Example 9: Methadone maintenance treatment in Alberta prisons

Milton Cardinal v. The Director of the Edmonton Remand Centre and the Director of the Fort Saskatchewan Correctional Centre

Project Type: Litigation

Organization 

This is an example of an individual bringing an action to challenge a human rights abuse.

“That [denial of MMT] was wrong . . . . They have no right to torture your client, none whatsoever. It’s almost like keeping food away from him, starving him. He needs this. It’s a medical necessity. He’s going to get it.” –Justice Feehan, Alberta Court of Queen’s Bench

The Problem 

Milton Cardinal was addicted to opiate-based narcotics for over 20 years when, in 2002, he applied for and received methadone maintenance treatment (MMT) through the Alberta Alcohol and Drug Abuse Commission (AADAC). In 2002, Mr. Cardinal was arrested and held in the Edmonton Remand Centre (ERC). It was the policy of the ERC to permit those already receiving MMT therapy to continue to receive MMT from the AADAC for 30 days, at which point the prisoner would be placed on “mandatory withdrawal.” Unsurprisingly, when Mr. Cardinal was placed on mandatory withdrawal, he experienced acute physical and mental pain as a result of the prison’s policy.

Arguments and Holdings 

The court never issued a judgment in this case. Since filing the action prompted the government to change its policy and allow Mr. Cardinal and others similarly situated to receive MMT, the case became moot.

Canadian Charter of Rights and Freedoms

s. 7 Everyone has the right to life, liberty and security of the person and the right not to be deprived thereof except in accordance with the principles of fundamental justice.

s. 12 Everyone has the right not to be subjected to any cruel and unusual treatment or punishment.

s. 15(1) Every individual is equal before and under the law and has the right to the equal protection and equal benefit of the law without discrimination and, in particular, without discrimination based on race, national or ethnic origin, colour, religion, sex, age or mental or physical disability.

Commentary and Analysis 

Mr. Cardinal brought a civil action against the ERC, arguing that withholding his MMT amounted to a violation of his rights under Sections 7, 12, and 15 of the Canadian Charter of Rights and Freedoms. Before the case could go to trial, a change in policy allowed prisoners in Alberta, like Mr. Cardinal, to receive MMT while in jail. The case settled with the two parties agreeing, “The provision of methadone maintenance treatment to persons who suffer from opioid drug addiction constitutes the community standard of health care in the province of Alberta.”

MMT therapy, particularly for prisoners, is an important element of any harm reduction program. Prisoners require MMT while in prison and referrals to community-based MMT programs prior to their release. Beyond the individual health benefits to the prisoners, MMT benefits the community by driving lower recidivism rates. Unfortunately, clear practical obstacles exists to establishing an effective MMT program, including the stigmas associated with pharmacological treatment, misconceptions regarding the nature of opioid addiction, logistics of control and storage of methadone, increased work load for nursing staff and general safety and control concerns. Therefore, an effective legal strategy, built on existing rights, may be the best way to leverage and pry open MMT programs for prisoners who need them.