If addiction is a disease, why is relapsing a crime?
This question was brought before the Massachusetts Supreme Judicial Court this past year where a ruling was presented on Monday. The case was raised when a Massachusetts woman, whose probation terms mandated she stay drug-free, failed a drug test and was jailed for ten days before being placed in an in-patient treatment facility.
The case has captured the attention of public health advocates, who say the judicial system should not punish people for having the disease of addiction, and law enforcement officials, who argue public safety is at risk otherwise.
On one side, the defendant, Julie Eldred, argued she had been sanctioned for an illness she struggled with for over a decade. A large body of scientific research shows that addiction has the properties of other medical disorders, including genetic links and a susceptibility to medication. Eldred’s lawyers argued that it’s unconstitutional to jail someone for an active medical condition, not to mention an inefficient form of rehabilitation. “If it worked to punish people for addiction and relapse we would have a cured nation,” one of her lawyers said.
On the other side, the attorney general argued that because Eldred committed a crime to support her drug habit (larceny in 2016 to support her heroin addiction), the judge had an obligation to protect the public that she may commit another. The judge was also protecting the defendant herself from overdosing, the prosecutors argued. Opposing briefs also highlighted the lack of consensus as to whether addiction is a brain disease, such as a 2013 study in AJOB Neuroscience that concluded that “it is not necessary, and may be harmful, to frame addiction as a disease.”
The highest court in Massachusetts ruled in favor of the prosecution, stating a person with addiction may be jailed for relapsing while on probation, though “such decisions should be made thoughtfully and carefully, recognizing that addiction is a status that may not be criminalized.”
However, the seven-member court declined to take a stance on whether addiction is a disease that affects a person’s ability to comply with sentencing requirements. Because of that evasiveness, this may just be the beginning of how we treat addiction during sentencing. Here’s Jan Hoffman for the New York Times :
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 prevent 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.”
In its 27-page decision , the Massachusetts Supreme Judicial Court made little mention of the scientific research cited in support of the defendant, including briefs from the Massachusetts Medical Society, the American Academy of Addiction Psychiatry, and Surgeon General.
“We also agree with the Commonwealth that the defendant’s claim of [substance use disorder] rests on science that was not tested below,” the ruling read.