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I<\/span><\/span>t was at Massachusetts General Hospital that Bryan found the care he needed for his opioid use disorder. He had previously tried, without success, to just quit. But when the hospital\u2019s renowned addiction medicine team prescribed him Suboxone, a medication that can tame cravings, it worked.<\/p>\n Bryan also had cystic fibrosis, which by 2017 had progressed to the point he needed a lung transplant. It made sense that he would get that done at MGH too.<\/p>\n The transplant team, citing the Suboxone Bryan took, rejected him.<\/p>\n advertisement<\/p>\n The denial confounded Bryan and his family. Bryan was doing what he was supposed to be doing, taking an effective medication that other doctors at that very institution had put him on. It helped him live free of misused painkillers and heroin. But the denial was also an emergency. Bryan kept getting sicker.<\/p>\n \u201cAt that point, you realize you\u2019re 27 and dying,\u201d Bryan said, recalling how he thought he would miss out on the future life he had envisioned for himself. \u201cYou\u2019re not going to give someone a chance because of the past they had when they were younger?\u201d<\/p>\n An unexpected ally agreed with Bryan.<\/p>\n advertisement<\/p>\n In a 2020 settlement<\/span><\/a>, the U.S. Justice Department found<\/span><\/a> that MGH discriminated against Bryan under the Americans with Disabilities Act, the landmark 1990 civil rights law meant to ensure that people with disabilities have the same opportunities as everyone else. It\u2019s not a well-known element, but the law classifies substance use disorder as a disability, meaning disfavoring someone for being in recovery or based on their past drug use is illegal. (The law does not extend its full protections to people still using drugs.)<\/p>\n Increasingly, Justice Department attorneys are leveraging the law to try to overcome some of the rampant discrimination that people with substance use disorders face. The cases typically center on people who are penalized because they take medication for opioid addiction \u2014 treatments that are considered the gold-standard \u2014 and on people who are denied those medications, particularly in the criminal justice system. The underlying argument rests on the idea that imposing barriers on treatment for a disability is tantamount to doing so on the basis of the disability itself.<\/p>\n \u201cWe have so stigmatized drug use that it doesn\u2019t even seem to register that what they\u2019re saying is not OK.\u201d<\/p>\n Kelly Dineen<\/p>\n Creighton University<\/p>\n<\/p><\/div>\n<\/p><\/div>\n<\/p><\/div>\n The pace of the cases is picking up, with the government reaching agreements with or filing suit against institutions in Pennsylvania, Rhode Island, and Colorado in recent months. And in April, the Justice Department\u2019s Civil Rights Division released guidance<\/span><\/a> outlining how the ADA applies to substance use disorders, aiming to explain to people with addiction histories that they have rights they might not be aware of.<\/p>\n \u201cWe have so stigmatized drug use that it doesn\u2019t even seem to register that what they\u2019re saying is not OK,\u201d Kelly Dineen, the director of the health law program at Creighton University, said about institutions that discriminate. The department\u2019s actions, Dineen said, convey that \u201cnot only is it unethical, it\u2019s unlawful.\u201d<\/p>\n If anything, advocates say it\u2019s an overdue enforcement of a law that\u2019s been on the books for three decades, a policy that Justice Department lawyers have acknowledged they\u2019ve only started wielding in recent years. But the hope is that what may seem like whack-a-mole investigations \u2014 a nursing facility that won\u2019t take patients on Suboxone here, a detention center that won\u2019t provide addiction medications there \u2014 will spark enough attention to motivate whole fields to change their policies, lest they want to duel with the Justice Department.<\/p>\n