If you’re taking medication for opioid use disorder, it can be difficult to understand your rights when it comes to employment.
For most people in recovery from opioid addiction, it can take a while to get used to the rhythm of “normal” life. Stuff like prioritizing rent and bills over padding your dealer’s pocket. Catching up on your dental health. Getting and keeping a steady job … that last one, while important, is also arguably the most anxiety-inducing. Especially if you’re taking medication for opioid use disorder, it can be really difficult to understand your rights when it comes to employment.
Unfortunately, discrimination is a very legitimate concern for people using medication-assisted treatment to treat opioid addiction, especially when it includes an opioid agonist like methadone or buprenorphine (known commonly by brand name Suboxone). There is still widespread misunderstanding about the use and effects of these medicines. Many people wrongly believe they are a crutch and that true recovery can’t begin until after one tapers or detoxes off of them. But in fact, methadone and buprenorphine significantly reduce the risk of relapse and dying from an overdose, and are listed as essential medicines by the World Health Organization. And they aren’t just medicines that can help with withdrawal during detox. Their intended use is as maintenance drugs—which means folks should take them as long as they feel necessary, even if that means staying on them for life. The dangers of stopping them too soon are far greater than the dangers of remaining on them long-term.
“Methadone and buprenorphine significantly reduce the risk of relapse and dying from an overdose, and are listed as essential medicines by the World Health Organization.”
A lot of people also think that as opioid medications, methadone or buprenorphine will lead to impairment. That’s also false. Because they are both opioids (methadone activates opioid receptors fully, and buprenorphine partially activates them), they can potentially cause initial euphoria or sedation in a person who doesn’t have a pre-existing opioid dependency. But for people prescribed these medicines to treat opioid use disorder, that’s not a serious concern. People with opioid addiction already have an opioid tolerance. During the induction period, while you and your provider work to determine your individualized, therapeutic dose, you might feel some effects. Once you’re on a stable, therapeutic dose, you should feel neither high nor in withdrawal. You’ll just feel normal. So these medicines won’t impair your ability to work, drive, or parent. In fact, all of those functions, which may have been impaired by your addiction, will be restored by the medication. But some employers might not understand that.
Addiction is covered under the ADA
Luckily, you have the law on your side. The purpose of the Americans with Disabilities Act (ADA) is to ensure that those with a qualifying disability are not judged based on stereotypes or generalizations about that disability—or the evidence-based treatments associated with it. If you have a diagnosed substance use disorder and you’re not currently using illegal drugs, then you are explicitly covered by the ADA. (Note that it does not protect you if you are currently using illegal drugs.) Substance use disorder is considered a medical condition. That means it is absolutely illegal for an employer to deny you a job, fire you, or to refuse you a promotion because he learns you have an addiction history or a diagnosis of opioid use disorder. They also can’t deny you responsibilities because you’re taking buprenorphine.
The qualifier, of course, is that the ADA doesn’t force people to endanger themselves or others, and only requires employer to make “reasonable accommodations.” If you genuinely cannot perform a job function because of your medication, your employer does have the right to deny you that duty. For example, if you’re nodding out at work, your employer doesn’t have to (and frankly shouldn’t) put you behind a forklift. But if that’s happening, you really need to talk to your doctor, because it shouldn’t be!
You must tell your employer before being drug tested
The caveat to all of this is that, if your employer or potential employer uses drug screening to help make decisions, you have to tell them about your medication before the results come in. If you don’t mention up front that you’re taking buprenorphine, you can’t cite discrimination if they fire you after a positive test result comes back. That’s because your boss will be able to say they’re firing you because you were dishonest. Even if that’s a load of bull and you know they’re doing it because they think buprenorphine is just “trading one addiction for another,” it doesn’t matter. You can’t prove it, so you don’t have a legal leg to stand on. They can still say it’s due to your dishonesty—and dishonesty is not covered by the ADA.
So, as uncomfortable as it is, if you’re going to be drug tested, tell your employer about your prescription. That way, they can’t fire you over it. At least not legally.
When does the ADA not apply?
Small businesses—specifically those with 15 or fewer employees—are not required to abide by federal ADA guidelines. States have differing regulations around this, so if you work for a small employer, check your own state regulations to see if they offer any protections.
The ADA also will not protect your job if you are currently using illegal drugs (in which case your employer can reasonably claim to be disciplining or firing you for illegal activities, rather than your medical condition), or if accommodating your condition would place an undue hardship on the business.
What happens if you suspect your employer is discriminating against you?
If you have been denied access to a job, demoted, fired, or otherwise discriminated against and you have a compelling suspicion that it was due to the fact that you are taking opioid agonist medicine, you can file a discrimination charge with the Equal Employment Opportunity Commission. This will launch an investigation into the matter, and could lead to an out-of-court monetary settlement or a lawsuit. It’s always helpful to consult with an attorney—but for those who can’t afford to hire an attorney, you don’t have to have one in order to file with the EEOC. The process of filing gives you a voice and allows you to potentially receive compensation, even if you can’t afford an attorney. These complaints are free and fairly simple to file. Even if you don’t want money, or you just want to wash your hands of the situation, it’s important that you file a claim. If your employer settles, you may be able to ask that part of the terms include training about addiction medicine, so that this type of thing never happens at that business again.
Navigating work while taking medication for opioid addiction can be scary. It’s okay to feel your feelings. But go in knowing you have the law on your side. Yes, it may be uncomfortable to disclose your medication use to your employer or potential employer before taking that drug test, but it will save your job. And you might just find out that your employer has experience with recovery, too.
*This blog post is intended for informational purposes and is not meant to take the place of legal advice.