Eldred’s lawyer, Lisa Newman-Polk, told me that to her knowledge, this case marks the first time that a court will debate whether relapse should be considered a medical symptom. Should the court rule in Eldred’s favor when it releases its decision this spring, it would have ramifications for how probation guidelines are imposed across the state, and likely spur similar suits across the nation. Legal observers have called this the most important case to come before the Massachusetts Supreme Court in the past decade.

As it stands, judges have tremendous discretion to determine when a failed drug test during probation should be met with additional treatment or incarceration. Though the judge in Eldred’s case ultimately moved her into inpatient treatment from jail, under Massachusetts law she could have put Eldred behind bars for the remaining two-and-a-half years of her theft sentence.*

Newman-Polk’s argument, which is shared by many medical professionals, is that incarceration poses a threat to the recovery process—not that court-ordered drug treatment or testing is unfair, or that criminal sanctions shouldn’t be imposed on probationers who don’t comply with treatment. Eldred had been on a regime of anti-craving medicine, Suboxone, for five days when she relapsed.

“From a therapeutic perspective, it is very disruptive to put somebody in a position where they’re afraid if they talk about relapse—or even talk about cravings to relapse—they could be jailed,” said Newman-Polk, who previously worked as an addiction counselor. “If the court feels that addiction treatment is a necessary probation condition, then the court system shouldn’t interrupt the treatment process.”

Assistant Attorney General Maria Granik’s argument in the case has contrasted sharply with her boss’s public remarks about substance abuse. In a brief to the court, Granik wrote that “most people with drug addiction retain the ability to exercise choice.” And in her oral arguments in early October, she said that it could “not be determined with any kind of scientific or medical certainty” that Eldred’s relapse was involuntary. By putting her in jail, the Commonwealth was protecting her, Granik has claimed.

Eldred has struggled with substance abuse for years. She first experimented with OxyContin in high school, which helped ease her social anxiety, she told The Boston Globe. “It made me feel like I could fit in wherever I wanted,” said Eldred, who told the paper her biological parents both had issues with addiction. Occasional use became daily, and in her early 20s, she turned to heroin.

Eldred’s 2016 probation violation wasn’t her first, though that doesn’t appear to have influenced the judge’s decision making. She was put on probation four years ago for a previous theft charge, but after testing positive for heroin in a drug test, she served two months in jail. That period of incarceration was counterproductive to her recovery, she’s said: Drugs were easily available, and the trauma of witnessing inmate-on-inmate violence and undergoing invasive search procedures set her back emotionally. “I wish they could spend one night in [jail], all the people who think it’s a good idea to send us there,” Eldred told the Globe.