Disability discrimination against people with substance use disorders by postacute care nursing facilities: It is time to stop tolerating civil rights violations

Abstract

People with substance use disorders (PWSUDs), including opioid use disorder (OUD), continue to face widespread discrimination, including in health care. As hospitals increasingly provide more appropriate and integrated care for PWSUDs, nursing facilities that provide postacute care are receiving more referrals for patients whose diagnosis of substance use disorders is acknowledged rather than ignored. A concerning number of these facilities refuse to admit or treat PWSUD, especially those with OUD receiving opioid agonist therapy (OAT). This practice violates multiple federal antidiscrimination laws. Postacute care nursing facilities, such a skilled nursing or rehabilitation facilities, must end discriminatory practices against PWSUDs. Legal actors, from government enforcers to public interest lawyers, should utilize existing laws to communicate that noncompliance is no longer tolerated and that the civil rights of PWSUDs matter.