The Americans with Disabilities Act (ADA) ensures that people with disabilities have the same rights and opportunities. This includes people with alcohol addiction and recovery from opioids and other substances.
The ADA (Title III) applies to private businesses, nonprofit organizations, and businesses that are open to the public and whose operations affect commerce. Examples include health care and nursing homes. The goods and services offered by these entities must be accessible to people with disabilities. The ADA also requires that when a person with a disability requests a modification to the policies or how the business operates, that modification must be considered.
Definition of disability
A person has a disability under the ADA if:
- You have a physical or mental impairment that substantially limits one or more major life activities, e.g., someone with bipolar disorder, diabetes, or alcohol addiction or
- You have a history of a disability that substantially limited one or more major life activities, e.g., someone who has a history of cancer or someone in recovery from illegal drug use or
- It has been considered to have such an impediment, e.g., someone has a family member who has an alcohol addiction so is also assumed to have an alcohol addiction and faces discrimination as a result of someone who is perceived to have a disability and is treated negatively based on the assumption of disability.
Major life activities include, but are not limited to, walking, seeing, caring for oneself, learning, thinking, communicating, and functioning of bodily functions such as neurological and brain functions.
Addiction is generally considered a disability because it is an impairment that affects the brain and neurological functions.
The ADA applies to alcohol addiction and illegal drug use differently. Alcohol addiction is generally considered a disability, whether the alcohol use occurs in the present or the past. For people addicted to opioids and other drugs, the ADA protects a person in recovery who is no longer involved in current illegal drug use.
Illegal drug use means:
- Use of illegal drugs such as heroin or cocaine and
- When the person does not have a prescription, the misuse of prescription drugs, such as opioids or benzodiazepines, has a fraudulent prescription or uses more pills than prescribed.
In recovery means:
- You are recovering from a substance use disorder and are no longer involved in illegal drug use or
- You are participating in a supervised rehabilitation program and are no longer using drugs illegally.
What does “current” mean?
- Drug use occurred recently enough that there is a reasonable belief that a person’s drug use is a natural and ongoing problem.
- It can be shown when a person fails a drug test or indicates that they may fail such a test.
- It is not limited to days, weeks, or months but is determined case-by-case.
Medication-Assisted Treatment
In a Medication-Assisted Treatment (MAT) program, a person has legally prescribed medications such as Suboxone, Methadone, or Vivitrol to treat their addiction and counseling. A person on MAT who is no longer engaged in illegal drug use is considered a person with a disability and is protected by the ADA. A person’s medication is so specific to them, and the treatment of their disability that denying someone access to goods and services because of a prescription drug is discrimination based on disability.
General Policies
Under the ADA, businesses and nonprofit organizations, including health care organizations, may not adopt blanket policies that negatively affect people with disabilities, such as denying people in recovery access to services. An individualized assessment must be made as to whether the business can provide services to the person with a disability with or without reasonable modifications of policies and practices.
Skilled Nursing Scenario
Josephine has been in recovery for five years since she started MAT. She was recently hospitalized for pneumonia and is now being transferred to a skilled nursing facility for continued care to return home. Her doctor had sent her completed admission paperwork and prepared her for transfer. The admissions coordinator contacted Josephine about her medications, precisely her prescription for Methadone. The coordinator explained: “We don’t accept anyone taking Methadone because we don’t have anyone to administer it or a way to store it. If you stop taking Methadone, I will be happy to reconsider your application.”
Does Josephine have protections under the ADA? Yes, she has them. The skilled nursing facility has discriminated against her because she is a person with a recovering disability and, more specifically. After all, Josephine is on MAT, taking Methadone. The skilled nursing facility cannot deny her admission based on her doctor’s medication for her disability. The skilled nursing facility must admit Josephine and allow her to continue taking prescribed medications, including Methadone, while she is a patient.
Recovery Home Scenario
Lucy is newly in recovery and on MAT. She has started applying to recovery homes, including a nonprofit recovery home in her town. The director of the recovery home asks her about her prescription, and she explains that she takes Adderall for her ADHD. The principal states that she does not allow any addictive medication in the home and would have to change her ADHD medication.
Does the ADA protect Lucy? Yes, Lucy is protected by the ADA because she is not currently involved in illegal drug use, and she qualifies for the recovery program. The recovery home may not have a blanket policy about denying access based on the medication an applicant is prescribed, as long as the drug is taken as prescribed. If security is a concern, the principal can set up a lockbox system or other security system that meets everyone’s needs.
