Recently, while working as an internist at the local county hospital at San Francisco General Hospital, I cared for a patient I’ll call Jack. He had been in the hospital for his two months, an unusually long period for a hospital stay, while most people’s hospital stay is his three to five days. He was hospitalized for a stroke and his recovery required post-acute rehabilitation in a skilled nursing facility.
Jack also suffered from opioid use disorder and had been in recovery for over 30 years. He attributed his success to being on methadone, a life-saving prescription opioid used to treat addiction and addiction. His methadone treatment was also the very reason he remained hospitalized for so long, as all nursing homes in the area refused to accept him.
This practice of facility managers denying methadone to patients is common. It’s both unethical and illegal.of Americans with Disabilities Act (ADA) was enacted in 1990 to protect the rights of individuals with disabilities and ensure that they receive equal treatment and opportunity in many aspects of life.
Under the ADA, opioid use disorder is considered Disability as a chronic disease. As was the case with Jack, many skilled nursing facilities across the country refuse to serve patients based solely on methadone prescriptions. recent research found that more than one-third of patient admissions resulted in refusal of patient referral to another facility because of methadone treatment.
Methadone is a drug approved by the U.S. Food and Drug Administration for the treatment of individuals with opioid use disorder. This is a proven and effective treatment that helps many people regain health, stability, and function. However, the stigma surrounding methadone and lack of understanding about the treatment has led many skilled nursing facility administrators to adopt discriminatory admission policies.
Patients are forced to choose between continuing life-saving methadone medication or remaining hospitalized or recovering from their illness. Patients who choose to discontinue methadone risk losing their baseline level of treatment stability and are at increased risk of returning to heavy drug use or fatal overdose. These discriminatory policies extend to prisons, depriving individuals of methadone treatment and subjecting them to excruciating withdrawal symptoms. the study show Incarceration spikes risk of fatal overdose both behind the bar And upon release.
These practices create an environment where methadone patients are routinely denied the care they need, ultimately exacerbating health disparities. It is imperative that administrators and policy makers at these facilities recognize that their policies and practices must be aligned with the ADA in order to provide equitable care for all.
Some skilled nursing facilities and prisons are already facing legal action for discriminatory For methadone patients. The Department of Justice recently issued a statement highlighting how the country is denying entry to people taking methadone. violate federal law.
Although some facility managers may argue that they refuse to admit methadone patients because of concerns about the potential for misuse or “diversion” of the drug to non-patients, these concerns are This can be addressed through protocols, oversight and compliance monitoring.
Refusing a patient because they are taking methadone is not only blatant discrimination; It also fails to consider the overall needs of the individual. People receiving methadone treatment often have complex medical requirements, and program staff at these facilities and prisons must strive to meet those requirements just as they would any other patient. .
Furthermore, methadone discrimination is not just a legal issue, but also a moral and public health issue. Denying individuals the opportunity to receive appropriate care not only violates their fundamental rights, but also impedes progress in substance use disorder treatment and recovery. This comes as drug overdoses have become one of the leading causes of injury-related deaths in this country. In 2023 alone, 100,000 people die from overdose Death rates in the United States are only increasing.
It is imperative that policymakers, health care professionals, advocates, community members, and individuals raise awareness about this issue and take action to ensure the ADA is upheld in all aspects of the health care system.
It is long past time for all stakeholders to recognize their responsibilities and provide equal access to all patients, regardless of their condition or treatment.
Individuals and families facing immediate and serious challenges in finding appropriate post-discharge care due to methadone treatment. file a complaint It called on the Department of Justice to launch an investigation into this practice. Hospitals and health care professional organizations can also partner with nursing homes to address concerns and set guidelines for the care of patients on methadone treatment.
The larger community of people who take methadone, those who care for them, and policy makers will come together to address this issue and ensure that principles of equity and compassion guide our approach to caring for all patients. Must be.
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