Hampshire Hope: Does the ADA protect people with substance use disorders?

Published: 11/30/2021 11:56:13 AM
Modified: 11/30/2021 11:55:42 AM

Marianna has a history of addiction to heroin, and has been in recovery for three years. She applies for a job she’s qualified to do, and the employer refuses to hire her because he knows about her addiction.

Is Marianna protected under the Americans with Disabilities Act?

In recovery for five years from addiction to Oxycontin, Julie is in treatment at a methadone clinic. Her boss at the day care center where she is an office worker learns of her treatment and tells her to get off methadone or she will be fired.

Does Julie have protections under the ADA?

What if Julie uses marijuana while being treated for her opioid addiction? Is she protected?

People in treatment with medication-assisted treatment, or MAT, for their opioid use disorder have their medicine discontinued when they enter a correctional facility. Do they have recourse under the ADA?

A sober home does not allow its residents to use methadone to treat opioid use disorder. Do residents there qualify for ADA protections?

The short answers to these questions are:

■ Yes, Marianna does have ADA protection.

■ While Julie would be protected under the ADA relative to her methadone treatment, she does not have protections under the ADA for the use of cannabis — although she may find protections if her state has a medical marijuana law.

■ People in a correctional facility taken off SUD treatment do indeed qualify for protection under the ADA.

■ As for people living in a recovery or sober home, the answer is it depends.

These were a few of the scenarios discussed Oct. 18 during The ADA, Addiction and Recovery, a presentation we offered to Hampshire HOPE.

By now, most people understand the ADA is a civil rights law that ensures people with disabilities have the same rights and opportunities as others without disabilities. What many people may not realize is that the law applies to people with alcohol and substance use disorders, and this is why we were invited to present to Hampshire HOPE members.

Some of the information about the scenarios we offered may have surprised you, as they did some of the people taking our training last month.

It’s important to understand that the ADA treats substance use disorders involving non-legal drugs and the misuse of legal drugs differently than alcohol. In addition, the ADA makes a distinction between people who are actively in recovery from substance use disorders and people who are actively using substances. People in recovery who are no longer using drugs illegally are protected under the ADA, while those who are currently using are not.

For the purposes of the ADA, recovery is defined as someone who is no longer using substances illegally, or is enrolled in a drug rehab program, or has completed a drug rehabilitation program successfully. The illegal use of drugs refers to using illegal drugs such as heroin or cocaine as well as the use of prescription medications such as OxyContin or morphine without a prescription or with a fraudulent prescription or using more than prescribed.

Let’s unpack some of the details of the scenarios we described at the start of this column to better explain the reasons behind the yes/no/it depends answers.

Marianna and Julie, both of whom were undergoing treatment for their substance use disorders, are entitled to protections under the ADA because they are no longer using substances illegally.

However, if Julie uses cannabis, she would not quality for ADA protection because under federal law, cannabis remains an illegal drug, and the ADA is a federal law. There may be protections under state medical marijuana laws.

According to the ADA, incarcerated people being treated with medicine for their substance use disorder have a right to continue that treatment, just as they would if they were being treated for diabetes or heart disease, so they could seek recourse under the ADA.

Some sober or recovery homes subscribe to abstinence-only models of recovery, and their practice of denying access to individuals being treated with medication for opioid use disorders is currently the subject of litigation. In a case that could settle the question, attorneys for a man named Mark Tassinari filed a federal class action lawsuit against the Salvation Army. After a judge ordered Tassinari into a Salvation Army program as a condition of probation, the program ejected him when he began taking physician-prescribed Suboxone.

Alleging that the sober home is discriminating against Tassinari, lawyers representing him are citing protections under the ADA as well as the federal Fair Housing Act, which requires reasonable modifications so individuals can access equal housing opportunities.

In our presentation with Hampshire HOPE, some participants on the Zoom call raised concerns that the ADA offers protection only for people who are not currently using substances illegally. Doesn’t that go against the principles of harm reduction, they asked. Harm reduction services cover a range of services, some of which may dovetail with the ADA, go beyond the ADA or conflict with the ADA.

Just as substance use treatment changed as providers better understood the physiology of addiction and accepted the idea that relapse is part of the disease, the ADA too can evolve. The ADA is a law that is tested, explained, challenged and sometimes strengthened based on real-world situations when people who need protection make a case for why they should receive it.

For more information including fact sheets and frequently asked questions about how the ADA specifically applies to people with alcohol and substance use disorders, visit the New England ADA Center’s Addiction Recovery website. For a confidential conversation, call 1-800-949-4232.

Oce Harrison is project director and Stacy Hart is an ADA specialist for the New England ADA Center, a project of the Institute for Human Centered Design and a member of the ADA National Network. Hampshire HOPE, the opioid prevention coalition run out of the city of Northampton’s Health Department is responsible for this monthly column about local efforts addressing the opioid epidemic.

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