Improving Care for Opioid Use Disorder in Nursing Facilities.

Abstract

As this issue of The Senior Care Pharmacist focuses on elder abuse, it is critical to recognize that people with opioid use disorder (OUD) are federally protected under the Americans with Disabilities Act (ADA). This was affirmed in 2022 by physician and Director of the Office of National Drug Control Policy, Dr. Rahul Gupta, in a recent public workshop on medications for opioid use disorder (MOUD) hosted by the National Academies of Sciences, Engineering, and Medicine. While the ADA specifies that discrimination against those with OUD is illegal, it also affords legal protection to access to health services and treatment for those with OUD that includes skilled nursing facilities (SNFs). The policy guidance document from the US Department of Justice Civil Rights Division titled “The ADA and Opioid Use Disorder: Combating Discrimination Against People in Treatment or Recovery” explicitly states that if a SNF refuses to admit a patient with OUD predicated on the patient taking a clinician prescribed MOUD or the SNF prohibited any of its patients from taking MOUD, then this exclusion/prohibition would be in violation of the ADA. Refusal to provide care for patients experiencing a drug overdose at emergency departments or to provide health services for a patient with OUD are also in violation of the ADA. The refusal of a city to open an OUD treatment center on the basis of hostility toward people with OUD may also be in violation of the ADA.