Employers, especially in the health care industry, continue to grapple with how to provide support to employees, clients, patients and family members suffering from substance-abuse disorders.
Two years ago, Rhode Island took a step toward acknowledging and tackling the opioid crisis when it passed the Alexander Perry and Brandon Goldner Act. The law requires specific treatment planning for substance-abuse patients upon discharge, sets up opioid-prescribing guidelines for physicians, requires insurers to cover certain specific substance-abuse treatments, requires pharmacies to upload opioid prescriptions to the federal Prescription Drug Monitoring Program system within 24 hours and loosens certification requirements for recovery housing facilities for residential substance-use disorder treatment.
Accidental drug-overdose deaths in Rhode Island climbed to a high of 336 in 2016 from 94 in 2011. Perhaps due to governmental efforts, including the Goldner Act, this continuous trend upward slowed slightly in 2017, with 314 drug-overdose deaths. However, the numbers remain too high. … By acknowledging substance abuse disorders as an illness, rather than a personal fault, and by providing open lines of communication and interaction on this topic, Rhode Island employers can do their part to help tackle this issue.
Many individuals who died from an opioid overdose had previously suffered one or more nonfatal overdoses. If family and friends of these victims were informed of the prior overdose incidents, perhaps they could have prevented some of the deaths that occurred.
Rhode Island and the federal government have strict confidentiality laws prohibiting the disclosure of personal health information and have in place even stricter protections against disclosure of mental health and substance-abuse disorder information.
More recently, however, the federal and state governments have recognized the value of including family and friends in helping substance-abuse disorder patients obtain treatment. In October 2017, the Health and Human Services Office for Civil Rights released new guidance on when and how health care providers can share a patient’s health care information with family members, friends and legal representatives when that patient may be in crisis and incapacitated, such as during an opioid overdose. In fact, HHSOCR has suggested disclosure of opioid-overdose information is allowed under federal law where a doctor informs family, friends or caregivers of a patient’s opioid abuse after determining, based on the facts and circumstances, the patient poses a serious and imminent threat to his or her health through continued opioid abuse upon discharge. The Goldner Act likewise encourages communication about opioid-patient information to family and friends by requiring hospitals, at discharge, and with patient consent, to notify the patient’s emergency contacts of an opioid overdose.
If you are not a hospital or health care provider, it is important to be sure you are likewise following relevant laws and establishing internal policies and processes to help reduce the stigmatizing of substance-abuse disorders, and to encourage your employees to seek treatment should they or their family members be victims of this disease. First, federal law forbids employers from discriminating against employees with a history of substance-abuse problems, or from taking disciplinary actions against employees who are in treatment for substance abuse. Second, you should implement substance-abuse prevention policies and procedures that not only provide discipline for substance use while on the job, but also encourage employees to seek treatment. Third, you can provide your employees with benefits that address substance abuse, including medical insurance benefits that include substance-abuse treatment, and mental and substance-abuse counseling.
Christopher Browning and Stephen Zubiago are partners in Nixon Peabody LLP’s Providence office. Michael Gorfinkle is an associate.
