky courts prohibit anyone released on bond from taking drugs such as methadone and Suboxone, even if they're taking it under a doctor's orders.

It's a familiar story among heroin and prescription painkiller addicts during a "raging heroin epidemic," say her lawyers.

The 38-year-old Floyd nurse has filed a federal lawsuit in Pikeville in Eastern Kentucky, claiming that the Kentucky court system is violating the Americans with Disabilities Act by prohibiting her use of medicine such as methadone, Suboxone and Vivitrol.

"It keeps going on, and it's a huge mistake," said Watson's physician, Dr. Stephen Lamb, reached by phone Tuesday.

The complaint names the Kentucky Administrative Office of the Courts – claiming the court system's Monitored Conditional Release program has wrongfully interfered with the right of individuals to be treated by Kentucky physicians.

The bond release program comes with rules to stay out of jail.

Laurie Dudgeon, director of the office, is named in the lawsuit for telling Watson in February that she couldn't take methadone or Suboxone or "similar substances," as a condition of her release, the lawsuit states.

"It was explained to Stephanie Watson that if she takes such drugs she is likely to have her bond revoked, which will result in incarceration."

That's dangerous for Watson, Lamb said, because abstinence programs for opiate addicts commonly lead to relapse.

"Should she relapse, she will likely lose her freedom, her career and possibly her family," the complaint states.

"She may even lose her life."

The Kentucky Administrative Office of the Courts declined to comment Tuesday. Spokeswoman Leigh Anne Hiatt said the office had not yet been served with the complaint.

Watson's lawyers and doctor say she and others are being discriminated against by the state court system.

The attorneys argue that she and other addicts are protected under Title II of the Americans with Disabilities Act, which prohibits discrimination on the basis of disability in all services, programs and activities provided to the public by state and local governments, except public transportation services.

"The ADA has long recognized addiction as a disability," said Mark Wohlander, one of the attorneys.

The case could impact "thousands" of people who are in the Kentucky court system, he said. And Ned Pillersdorf, another of Watson's attorneys, said it could have implications for abstinence-based drug courts across the United States.

Watson's physician, Dr. Lamb, has been working in addiction medicine since 1991 and has treated patients with Suboxone since 2003.

Lamb comes to Northern Kentucky once a month, offering his help to NKY Med Clinic, the methadone clinic in Covington.

"I won't say there is no place for abstinence, because there is," Lamb said.

But with opioids and heroin, medicine-assisted treatment – which includes counseling – works best, stabilizing the brain and allowing people to function without persistent cravings or withdrawal, according to addiction experts including Dr. Adam Bisaga, professor of psychiatry at Columbia University Medical Center's Department of Psychiatry Division on Substance Abuse.

The Office for National Drug Control Policy's strategy to fight the opioid epidemic includes evidence-based, medicine-assisted treatment.

"For many people, that's the only way they're going to make it," Lamb said.

Watson developed an opiate addiction in 2012, the lawsuit states. She has a pending criminal case in Floyd District Court involving her arrest for allegedly taking drug remnants from a bio-hazardous disposal box at the Highlands Regional Medical Center in Prestonsburg, in Floyd County, the suit says.

She isn't seeking monetary damages from the court.

She wants the federal court to stop the Kentucky courts from "unilaterally refusing to approve the prescription of any medication written by competent doctors," according to her complaint.

The Kentucky court system also runs the state's drug courts – an abstinence-based program for drug offenders that can keep them out of prison.

Watson's lawsuit claims she might be, and likely will be, referred to drug court – but it's another program for which she'd be denied her medicine.

Kentucky's drug courts require clients to remain abstinent, although judges can allow a person time to taper off medicine. The only commonwealth judge who allows medicine – specifically the non-narcotic Vivitrol – is Circuit Court Judge David Tapp, who serves Lincoln, Pulaski and Rockcastle counties.

Northern Kentucky's drug court judges have had conversations with Tapp. His program is a pilot for the Kentucky Administrative Office of the Courts, which told the Enquirer in February it is monitoring the program.

Watson's suit also asks for declaratory relief, stating that the court system should limit its interference with Kentucky doctors prescribing drugs for addiction.

"The reality is, most addicts who are in the court system are denied access to Suboxone and methadone, or any other medicine their doctors want them to take," Pillersdorf said.

"I find that many lawyers and judges arrogantly think that they know more than doctors," he said. "It's unconscionable to me."