The notion that drug addiction is a health condition is not, in the main, controversial in 2017—not politically and not medically. For decades, doctors and researchers have categorized it as a disease, and in recent years the majority of the American public has caught up with them, with widespread support for increased access to treatment and reduced reliance on incarceration. But this consensus hasn’t entirely translated to the courts.
There’s perhaps no case that illustrates this disconnect more clearly than one that’s playing out in Massachusetts. There, the state Supreme Court is considering the appeal of 29-year-old Julie Eldred, who’s contesting a trial court’s decision that she violated probation by failing a mandatory drug test. She’d been under court supervision for theft for 12 days in 2016 when she tested positive for fentanyl, a powerful opiate; she subsequently spent 10 days in jail before being sent to an inpatient treatment facility.**
Eldred says that she shouldn’t be punished for her inability to abstain from drugs, and that the jail time violated her constitutional protection against cruel and unusual punishment. Relapse is a symptom of her illness, she’s argued, and doesn’t amount to a purposeful violation of court orders. On the one hand, the top law-enforcement officer in Massachusetts would seem to agree: Attorney General Maura Healey told the Associated Press last year that “for far too long” addiction hasn’t been treated like a medical condition: “I think about addiction as a disease in the same way we think about diabetes as a disease or heart disease as a disease.” But in Eldred’s case, that thinking hasn’t influenced the state’s argument: Healey’s office has refined its stance to say that, in a legal setting, it’s not the same thing.