A deepening opioid epidemic is prompting the U.S. Department of Justice to warn about discrimination against those who are prescribed medication to treat their addictions.
In guidelines published Tuesday, the department's Civil Rights Division said employers, health care providers, law enforcement agencies that operate jails and others are violating the Americans with Disabilities Act if they discriminate against people for taking prescription drugs to treat opioid use disorder.
“People who have stopped illegally using drugs should not face discrimination when accessing evidence-based treatment or continuing on their path of recovery,” Assistant Attorney General Kristen Clarke said in a statement.
The nation's addiction overdose crisis has intensified in recent years. The U.S. Centers for Disease Control and Prevention announced last year that more than 100,000 people had died from overdoses over a 12-month period, the highest level ever recorded.
Most of the deaths are linked to opioids, which include prescription painkillers, morphine, heroin and potent laboratory-made drugs such as fentanyl that often are mixed into the supplies of other illegal drugs.
Public health experts believe that increasing the availability and acceptance of medications such as methadone and buprenorphine to treat opioid addiction is essential to curtailing the crisis. But those drugs — which are themselves opioids — have long had stigmas attached to them.
The Justice Department guidelines clarify that drug addiction is considered an impairment under the ADA. The department says they do not represent a policy change but rather clarify existing requirements.
“We know that seeking and accessing treatment is a critical part of reversing the addiction crisis and the overdose crisis,” said Kevin Roy, the chief public policy officer at the advocacy group Shatterproof. “People are going to be more likely to get treatment because of this policy, and that has the potential to reduce the number of people at risk of overdose death.”
The guidelines give examples of possible violations: A doctor's office denying care to patients receiving treatment for opioid addiction; a town refusing to allow a treatment facility if the opposition is based on residents' hostility toward people with addictions; a jail barring inmates from taking prescribed medication to block opioid addiction.
In February, the department sued the judicial system in Pennsylvania, alleging that some courts under its jurisdiction prohibit or limit people in court supervision programs from using medication to treat opioid use disorder. In a response, Pennsylvania officials said they had taken steps to “enhance awareness in the few, discrete judicial districts involved,”
The U.S. reached a settlement with Massachusetts courts last month over similar allegations, prompting the courts to change their practices.
The government last month also reached a settlement with Ready to Work, a Colorado agency that provides services to the homeless. It was accused of denying admission to one would-be participant because she was on medications to treat opioid use disorder. In addition to stopping the discrimination, Ready to Work was required to pay the person who complained $7,500.
The department also sent a letter in March to the Indiana State Board of Nursing over its decision to remove a nurse from a required licensing program over her use of medication to treat an addiction. A spokesperson for the board did not immediately respond to a request for comment Tuesday.
The Justice Department document notes that federal law does not protect people who are using illegal drugs. A drug rehabilitation program, for example, would not be violating the law if it kicked out a participant who routinely kept using drugs.
But the guidelines do say that a person who uses opioids legally prescribed to treat pain could not be fired because of it.
“The Justice Department is committed to using federal civil rights laws such as the ADA to safeguard people with opioid use disorder from facing discriminatory barriers as they move forward with their lives," Clarke said.