Kentucky prison must offer inmates access to medications for opioid use disorder, feds say

The Big Sandy Regional Detention Center has reached an agreement with the federal government requiring the facility to ensure people with opioid use disorder receive access to their FDA-approved medications, required by the Americans with Disabilities Act (ADA).

On Monday, U.S. Attorney Carlton S. Shier IV announced the agreement with the Big Sandy Regional Jail Authority, which operates the detention center. The settlement requires Big Sandy to revise policies to provide access to all three forms of FDA-approved medications — methadone, buprenorphine and Naltrexone — to people with opioid use disorder.

“The ADA prohibits state and local governments from discriminating against individuals with disabilities and protects people in recovery from OUD (opioid use disorder), including individuals who are taking OUD medication at the direction of a medical provider,” the U.S. Attorney’s Office said in a news release.

Opioid use disorder is the medical terminology used to define opioid or drug addiction.

Despite the ADA protections, people still have trouble accessing medication they were previously taking while inside local jails and prisons.

According to the settlement agreement, the Department of Justice opened an investigation of Big Sandy under Title II of the ADA after receiving a complaint by a medical provider on behalf of a patient identified in court documents as “J.F.,” who was lawfully prescribed buprenorphine to treat his opioid use disorder. The settlement alleges that once the inmate was booked in Big Sandy, he was denied his medication — a direct violation of Title II of the ADA regulations.

As part of its investigation, the United States substantiated allegations that Big Sandy effectively bans medications for addiction without an evaluation of a medical professional, according to the settlement agreement.

Decisions about treatment will now be based on an individualized determination by qualified medical personnel.

The facility will be required to evaluate all individuals with opioid use disorder upon arrival and ensure individuals who were receiving medication from a licensed treatment provider before their incarceration are continued on that medication. If an inmate was not receiving medication before incarceration, the detention center will now be required to offer medication options, according to the settlement.

“Eastern Kentucky has long been on the front lines of the opioid epidemic and our office remains committed to a comprehensive approach to fighting this public health crisis, including enforcement of the ADA’s requirements safeguarding treatment,” said Shier in the release.

“Considering the impact this crisis has had on our area, treatment must be a critical tool in our efforts to fight back. Access to medications that treat opioid use disorder saves lives, and we are pleased we were able to reach a settlement with the Big Sandy Regional Detention Center to better ensure access to this important treatment for the people in its custody,” Shier said.

This announcement comes more than one year after the same group agreed on a settlement which would require similar measures at the Fayette County Detention Center. In November 2022, the U.S. Attorney’s Office found the Lexington facility did not provide most individuals with access to methadone and buprenorphine, or stopped their access.