Our recent articles on two opioid treatment programs (OTPs) in Alabama — Shelby County Treatment Center and Chilton County Treatment Center – which reported police harassment of methadone patients, produced results. According to owner and director Susan Susan Staats-Combs, after she posted the articles all over town, the harassment abruptly stopped. Kudos to the power of the press. (For the articles, go to
However, now two of her patients are in jail; her program delivers their methadone to them. However, these two people have to be in solitary confinement unless they refuse their methadone, she said. One patient is being “taken down from 80 to 20” milligrams, and “so far they’re telling him he can’t get out of solitary until he refuses his methadone.” The other has been in solitary confinement for more than a week, and still taking his methadone.
Below is an email which Staats-Combs wrote to county officials on February 7 regarding her patients in the Shelby Jail. She is being polite, informative, and has as the one goal, stopping the abuse of her patients.
Sometimes we even hear comments that violate their ethical duty. For an example would be a medical professional encouraging a patient to get off methadone. Law enforcement are on another side are often unaware of all the conditions of a methadone treatment center and do not realize opioid use disorder is a permanent brain disease.
These have all been huge contributor to the opioid crisis. The lack of understanding of the permanent brain disease, opioid use disorder and the need for treatment to reduce the crisis is often minimized and mocked.
Alabama suffers from the opioid crisis, a large percentage of the opioid deaths are related when the inmate is leaving jail / prison thinking they have the same tolerance. It is illegal now for drug courts to interfere with methadone treatment. Many people have died because judges were practicing medicine and demanding they stop treatment.
- Patients with opioid use disorder are protected by the American Disabilities Act, HIPAA,42CFR which are specific laws to protect MAT patients developed solely because of the unfounded stigma.
- Patients cannot be singled out because they are on methadone. They cannot be segregated , treated any differently than anyone of any other prescription. For example, It would be illegal to place a methadone patient in solitary because they were on methadone and told they could leave solitary if they refuse their dose. This for example would be a violation of human rights.
- If persons are allowed glasses to see, insulin, etc. then they are allowed methadone. There is simply too much scientific based research about MAT in this day and age to not stand up for it. That is why the Department of Justice has been actively monitoring and enforcing the rights of the methadone patients.
We are helping to accommodate your jail by bringing the methadone to you, so that the jail will stay in federal compliance. We are also in hope that as we work hard to teach patients to choose the law abiding road that other persons are trained about patient rights and federal protections. I am aware in all walks of life there are Nay Sayers but it is our ethical duty to teach the new way, the better way, the scientifically proven way to peers etc. We must represent to the inmates and people struggling to follow by example the highest of integrity. I have been in the field for about 30 years and would be happy to provide a more in depth education about treatment, to answer questions and help to foster some trust about how treatment benefits us all. We could also do a tour and provide lunch at your convenience.
Below is a handout from ACLU that might also be informative.
Susan Staats -Combs, M.Ed, LPC,NCC,MAC,PhT
Shelby County Treatment Center
Chilton County Treatment Center
Alabama Governor’s Council on Opioid Misuse and Addiction
National Stop Stigma Board
President of ALAMTA
President of Recovery Gardens
Alabama Substance Abuse Coordinating Committee
Alabama Opioid Data Committee
Alabama Opioid Treatment Committee
Alabama Opioid Workforce Committee
We have one comment here. There are massive changes proposed by the Substance Abuse and Mental Health Services Administration to OTP regulations (see https://atforum.com/2022/12/samhsa-proposal-update-methadone-regulations/). The deadline for comment is February 14. If these much-needed proposals become final, that is great, but what will it do for treatment in Alabama and other “nay-saying” states?