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Navigating Medication Assisted Treatment (MAT) and Employment

“I just started on a medication assisted treatment program and I am worried how it will affect my employment?”

This is a common question we receive from our clients who are concerned about how drug testing in the workplace will affect them while they are undergoing medication assisted treatment (MAT). It is important to understand your rights under the Americans with Disabilities Act (ADA) and know how you are protected while undergoing MAT.

Understand your rights when applying for employment while undergoing medication assisted treatment.

Protection for Employees Undergoing MAT Under the ADA

The ADA prohibits discrimination against a "qualified person with a disability" (a person who possesses the skills, experience, and education that will facilitate the successful performance of the “essential functions” of the job with or without reasonable accommodation) in all stages of employment. This includes protecting workers from discrimination based on a qualifying disability or a perceived disability—including alcoholism and past illegal drug use. The important note here is “past” use.

See the bolded sections below for how the ADA approaches individuals with an addiction disability such as alcoholism and medication use.

“Has a physical or mental impairment that substantially limits one or more major life activities, e.g., someone with bi-polar disorder, diabetes, or addiction to alcohol; or Has a history of an impairment that substantially limited one or more major life activities, e.g., someone who is in remission from cancer or someone in recovery from the illegal use of drugs; or Is regarded as having such an impairment." For example, if an employer assumes an employee has an addiction to drugs (whether or not person actually has an addiction) and takes a negative employment action based on that belief, such as refusal to promote, a poor performance rating, or termination. Major life activities include, but are not limited to walking, seeing, caring for oneself, learning, working, thinking, communicating and also the operation of bodily functions, such as neurological and brain functions. Addiction is generally considered a disability because it is an impairment that affects brain and neurological functions."

Make Sure You Know How the ADA Treats Alcohol Addiction vs Individuals in Recovery for Drug Use

“The ADA applies to addiction to alcohol and to the illegal use of drugs differently. Addiction to alcohol is generally considered a disability whether use of alcohol is in the present or in the past. For people with an addiction to opioids and other drugs, the ADA protects a person in recovery who is no longer engaging in the current illegal use of drugs.”

Will My MAT Prescribed Medications Impact My Employment Drug Test?

One of the primary concerns raised around employment is the impact on drug tests. Will the methadone or suboxone that I am taking show up on a drug screen? The answer to that question is dependent on the type of drug screen you are taking.

Drug screening is a common part of the new employment process.  Understand your rights if you are in medication assisted treatment.

Methadone is an opioid and will show up on a drug test if it is screening for opioids. Suboxone or buprenorphine in the generic form requires a specific type of drug test to be identified in the screening process. If your prospective or current employer includes that as part of their screening, then suboxone use would be identified.

What Can I Do if I Test Positive on My Employer Drug Test?

What can you do if you test positive?

  1. Be prepared with a written prescription from your doctor clearly indicating that you are enrolled in a MAT program.

  2. It may also be important to have a note from your doctor that outlines how your participation in a MAT program will not impact your ability to perform you job.

  3. Make sure you know your rights under the Health Insurance Portability and Accountability Act (HIPPA)

  4. Make sure you understand your rights under the ADA for necessary accommodations

You cannot be forced to disclose your medical history including any substance use disorders or history or your use of MAT.

Per number three above: It is also important to understand your rights under the Health Insurance Portability and Accountability Act (HIPAA). Under HIPAA, you are protected, and your medical conditions are supposed to remain protected and private unless you have given express permission to share them. You cannot be forced to disclose your medical history including any substance use disorders or history or your use of MAT.

Per number four above: You have rights under the ADA to receive necessary accommodations for your disability. These accommodations might include an adjusted schedule to ensure you are able to attend appointments at a daily methadone clinic or monthly appointments with your provider who is treating you with MAT.

Closing Note on Drug Testing While Going Through MAT

It is always up to you whether you choose to disclose your participation in MAT. The best thing you can do is be willing to follow the requirements of your employer’s drug testing program while also protecting your rights. And sometimes having an open and honest conversation could make you and the employer feel more comfortable and confident in the process and in your relationship as employer and employee.

Looking for more information to help you in this situation? Click here to access to a helpful factsheet which outlines scenarios related to your rights under the ADA. You may find it beneficial to review these examples.


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