People in recovery face discrimination in the workplace, health care, and everyday life, and litigation may be the only way to force changes in some cases, experts told a panel convened at the annual meeting of the American Bar Association (ABA) in Washington, D.C., last weekend.
“Where are the lawyers?” asked Deb Beck, president of the Drug and Alcohol Service Providers Organization of Pennsylvania, who charged that managed-care firms routinely violate the minimum insurance laws on the books in 40 states, including Pennsylvania.
“Managed care has to be taken to task,” Beck said. Pointing to efforts to pass laws requiring addiction to be treated on par with other health conditions, she added, “Parity won't solve that; it will be just another type of coverage to be denied … We don't need parity; we need people to enforce the laws.”
Beck was among more than a dozen advocates who presented testimony before Join Together's Policy Panel on Discrimination Against Individuals in Treatment and Recovery, cosponsored by the ABA.
“This is an issue I unfortunately have encountered from time to time, both personally and in my professional life,” said Alfred P. Carlton, president-elect of the ABA. “We must work to end discrimination of any kind, but especially for people seeking treatment for addiction. It's a disease and should be treated as such.”
Former First Lady Betty Ford said that while up to 80 percent of Betty Ford Center clients used to be able to pay for their treatment through insurance, today just 20 to 25 percent can access their insurance benefits. Not even lawyers are immune to addiction-related discrimination, she added.
When the Betty Ford Center recently tried to set up a residential treatment program for lawyers, doctors, and other professionals, nearby residents picketed and told clients to go home. “They threatened to videotape our patients going to and from the homes and make public their tapes,” Ford testified. “The ignorance and hate were surreal. A few residents stood up and spoke in our support, but were shouted down. So, the Betty Ford Center, maybe the best-known treatment center in the world, has to find alternative housing for our patients.
“NIMBY is alive and well in 2002,” said Ford.
Robert Newman, M.D., director of the Baron Edmond de Rothschild Chemical Dependency Institute at Beth Israel Medical Center in New York, said that people with addictions are “subjected to conditions that would be unthinkable in any other medical practice,” such as having their medication levels capriciously reduced or eliminated, or being told to deal with their problems through behavior modification rather than medical intervention.
“You're talking about horrid malpractice of medicine,” said policy panel member Lisa Mojer Torres, a New York attorney who represents clients with opiate addictions.
Brent Coles, the mayor of the city of Boise, Idaho, agreed. “When you have a 16-year-old with a chronic, acute disease, we would have to find her treatment if she had diabetes,” he said. But 90 percent of Idaho cities offer residents no access to treatment, said Coles. Even Boise, with its 200,000 residents, does not have a single detoxification center, he said.
“Eighty-five percent of narcotics addicts in US have no access to methadone treatment,” added Newman. “My doctor can treat a patient for pain relief with methadone, but if he does so for addiction, it is illegal.”
Newman said that the only hope for fighting such discrimination is through litigation.
Having a drug arrest on your record or a history of addiction also dogs people in recovery in the workplace — even after years of sobriety.
Susan Rook, director of communications and outreach for the advocacy group Faces and Voices of Recovery, said a recent Peter D. Hart survey found that one in four people in recovery have experienced discrimination in the workplace or in seeking health care, and one in five fear being fired if their employer finds out they are in recovery from addiction.
Citing a pattern of “systematic and illegal discrimination against people who are in recovery,” Rook said, “When personal prejudices influence my ability to get a job, receive an earned promotion, get and keep health insurance, life insurance, housing and other basic benefits of being a member of a community — then someone else's opinion of me matters. And that personal prejudice is not merely stigma … [its] discrimination.”
Rook stressed that despite the risks, it is important for people in recovery to speak out against violations of their basic civil rights. “It's not just about what other people say, but what those of us in recovery don't say,” Rook testified. “The public silence of people in recovery speaks volumes. Our silence says to others that we have something to be silent about. By our silence, we let others define us.”
Adele Rappaport, a lawyer in the Detroit office of the Equal Employment Opportunities Commission, said that people with addictions are frequently the target of “hysterical terminations.” She told the story of a client who told his employer that he needed addiction treatment, and instead was fired for violating the company's zero-tolerance policy. “What kind of personnel decision is that?” she asked.
Unfortunately, the Americans with Disabilities Act (ADA), which ostensibly provides some protection for people with addictions, provides little help. Rappaport estimated that 95 percent of people with addictions fail to meet the ADA's standard for disability (e.g. impairment of a major life function), while others run afoul of the law's exclusion of coverage for current users of illicit drugs.
Nonetheless, addiction remains the most common personnel problem in most workplaces, accounting for 20 percent of voluntary employee-assistance program referrals and 50 percent of supervisory referrals, according to Dorothy Blum, vice president of the Employee Assistance Professionals Association. Employers should be warned that discriminating against people with addictions not only will harm their bottom line in the long run, but also opens companies up to litigation, said Blum.
The workplace woes experienced by people with addictions are compounded in many cases by a criminal record, which makes finding a job even more difficult.
“Many ex-offenders with drug-related offenses are also currently in recovery or treatment. Logically, their ability to truly recover and move on in their lives is directly connected to their ability to obtain and maintain employment,” said Robin Runge, coordinator of the program on women's employment rights at the D.C. Employment Justice Center, during her testimony before the policy panel.
But Runge, who works with ex-offenders trying to get jobs, said having a criminal record is often the primary barrier to employment for people in recovery — especially with the increase in the use of criminal background checks after 9/11.
“For example, I had a client who was a teaching assistant in the D.C. public schools for over a year when a background check showed that she had been arrested over 20 years ago for drug possession,” said Runge. “Although the employer knew about this arrest when she was hired, they used this background check as a basis to fire her.”
In a recent survey, 59 percent of California employers said they would never hire anyone with a felony drug conviction — even though such discrimination is illegal in most cases.
“We need to help employers understand that hiring someone with an arrest from 10 years ago is no more risky than hiring someone without a criminal record,” said Runge. “In fact, they may find that the employee with the record is harder working and more committed.”