Policy 2021-15: Policy Regarding Methadone
America is in the midst of a devastating opioid epidemic—and Michigan has been particularly hard-hit. Since 1999, the number of opioid deaths in Michigan has increased by more than 17 times. In Michigan, moreover, opioid overdoses account for nearly 80% of all drug-related deaths.
Because opioids cause a physical chemical dependency—and often result in permanent changes to neurochemical balance—recovery from opioid dependency can be particularly difficult. Abstinence-based treatment approaches, under which a person is expected to completely abstain from substance use, have been successful for many people. But abstinence does not work for everyone. For many, a more viable path to recovery involves medication for addiction treatment (“MAT”). Under a MAT approach, abstinence from illicit opioids is aided by longer-acting opioid medications that help to normalize brain chemistry, relieve physiological cravings, and block the euphoric effects of opioids.
In Policy Directive 2021-07, effective January 13, 2021, this Office issued new charging policies regarding the unauthorized use, possession, and small-scale distribution of buprenorphine—a particularly effective medical treatment for opioid addiction. In addition to buprenorphine, another medication prescribed to people receiving treatment for their opioid use disorder is methadone. Though there are pharmacological differences between buprenorphine and methadone, there are also compelling reasons to extend this office’s general harm-reduction approach to methadone.
Among those reasons: Buprenorphine is a medication that is significantly more likely to be prescribed to people in treatment who are white, employed, and have some college education. Methadone, by contrast, tends to be more frequently prescribed to Black and Hispanic people, as well as people of lower socioeconomic status. It is the mission of this Office to ensure that justice is dispensed evenhandedly—regardless of race and socioeconomic status. It would run contrary to that mission to prosecute people in recovery for unauthorized use of methadone (a medicine that is frequently used by people of color and those of lower socioeconomic status), while declining to prosecute cases arising from unauthorized use of buprenorphine (which is more frequently used by people who are white and of higher socioeconomic status).
Given all of this—and given this Office’s general belief that substance-use issues should be treated as health issues, not as criminal matters—the Washtenaw County Prosecutor’s Office has extended its existing policy on buprenorphine to methadone. In short, as with buprenorphine, the Prosecutor’s Office now maintains a general presumption against prosecuting the use or possession of methadone. The Prosecutor’s Office will, however, continue to prosecute cases involving a pronounced risk to health or public safety. That includes those who engage in large-scale sale, for profit, of methadone, or whose activities threaten to harm others.