The top Massachusetts court unanimously ruled on Monday that a judge can require defendants with substance use disorders to remain drug-free as a condition of probation and send them to jail if they relapse.
The case, which challenged a requirement routinely imposed by judges across the country, had been closely watched by prosecutors, drug courts and addiction medicine specialists. For many, it represented a debate over the nature of addiction itself.
The defense argued that addiction is a chronic, relapsing brain disease that compromises an individual’s ability to abstain. The prosecution maintained that addiction varies in intensity; that many individuals have the ability to overcome it and can be influenced by institutional penalties and rewards, like incarceration or a cleared criminal record.
While acknowledging the numerous experts who weighed in on each side, the seven justices of the Massachusetts Supreme Judicial Court declined to take a stance in the debate. Instead, they said, the defendant in the case should have raised the issue when her probation condition was first imposed, when it could have been fully argued before a trial judge.
Justice David A. Lowy wrote that a judge has the power and discretion to determine probation requirements tailored to an individual and that further probation’s twin goals: rehabilitation and public safety. Judges, he said, “stand on the front lines of the opioid epidemic,” and are “faced with difficult decisions that are especially unpalatable.”
The challenge was brought by Julie A. Eldred, now 30, who had been convicted of larceny for stealing jewelry to support her heroin habit. In August 2016, a district judge gave her a year’s probation, facing up to a 30-month sentence for violating conditions. The judge ordered her to begin outpatient treatment and remain drug-free. Ms. Eldred enrolled in a program and began taking Suboxone, a medication that can reduce cravings and symptoms of withdrawal. Shortly after, she relapsed and, she said, returned to her doctor for help, asking for a stronger dose of Suboxone.
Eleven days after her probation began, Ms. Eldred tested positive for fentanyl. The judge ordered her to go to inpatient treatment but no placement could immediately be found. What should be done with her? It was the beginning of Labor Day weekend, and Ms. Eldred’s parents were out of town.
“The judge was faced with either releasing the defendant and risking that she would suffer an overdose and die or holding her in custody until a placement at an inpatient treatment facility became available,” Justice Lowy wrote, in the decision handed down Monday.
During the 10 days she was in a medium-security prison, Ms. Eldred went through withdrawal. Suboxone was not prescribed.
Lisa Newman-Polk, one of Ms. Eldred’s lawyers, called Monday’s decision a “massive blow,” and said that the court had missed an opportunity to incorporate mainstream medical opinion about addiction. She said the court had “rubber-stamped the status quo, dysfunctional way in which our criminal justice system treats people suffering from addiction.”
Ms. Eldred’s lawyers had argued that sending someone with severe substance use disorder to jail for relapsing amounted to cruel and unusual punishment — that she had been sanctioned for her illness. The Massachusetts attorney general’s office disagreed, saying that many successful treatment models rely on a person’s ability to abstain. Because Ms. Eldred committed a crime to support her drug habit and her addiction was active, prosecutors said, the judge also had an obligation to protect the public from the likelihood that she might commit another crime.
“We are pleased the Supreme Judicial Court today affirmed a court’s ability to take an individualized approach to probation that encourages recovery and rehabilitation to help probationers avoid further incarceration,” said a spokeswoman for Maura Healey, the Massachusetts attorney general.
But Fiona Doherty, a clinical professor of law at Yale Law School and an expert on probation, said that because the court did not take a position on addiction, the case was only a qualified win for the prosecution, confined to Ms. Eldred’s circumstances and timing.
“The impact of substance use disorder and a defendant’s ability to relapse is still open,” she said. “There is lots of room for lawyers and defendants to remount a challenge to the same drug-free condition. They can object at the time the condition is imposed and seek a full hearing on the science.”
