Fifteen Examples of Discrimination Against People With Substance Use Disorders

    In light of the imminent threats to the confidentiality of substance use disorder patients, Legal Action Center, along with Faces and Voices of Recovery, has documented some of the impacts of stigmatization and discrimination due to SUD treatment.

    Here are some of the numerous examples they cite (the full information, which includes all comments, pro and con, is available here):

    * A young father in recovery who was being denied visitation with his children because he was in methadone treatment, despite the fact that he was not using any illegal substances

    * A mother in recovery who had her 2-month-old infant removed from her custody after the hospital where she gave birth reported her for having legally prescribed methadone in her system; 

    * A young mother who was being threatened with eviction from a shelter because she was taking prescribed methadone for her opioid addiction (another young mother had already been evicted from the same facility for the same reason, and had become homeless; neither woman was using illegal substances)  

    * A young man whose employer refused to allow him to return to work after he successfully completed treatment for alcohol use disorder, saying that he was a safety threat even though his physician had cleared him to return to work with no restrictions.

    * A 29-year-old mother who lost her 3-year-old in a child custody case because, after the unlawful disclosure of her addiction treatment records, she was deemed unfit by a judge and her child was put in the custody of child protective services.

    * A bright young lawyer who learned after two weeks at her new job that she would be terminated because the fact she was on methadone came up in a background check.

    * A woman who had to give up her dream of owning her own small business because she could not get a health insurance policy for her employees

    * A husband with four children who was in a high-risk fisheries job and was unable to get life insurance to protect his wife and children


    Here are still more examples of discrimination against people with SUD (full information here):


    Overdose Victims Cited in One Ohio City

    Washington Court House Police Chief Brian Hottinger told NBC4 that his department has started citing people with inducing panic if they need to be revived with naloxone. He said his department started doing it in February. Hottinger said if officers can’t charge them with anything else, they will charge them with inducing panic as a way to track the overdoses. Inducing panic is a first-degree misdemeanor, punishable by up to six months in county jail and a $1,000 fine.

    Alcohol, Drug, and Criminal History Restrictions in Public Housing

    The data show that nearly all Public Housing Associations institute more stringent bans than required by federal law and that individual PHAs exercise a great deal of discretion in setting ban lengths and defining individual problematic behavior. As a result, similar households may encounter radically different rules when attempting to access or retain housing assistance, even within a single PHA. The decision to define those with alcohol, drug, or criminal histories as categorically undeserving of housing assistance undermines other important public policy goals to treat similar populations equitably and to support ex-offenders and their families. 

    Parental Drug Use as Child Abuse

    States have responded to this problem by expanding the civil definition of child abuse or neglect to  include this concern. Specific circumstances that are considered child abuse or neglect in some states include:

    * Manufacturing a controlled substance in the presence of a child or on premises occupied by a child 4 In 11 States (Alabama, Colorado, Indiana, Iowa, Montana, Oklahoma, Oregon, Pennsylvania, South Dakota, Tennessee, and Wisconsin) and the District of Columbia.

    * Exposing a child to, or allowing a child to be present where, chemicals or equipment for the manufacture of controlled substances are used or stored 5 In 8 States: Alabama, Arizona, Arkansas, Iowa, New Mexico, North Dakota, Oklahoma, and Oregon. ƒ Selling, distributing, or giving drugs or alcohol to a child 6 In 7 States (Arkansas, Florida, Hawaii, Illinois, Iowa, Minnesota, and Texas) and Guam.

    * Using a controlled substance that impairs the caregiver’s ability to adequately care for the child 7 In 11 States: California, Delaware, Florida, Iowa, Kentucky, Minnesota, New York, Oklahoma, Rhode Island, Texas, and West Virginia.

    * Exposing a child to the criminal sale or distribution of drugs

    Stigma Among Health Professionals Towards Patients With Substance Use Disorders and Its Consequences for Healthcare Delivery: Systematic Review.

    Conclusions: This review indicates that negative attitudes of health professionals towards patients with substance use disorders are common and contribute to suboptimal health care for these patients. However, few studies have evaluated the consequences of health professionals’ negative attitudes towards patients with substance use disorders.

    SSA–Office of Policy “Follow-up of Former Drug Addict and Alcoholic Beneficiaries Research and Statistics Note No. 2001-02 (released October 2001)”

    Because of the rising number of people with DA&A status receiving disability benefits, Congress included several provisions for them in the Social Security Independence and Program Improvements Act of 1994 (P.L. 103-296). Section 201 of P.L. 103-296 placed a three-year time limit on both SSI and DI benefits to individuals whose primary impairment was drug addiction or alcoholism. Then, on March 29, 1996, Congress enacted P.L. 104-121, the Contract with America Advancement Act of 1996, which contained new, more restrictive provisions affecting DA&A cases. Beginning on the day of enactment (under section 105), SSA ceased to award SSI payments and DI benefits to new applicants. As of January 1, 1997, the law also terminated eligibility of DA&A beneficiaries receiving SSI and DI on March 29, 1996, unless they successfully appealed the termination. SSA granted DA&A beneficiaries 60 days to file an appeal after they received the termination notice.

    The Americans with Disabilities Act and “Current” Illegal Drug Use

    During the past several years, federal law and policy have moved to discourage the use of illegal drugs in the United States through the Americans With Disabilities Act (“ADA”), which became effective in 1992. The ADA is crafted to protect people with disabilities from discrimination in numerous areas. Nevertheless, Congress explicitly struck a blow against current illegal drug users by excluding them from ADA coverage. However, recognizing that problematic drug users should be encouraged to seek help, Congress sought not to punish people who had participated in a supervised rehabilitation program and no longer engaged in the use of illegal drugs.

    Discrimination Against Patients With Substance Use Disorders Remains Prevalent And Harmful: The Case For 42 CFR Part 2 

    The purpose of the confidentiality law is to ensure that a person with a substance use disorder is not made more vulnerable to discriminatory practices and legal consequences as a result of seeking treatment. Unfortunately, patients with substance use disorders still face enormous consequences associated with disclosure, including loss of employment, loss of housing, loss of child custody, loss of benefits, discrimination by medical professionals, and even arrest, prosecution, and incarceration. As our country faces an unprecedented epidemic of opioid addiction and overdose, we must ensure that fear of discrimination does not deter people from seeking treatment.

    Photo by Jose Fontano on Unsplash

    • Alison has written about substance use for more than 30 years. She has also written for many years about medical coding. A freelance writer, she is also the editor of Alcoholism & Drug Abuse Weekly, and managing editor of Child & Adolescent Psychopharmacology Update and Child & Adolescent Behavior Letter—all published by WILEY. She also writes for Addiction Treatment Forum.

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