US settlement signals protections for addiction medicine

NASHVILLE, Tenn. (AP) — A former Tennessee correctional officer will receive $160,000 in back pay and damages after he was forced to resign for taking Suboxone to treat his opioid use disorder, if a judge approves a landmark consent decree filed in federal court in Nashville on Wednesday.

It is the first time the U.S. Department of Justice has used the Americans with Disabilities Act to settle a claim that an employee was discriminated against for taking a prescribed medication to treat drug addiction, according to the Department.

It comes less than a year after the Justice Department's Civil Rights Division issued new guidelines advising that employers, health care providers, law enforcement agencies that operate jails, and others are violating the ADA if they discriminate against people taking prescription medications to treat opioid use disorder. The Department noted federal law does not protect people who are using illegal drugs.

In the present case, the complainant, who is not identified by name, was hired as a correctional officer at the Cumberland County jail in January 2015. He received positive employment evaluations and was even promoted, but when a drug screen showed he was taking Suboxone to treat his opioid addiction in 2018, he was given the choice of resigning or being fired for drug use.

The complaint filed in federal court Wednesday claims a Cumberland County's sheriff's office policy prohibiting employees from being on controlled substances while at work “fails to make individualized assessments of its employees’ ability to perform the essential functions of their jobs ... when they are taking legally prescribed medications.”

In addition to providing $160,000 to the former employee, the county has agreed to revise its employment policies and implement training around ADA compliance as part of a consent decree also filed Wednesday. The decree won't become final until approved by a judge. An initial case management conference is scheduled for Friday.

Drugs like Suboxone often carry a stigma because they contain opioids, but Dr. Marc Stern, a correctional physician who is on faculty at the University of Washington School of Public Health, said they should not.

“When these drugs are prescribed for someone who has a disorder, it helps them be normal. It helps them be healthy. It helps them to hold a job,” Stern said. “More importantly, the Department of Justice has spoken, and this is the law. It's not up to employers to decide whether they like it or not."

Because of how opioids act on the brain, people dependent on them get sick if they stop using. Withdrawal can feel like a bad flu with cramping, sweating, anxiety and sleeplessness. Cravings for the drug can last for years and be so intense that relapse is common. Suboxone is a common form of buprenorphine, a gold standard medicine approved by the U.S. Food and Drug Administration that reduces cravings.

Overdose deaths in the U.S. remain at near-record levels. The U.S. Centers for Disease Control and Prevention estimates that overdoses contributed to more than 107,000 deaths in the 12 months that ended Aug. 31. Opioids were involved in more than 81,000 of those.

The proposed consent decree in Tennessee comes as President Joe Biden's administration pushes for greater access to addiction treatment. Most recently, Biden signed a law eliminating the need for doctors to get a special waiver to prescribe buprenorphine. He has also released a national drug control strategy that, for the first time, prioritizes preventing death and illness in drug users while trying to engage them in care and treatment.

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AP Medical Writer Carla K. Johnson in Washington state contributed to this report.