New legal project aims to protect rights of Kentuckians with substance use disorder | Opinion

Jane Connell Young, Ben Carter, Sally Friedman, and Dr. Mel Ruberg
·3 min read

Almost every Kentuckian knows someone who has died of an overdose. The crisis is so acute that Kentucky claims the 4th highest overdose death rate in the country, with the rate among Black Kentuckians more than doubling in recent years. While 2022 data shows a slight decrease in overdose deaths, much more must be done. This is why the Kentucky Equal Justice Center (KEJC) has launched a project to address discrimination that keeps far too many people from accessing lifesaving care needed to stay safe, get well, and enter recovery.

People who use drugs or have a substance use disorder face pervasive discrimination within the health care system due to stigma about addiction. One common example is the denial of access to FDA-approved medications for opioid use disorder (MOUD), including methadone and buprenorphine. MOUD is the gold standard of care, yet it is often denied due to misunderstanding about the medication and outdated views of addiction as a moral failing rather than a medical condition.

For example, we have heard of Kentuckians suffering opioid overdose being brought to the emergency room and revived with naloxone but not being screened for opioid use disorder (OUD) nor offered MOUD while there. In one case, a man was back at the ER within 24 hours for another opioid overdose — this one fatal and likely preventable.

Further, many skilled nursing facilities, recovery homes, and treatment programs prohibit people from taking MOUD – either by preventing them from starting, forcing them to taper, or refusing them admission altogether. Such MOUD bans can thus impede people’s recovery from substance use disorder and also prevent them from getting other necessary medical care.

Denying health care to people with SUD not only jeopardizes lives, but also violates the Americans with Disabilities Act (ADA) and other laws that protect people with disabilities – including people with SUDs.

The U.S. Department of Justice (DOJ) is increasingly taking action against providers that illegally deny care to individuals with SUD. In 2022, the U.S. Attorney’s Office in the Eastern District of Kentucky required King’s Daughters Medical Center in Ashland to pay $40,000 in compensatory damages and a $50,000 civil penalty as well as adopt a nondiscrimination policy because the Center turned away patients from its outpatient behavioral medicine program based on their OUD/taking MOUD.

Along with the Department of Health and Human Services (HHS), DOJ has pursued many similar actions against health care facilities across the country and issued guidance about using the ADA to combat discrimination against people in addiction treatment and recovery. HHS also recently proposed regulatory amendments under the Rehabilitation Act of 1973 to make protections against health care discrimination explicit, including for people with SUD.

KEJC, in partnership with national organizations Vital Strategies and the Legal Action Center, aims to enforce the legal rights of Kentuckians with SUDs, so everyone can access the care they need to become and remain healthy. Kentuckians denied health care because of their drug use or SUD can contact KEJC for help, as can Kentucky-based health care providers, policymakers, or advocates who want to learn more.

Jane Connell Young and Ben Carter are attorneys at the Kentucky Equal Justice Center. Sally Friedman is an attorney at the Legal Action Center. Dr. Mel Ruberg is a Family Medicine doctor in Louisville who provides care for individuals with substance use disorder. For more information on KEJC and this project, visit https://www.kyequaljustice.org/substance-use-disorder-discrimination.