Study Shows Abundant Discrimination Against Individuals Dependent On Opioids

Nearly 30 percent experienced such treatment in recent research

A new study shows 29 percent of private post-acute care facilities in Massachusetts explicitly discriminated against hospitalized individuals with opioid use disorder, rejecting their referral for admission. Led by researchers at Boston Medical Center’s (BMC’s) Grayken Center for Addiction, the study showed that 15 percent of the rejections among patients with substance use disorders were denied due to a substance use disorder diagnosis or because they were being treated for opioid use disorder with buprenorphine or methadone.

These denials included documented and explicit discrimination. Published in the Journal of Addiction Medicine, the results demonstrate the urgent need to eliminate discrimination in order to ensure patients taking a medication to treat opioid use disorder get access to the ongoing medical care they need.

In 2016, the Massachusetts Department of Public Health issued guidance to post-acute care facilities in the state, advising that individuals taking buprenorphine or methadone to treat opioid use disorder who were otherwise eligible for admission could not be denied admission because of their opioid use disorder medication status. In 2018 and 2019, the United States Attorney’s office for the District of Massachusetts settled with two different private post-acute care organizations for their discriminatory practices of denying admittance of patients taking an opioid agonist therapy, putting them in violation of the Americans with Disabilities Act.

“As clinicians treat individuals with opioid use disorder, we frequently encounter issues getting our patients accepted to post-acute care facilities. Given the landscape in Massachusetts, we wanted to take a look at the data to determine the reasons why this continues to be an issue,” explained Simeon Kimmel, MD, MA, an addiction medicine and infectious diseases specialist at the Grayken Center who serves as the study’s corresponding author.

Researchers analyzed electronic health record data (EHR) from BMC patients over the age of 18 diagnosed with opioid use disorder to track their referrals to private Massachusetts post-acute medical care facilities in 2018. Of those referrals, 81.8 percent (1,348) were rejected. Among those rejections, 15.1 percent were deemed discriminatory based on the reasons cited: 105 were rejected because the patient was treated with buprenorphine or methadone, and 98 were rejected because the patient had a substance use disorder diagnosis.

Of the facilities included in the study, 29.1 percent (83) had at least one discriminatory rejection based on information they included in the patient’s EHR.

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