The Laws Prohibiting Employer Discrimination Against Suboxone Patients

People enrolled in a Medication for Addiction Treatment (MAT) program usually cannot be denied employment, demoted, or fired for it as long as they are taking the medications as prescribed. Buprenorphine/naloxone (Suboxone) and other opioid treatments like methadone are all protected by laws enacted at both the state and federal level.

That said, some patients still face social or legal discrimination while on these medications. If this is the case for you, it is essential to know your rights and how to protect those rights while taking these medications.

Below we summarize some basic information about your legal rights while on either Suboxone or Methadone. This article is meant to give some general information, but should not be taken as legal advice. If you have been fired, demoted, or denied employment because of your legal use of prescribed medication, we strongly encourage you to contact a lawyer or legal aid organization in your state.

What Laws Protect Workers?

The Americans with Disabilities Act (ADA) prevents discrimination against someone with a disability in the workplace, including people taking medications for addiction treatment. [1]

The ADA is a federal law that applies to most employers in the United States and prohibits discrimination against employees and job applicants based on a medical disability, which includes addiction disorders.

In addition to protections under the ADA, many states have laws to protect people with disabilities against discrimination. Substance use disorders are considered a medical condition/”disability” under this act.

The state laws are always in addition to federal laws like the ADA, so the ADA sets a minimum set of protections, and many states may have added protections in addition.

If you believe you have been discriminated against at work because of being on MAT, it is important to talk to a lawyer or legal aid organization in your state.

Who Isn’t Protected by the ADA?

A safe harbor provision in the ADA protects former illegal drug users from discrimination when they're taking prescribed medications as directed.[2] The law is complex, but it provides broad protections.

A few exceptions exist. If you fall into one of these categories, you may not be able to lean on the ADA:

Current Use of Illegal Drugs 

The ADA does not protect employees and job applicants who currently use illegal drugs, even if they are taking Suboxone. Employers may subject patients to drug testing and if they are found to be on substances for which they do not have a valid prescription, they may be subject to penalties or even termination from their job at the employers discretion.

Suboxone is legal with a valid prescription. Therefore, most employers cannot fire, demote, or refuse to hire based solely on a person taking Suboxone as prescribed.

But relapsing to illegal drugs can be grounds for termination. To keep your job, it's important to stick with your MAT plan. Suboxone is extremely effective at preventing this kind of relapse.[3]

People Working for Small Companies 

ADA protections extend to people working for private or public employers with 15 or more employees.[4] If you work for a very small shop without many colleagues, your employer could be exempt from ADA rules at the federal level, but state laws may still apply.

People Requiring ‘Undue Hardships’ for Employers

The ADA requires employers to accommodate employees with disabilities but only if those changes don't create an “undue hardship” for the employer.[4]

If accommodating an employee’s disability would be very expensive or disruptive for the business, the employer will not need to make the accommodations the employee needs.

Most MAT programs don't require expensive or disruptive accommodations (or usually any accommodations at all). The vast majority of people prescribed Suboxone won't face any hardship issues.

People Working in Sensitive Areas

Employers can make decisions based on the employee's work. If taking a medication represents a “direct threat,” the employer can act accordingly. Suboxone shouldn't cause such a threat.

The decision cannot be made arbitrarily. The employer should individually assess whether taking Suboxone would interfere with an applicant’s or employee’s “ability to effectively perform [their] job.”[5]

The providers at Bicycle Health will usually connect with employers, stating intoxication will not be an issue. Medical letters of support will not always fix the problem, but they can help advocate for you. Bicycle health (and other Suboxone providers) are usually quite familiar with how to provide these letters for their patients on MAT. 

Can You Work While on Suboxone?

Yes, absolutely. Many people hold down jobs, accept promotions, and lead teams while taking Suboxone. This prescription medication is both safe and effective. It shouldn't interfere with your ability to do your job properly.

Suboxone is a combination of two medications:

• Buprenorphine is a partial opioid, which means that it does not produce a “high” like full opioids do (such as heroin and oxycodone).
• Naloxone is an opioid antagonist, which lowers the risk of misuse and overdose.

These two ingredients make Suboxone both effective and hard to misuse. Researchers say buprenorphine has only mild dependence potential, and adding naloxone makes misuse even less likely.[6] 

Can You Get Hired While on Suboxone?

Some employers use drug tests to screen potential staff. If you’re taking Suboxone, you may worry that you won’t get the job.

Buprenorphine (and therefore Suboxone) does not appear on most drug tests, but employers can request a special screen for buprenorphine. The ADA does not ban drug tests, so employers can test employees and job applicants for any drugs they choose. 

Disclosing MAT to Employers

It is very much the personal decision of the employee whether to disclose Suboxone treatment to their employer.

If you do take a drug test that is positive for Suboxone, tell your employer you’re taking Suboxone and be prepared to provide proof of your prescription, either from the prescription bottle itself with your name on it, or with a medical letter from your doctor.

Most employers cannot make employment decisions based on a person’s legal medication use. But (as prior cases prove) if an employee or applicant does not inform the employer about a prescription, the employer may incorrectly assume that a positive drug test is the result of illegal use. [7]

A failed test could ruin your career, but a frank conversation could save it. In this situation, it might be best to tell your employer about your Suboxone prescription.

You can also submit a physician’s letter saying the medication will not interfere with your ability to do the job safely. The providers at Bicycle Health can usually write these letters.

Ultimately, if you are unclear about what to do, we suggest contacting a legal aid organization or lawyer in your state for advice. Many legal aid organizations offer free consultations to people who cannot afford them.  

Common FAQs About Employment

Getting and keeping a job is an important part of recovery. It is usually illegal for employers to discriminate against people for taking Suboxone as prescribed. These are common questions we often hear:

Can you be on Suboxone and get a commercial driver’s License (CDL)?

Drivers can't get a CDL while on a controlled substance without a prescription.[8] Depending on the state, some drivers can be considered medically unqualified if they take a medication listed in the federal Schedule of Controlled Substances.[9] Per this list, Suboxone is controlled.

Depending on where you live, you may need a note from your doctor, stating that your Suboxone doesn't impair your ability to drive before you get a CDL, or complete additional requirements prior to getting a CDL. The best thing to do if this if driving is part of your job requirements is to speak to your local department of motor vehicles about the rules and regulations in your state. 

Can truck drivers take Suboxone?

There may be extra paperwork or requirements if you take Suboxone, depending on your state. You may need a letter from your doctor demonstrating that your medication doesn't harm your ability to drive. The best thing to do is investigate the specific rules and regulations in your state. 

Can you operate machinery on Suboxone?

Most people taking Suboxone don't feel impaired or high. If your medication dosage is correct, you should be able to operate machinery quite well while taking your medication. However, your employer may request a medical letter from your doctor verifying this. The best thing to do is speak to your employer about the requirements for operating machinery safely. 

Can you pass a DOT physical on Suboxone?

A DOT physical is a “department of transportation” physical exam proving that you are safe to operate a commercial motor vehicle. Again, the requirements for a DOT physical vary by state. You may need a letter from your doctor demonstrating that you have a valid prescription and are complying with your MAT program. Often, this letter works as proof that you’re fit to work. But sometimes, officials deny the petitions.[10] The best thing to do is to speak directly to your department of motor vehicles to determine the requirements in your state. 

What to Do if You’re Discriminated Against

If you are discriminated against based on your legal use of prescribed Suboxone, consulting an attorney or legal aid organization in your state is the next best step. If no affordable attorneys are available, you can still take steps against the employer without one, or pursue pro-bono legal counsel.

Any employee (including part-time staffers) can file a complaint with the U.S. Equal Employment Opportunity Commission (EEOC). Submit your report as soon as the event happens, when it’s fresh in your mind. Be prepared by collecting written documentation, if possible, of the discriminatory incident.

If you work for the federal government, your process is slightly different. You’ll contact an EEO counselor at the agency where you work, and that professional will help you file a complaint.[11]

How We Can Help

The team at Bicycle Health is available to provide medical guidance and can usually write letters to employers when needed documenting that a person is being prescribed Suboxone therapy. Bicycle Health does not provide legal advice.

To learn more about Bicycle Health’s telemedicine addiction treatment, call us at (844) 943-2514 or schedule an appointment here.

Sources

1. Sharing the Dream: Is the ADA Accommodating All? U.S. Commission on Civil Rights. https://www.usccr.gov/files/pubs/ada/ch4.htm. Accessed October 2022.
2. Understanding the Safe Harbor Provision of the ADAAG. Abadi Accessibility. http://abadiaccess.com/understanding-the-safe-harbor-provision-of-the-adaag/. August 2011. Accessed October 2022.
3. Discontinuation of Buprenorphine Maintenance Therapy: Perspectives and Outcomes. Journal of Substance Abuse Treatment. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4382404/. December 2014. Accessed October 2022.
4. Fact Sheet: Disability Discrimination. U.S. Equal Employment Opportunity Commission. https://www.eeoc.gov/laws/guidance/fact-sheet-disability-discrimination. January 1999. Accessed October 2022.
5. Connolly v. First Personal Bank. Casetext. https://casetext.com/case/connolly-v-first-personal-bank. November 2008. Accessed October 2022.
6. Evidence-Based Practices for Substance Use Disorders. Psychiatric Clinics of North America. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3678283/. December 2003. Accessed October 2022.
7. Equal Employment Opportunity Commission vs. Grane Healthcare Co. AnyLaw. https://www.anylaw.com/case/equal-employment-opportunity-commission-v-grane-healthcare-co-et-al/w-d-pennsylvania/09-14-2015/jtTU5GYBTlTomsSBgE6R. 2015. Accessed October 2022.
8. What Medications Disqualify a CMV Driver? Federal Motor Carrier Safety Administration. https://www.fmcsa.dot.gov/faq/what-medications-disqualify-cmv-driver. September 2017. Accessed October 2022.
9. Part 1308—Schedules of Controlled Substances. Code of Federal Regulations. https://www.ecfr.gov/current/title-21/part-1308. Accessed October 2022.
10. Let Former Opioid Users Keep on Trucking. Wall Street Journal. https://www.wsj.com/articles/opioid-users-trucking-drug-policy-regulations-supply-chain-methadone-buprenorphine-drug-addiction-11635708444. October 2021. Accessed October 2022. 
11. Overview of Federal Sector EEO Complaint Process. U.S. Equal Employment Opportunity Commission. https://www.eeoc.gov/federal-sector/overview-federal-sector-eeo-complaint-process. Accessed October 2022.

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