The Pennsylvania Commonwealth Court, in an opinion released earlier this week, might be opening the door for the use of Medication-Assisted Treatment for substance abusers who are in state prisons.

The use of medications such as methadone, Suboxone and Vivitrol to treat substance abusers has become more common for addicts who are not in prison.

However, an inmate like Mark C. Rokita Jr., 37, who was committed to the State Correctional Institution at Houtzdale on drug and gun offenses, is barred by the Pennsylvania Department of Corrections from even seeking MAT assistance to deal with his admitted opioid abuse.

Rokita, who has been diagnosed with “substance abuse disorder,” has requested that he receive treatment while behind bars through the use of Vivitrol.

That treatment would be under the supervision of medical professionals, if Rokita has his way.

While the Department of Corrections allows Medication-

Assisted Treatment in some cases, such as the use of methadone for pregnant inmates to protect the unborn child from having to endure withdrawal symptoms upon birth, or for inmates being released from custody, it does not permit such treatment for inmates serving long prison sentences, such as Rokita.

The treatment offered to Rokita consists of group counseling sessions, according to the Commonwealth Court opinion written by Judge Patricia A. McCullough.

Rokita appealed DOC’s opposition to MAT by filing an appeal with the court.

He stated that he developed a dependence on opioids prescribed for him due to an injury.

He became addicted, and he claims he turned to the illegal opioid pill trade when he could no longer receive the pills legally.

He said he has been using Suboxone obtained through the “prison black market,” but more recently he asked a prison social worker that he be permitted to explore the use of Vivitrol.

In his appeal, he contends that there are no MAT programs offered to DOC’s general population.

He contended the DOC policy violates his Eighth Amendment rights barring cruel and unusual punishment.

The policy, he stated, also violates the Americans With Disabilities Act.

The Rokita petition requests an order “compelling the (DOC) to allow him access to a doctor who specializes in substance abuse disorder and who is authorized to prescribe MAT,” according to the McCullough opinion.

Three Commonwealth Court judges joined with McCullough in an order dismissing DOC’s objections to Rokita’s request.

They included the court’s President Judge Renee Cohn Jubelirer and Judges Anne E. Covey and Christine Fizanno Cannon.

The appeals court ordered the department to file an answer to Rokita’s request for medical assistance within 30 days.

Judge Michael H. Wojcik dissented.

Wojcik contended that the department has not denied treatment to Rokita and that no medical professional has clarified that MAT is necessary to treat Rokita’s drug addiction.

The dissenting judge pointed out that Rokita simply believes his present treatment program is not what he prefers.

He stated, “The majority, in advocating for social reform by expanding the use of MAT in Pennsylvania’s prisons, has not cited any controlling legal authority to support the proposition that (Rokita) has pleaded a viable Eighth Amendment claim.”

He further contended the General Assembly and the DOC are the bodies charged with enacting laws and social policy.

“I cannot support the majority’s dangerous and unwarranted expansion of the use of MAT in these facilities (state prisons),” said Wojcik in his dissent.

McCullough, representing the majority of the court, took a different stance, stating that the use of medications to combat drug abuse is a “developing area of the law … which cannot escape the Court’s notice.”

“The prevalence of opioid use and addiction has become a crisis in the United States, to the extent that it has been recognized as a public health emergency by both the federal government and this commonwealth.

“As this crisis permeates all levels of society, it is no surprise that its effects are felt within prison walls, where many individuals who are addicted to controlled substances eventually find themselves,” according to the opinion.

In discussing the drug crisis in America, the court’s majority opinion also noted the multiple lawsuits that have been filed against pharmaceutical companies which assured the medical community that patients would not become addicted to pain relievers.

The McCullough opinion argued in favor of allowing Rokita to move forward with his attempt to obtain Medication-Assisted Treatment.

“Absent effective treatment during incarceration, relapses and overdoses upon release are the leading cause of death among inmates after their release.” McCullough stated.

The opinion explained Rokita is being denied “an entire category of medical treatment … as are other inmates.”

“Because the provision of adequate medical care in prison is a constitutional necessity, it follows that the denial of an entire class of medical treatment may raise a question under the Eighth Amendment,” it concluded.

The majority opinion addressed Wojcik’s concern that the judges were overstepping their bounds by allowing Rokita’s petition for MAT to move forward.

“We merely conclude that, given recent developments in the law … it is possible that Rokita can establish that he has been denied necessary medical treatment in violation of the Eighth Amendment,” the opinion explained.