If you're taking opioid agonist medication, it can be really difficult to understand your rights when it comes to employment.
For most, emerging from an addiction means getting 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, and getting a steady job. That last one, while important, is also arguably the most anxiety inducing. Especially if you're taking opioid agonist medication, it can be really difficult to understand your rights when it comes to employment.
Unfortunately, discrimination is a very legitimate concern for patients using opioid agonist therapy, like methadone or buprenorphine (known commonly by brand name Suboxone), to treat opiate addiction. 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 detoxing. 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 patients should take them as long as they feel necessary, even if that means for life.
A lot of people also think that using methadone or buprenorphine will lead to impairment. That's also false. Because they are both opioids (methadone binds to opioid receptors fully, and buprenorphine partially binds to them), they can potentially cause initial sedation in a patient who doesn't have a pre-existing opioid dependency. But if you're taking these medicines because you're addicted to opiates, then that's not you. You already have an opiate tolerance. During the adjustment period, while you and your prescriber work to figure out your individualized, therapeutic dose, you might feel some sedating effects—that means your dose needs adjustment. Once you're on a stable, therapeutic dose, you shouldn't feel high or in withdrawal. You 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 Patients Are 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 patients 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. 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. He 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. 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 testing to help make decisions, you have to tell her about your medication before the results come in. If you don't mention you're taking buprenorphine, you can't cite discrimination when he fires you after that positive comes back. That's because your boss will be able to say she's firing you because you were dishonest. Even if that's a load of bull and you know she's doing it because she thinks buprenorphine is just "trading one addiction for another," it doesn't matter. You don't have a legal leg to stand on. She 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, she can't fire you over it. At least not legally.
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 need one to file with the EEOC. This process 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 again.
Going to work while on opioid agonist therapy can be really scary. It’s okay to feel your feelings. But go in knowing you have the law on your side. Yes, it will probably be really uncomfortable to disclose your medication use to your potential employer before taking that drug test, but it will save your job. And you might just find out that your employer has an addiction past herself.
Workit Health offers medication & online therapy.
Elizabeth Brico is a freelance writer with an MFA in Writing & Poetics from Naropa University. Her blog, Betty's Battleground, was recently ranked by Feedspot as one of the top 75 PTSD blogs. She is also a regular contributing writer for HealthyPlace's trauma blog. Her work has appeared on Vice, Vox, Stat News, The Fix, and others. When she isn't working, she can usually be found reading, writing, or watching speculative fiction.