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Civil Rights Protections for People With Opioid Use Disorder

Medically Reviewed by Jennifer Casarella, MD on April 22, 2022

If you have opioid use disorder (OUD) and you are in treatment for it, or you are no longer taking opioids, you have certain rights and protections. These span federal, state, and local levels.

The federal Americans with Disabilities Act (ADA) protects the civil rights -- personal rights under the U.S. Constitution that make sure you’re treated fairly -- of people with a wide range of mental and physical disabilities. The law treats drug addiction, including OUD, as a disability. This is because it can keep you from fully engaging in life and handling responsibilities, and it can harm your health. OUD was added to ADA protections to help fight the opioid crisis in the U.S.

ADA Requirements for OUD

You’re protected under the ADA if:

  • You’re in recovery from OUD and aren’t taking illegal drugs now.
  • You’re in a drug rehab or treatment program and not taking illegal drugs.
  • You take FDA-approved meds, such as methadone, that are legally prescribed by a licensed medical worker to treat your OUD. This includes medication assisted treatment, or MAT, which combines legal meds with counseling or behavioral therapies.
  • You’re in recovery but need services to help you manage certain parts of your life.

Employment Rights

Under the ADA, you’re entitled to the same job opportunities, advancement, pay, and benefits as anyone else, with these conditions:

You’re qualified for the job and meet all the requirements. An employer doesn’t have to hire you over another applicant who is more qualified than you are. The law simply says your disability can’t be a factor in the decision. The ADA won’t protect you from being fired for reasons unrelated to your OUD, such as not meeting work standards.

You’re not taking an illegal drug. If you take opioid meds prescribed for you through a recovery program, your use is legal. You also don’t need to worry if you’re legally taking methadone and your employer gives you a drug test. However, you still need to be able to do your job safely and adequately.

You’re applying to a company with 15 or more employees. Very small companies are exempt.

Having a “record of” -- meaning a history of -- opioid addiction will protect you under the ADA. You also have the right to ask for reasonable accommodation in your job. This means your employer must adjust or adapt your job description, within reason, so you can do your job as well as others. For example, you might ask for a shift change or a different break time so you can go to treatment meetings or appointments for your OUD.

ADA workplace issues are enforced by the U.S. Equal Employment Opportunity Commission (EEOC).

Health Care Rights

Under the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008, most health insurers and group health plans must offer you the same benefits for OUD treatment and services that they do for medical and surgical care for other conditions. This includes employer-sponsored group health plans and individual health plans, like you might find on Health Insurance Marketplace websites.

Your number of yearly visits, copays, deductibles, and other health care policy features should also be the same as everyone else’s. Likewise, under the ADA, state and local hospitals, doctors’ offices, and any other health care facilities, including private or nonprofit, must allow you access to their services.

These rights extend to people in the military, too. Tricare, the health care provider for service members and their families, pays for medication and has broadened coverage for OUD treatment.

Rights to State and Local Government Programs

The ADA protects you from unfair treatment when you seek services or interact with these programs:

  • The criminal justice system. For example, someone being admitted to jail or a court supervision program must be allowed to stay on their medication for OUD.
  • Housing, such as half-way houses and recovery homes
  • Social services programs
  • Schools, colleges, and universities

HIPAA and Your Privacy Rights

By definition, your ADA rights involve your sharing at least some information about your OUD. However, you can choose to keep your records private in most cases. The Health Insurance Portability and Accountability Act of 1996 (HIPAA for short) lets you control your own health information. You have the right to request medical records for yourself, find out who has seen them, and for the most part, be in charge of how it’s used by your health care and insurance providers.

  • Your doctor can’t share your records with your employer, or marketing and advertising agencies, without your written permission.
  • You can ask that your health information not be shared with certain people, groups, or companies.
  • You can also ask your health care provider or pharmacy not to tell your health insurance company about care you receive or drugs you take. To do this, you must pay for your care and drugs yourself, without the provider or pharmacy needing payment from your insurance company.

Providers don’t need your permission to share your health records in situations that directly affect your care.

Show Sources

SOURCES:

ADA National Network: “Health Care and the Americans With Disabilities Act,” “The Americans With Disabilities Act, Addiction, and Recovery for State and Local Governments.”

U.S. Equal Employment Opportunity Commission: “Use of Codeine, Oxycodone, and Other Opioids: Information for Employees.”

National Institute on Drug Abuse: “Medications to Treat Opioid Use Disorder Research Report: Is Medication to Treat Opioid Use Disorder Available in the Military?”

Substance Abuse and Mental Health Services Administration: “Know Your Rights: Parity for Mental Health and Substance Use Disorder Benefits.”

U.S. Department of Health & Human Services: “U.S. Department of Health and Human Services: Does Insurance Cover Treatment for Opioid Addiction?” “What are Civil Rights?”

U.S. Department of Justice: “Justice Department Issues Guidance on Protections for People with Opioid Use Disorder under the Americans with Disabilities Act,” “The Americans With Disabilities Act and the Opioid Crisis: Combating Discrimination Against People in Treatment or Recovery,” “Your Health Information Privacy Rights.”

U.S. Department of Labor: “Accommodations,” “Employers and the ADA: Myths and Facts.”

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