Drug Addiction

About Drug Addiction

Drug addiction is a chronic, relapsing, and treatable disease. Addiction begins with a conscious choice to use drugs, but addiction is not just "a lot of drug use." Recent scientific research provides overwhelming evidence that not only do drugs interfere with normal brain functioning creating powerful feelings of pleasure, but they also have long-term effects on brain metabolism and activity. At some point, changes occur in the brain that can turn drug abuse into addiction. Those addicted to drugs suffer from a compulsive drug craving and usage and cannot quit by themselves.

Job accommodations may include the use of paid or unpaid leave for inpatient medical treatment or flexible scheduling for counseling or to attend support meetings. When, as a part of a job, an individual is exposed to drugs in the workplace (e.g., hospitals, pharmacies), an employer may need to implement additional workplace supports, provide extra supervision, or reassign an individual to a position that does not involve exposure to drugs. JAN's Accommodation Solutions: Executive Functioning Deficits is a publication detailing accommodations for individuals with limitations related to executive functioning. These ideas may be helpful in determining accommodations.

How can you tell if an employee is addicted to drugs?

The following are some of the behavioral characteristics that may occur with drug addiction. Note that these behavioral characteristics do not always indicate drug addiction, but may warrant further investigation.

• Absences without notification and an excessive use of sick days
• Frequent disappearances from the work site, long unexplained absences, improbable excuses
• Unreliability in keeping appointments and meeting deadlines
• Work performance that alternates between periods of high and low productivity
• Mistakes made due to inattention, poor judgment, and bad decisions
• Confusion, memory loss, and difficulty concentrating or recalling details and instructions
• Ordinary tasks require greater effort and consume more time
• Interpersonal relations with coworkers suffer
• Rarely admits errors or accepts blame for errors or oversights
• Progressive deterioration in personal appearance and hygiene
• Wearing long sleeves when inappropriate
• A personality change that includes mood swings, anxiety, depression, lack of impulse control, suicidal thoughts or gestures
• Increasing personal and professional isolation

Can drug addiction be treated?

Yes. A variety of approaches are used in treatment programs to help patients deal with cravings and possibly avoid drug relapse. Through treatment that is tailored to individual needs, individuals can learn to control their condition. There are several types of drug abuse treatment programs. Short-term methods last less than six months and include residential therapy, medication therapy, and drug-free outpatient therapy. Longer term treatment may include, for example, methadone maintenance outpatient treatment for opiate addicts and residential therapeutic community treatment.

Drug Addiction and the Americans with Disabilities Act

The ADA does not contain a definitive list of medical conditions that constitute disabilities. Instead, the ADA defines a person with a disability as someone who (1) has a physical or mental impairment that substantially limits one or more "major life activities," (2) has a record of such an impairment, or (3) is regarded as having such an impairment. For more information about how to determine whether a person has a disability under the ADA, see How to Determine Whether a Person Has a Disability under the Americans with Disabilities Act Amendments Act (ADAAA).

The following information is from Chapter VIII of the Title I Technical Assistance Manual:

Current illegal users of drugs are not "individuals with disabilities" under the ADA when an employer acts on the basis of such use. However, persons addicted to drugs but who are no longer using drugs illegally and are receiving treatment for drug addiction or who have been rehabilitated successfully are protected by the ADA from discrimination on the basis of past drug addiction.

A person who casually used illegal drugs in the past but did not become addicted is not an individual with a disability based on the past drug use. For a person to be "substantially limited" because of drug use, s/he must be addicted to the drug.

Individuals who are not illegally using drugs but who are erroneously perceived as being addicts and as currently using drugs illegally are protected by the ADA.

What does “illegal” drug use mean?

The illegal use of drugs includes the use, possession, or distribution of drugs that are unlawful under the Controlled Substances Act. It includes the use of illegal drugs and the illegal use of prescription drugs that are "controlled substances."

What does “current” illegal drug use mean?

"Current" drug use means that the illegal use of drugs occurred recently enough to justify an employer's reasonable belief that involvement with drugs is an ongoing problem. It is not limited to the day of use or recent weeks or days in terms of an employment action. It is determined on a case-by-case basis.

Are tests for illegal drugs considered medical tests under the ADA?

No. Drug tests are not considered medical examinations, and an applicant can be required to take a drug test before a conditional offer of employment has been made. An employee also can be required to take a drug test, whether or not such a test is job-related and necessary for the business. (On the other hand, a test to determine an individual's blood alcohol level would be a "medical examination" and only could be required by an employer in conformity with the ADA.)

While an employer may conduct tests to detect illegal use of drugs, the ADA does not prohibit, require, or encourage drug tests. Employers may comply with applicable Federal, State, or local laws regulating when and how drug tests may be used, what drug tests may be used, and confidentiality.

If a test for illegal drugs is given to a job applicant before a job offer is made, what happens if that drug test reveals the presence of legally prescribed drugs?

If a person is excluded from a job because the employer erroneously "regarded" him/her to be an addict currently using drugs illegally when a drug test revealed the presence of a lawfully prescribed drug, the employer would be liable under the ADA. To avoid such potential liability, the employer would have to determine whether the individual was using a legally prescribed drug. Because the employer may not ask what prescription drugs an individual is taking before making a conditional job offer, one way to avoid liability is to conduct drug tests after making an offer, even though such tests may be given at any time under the ADA. Because applicants who test positive for illegal drugs are not covered by the ADA, an employer can withdraw an offer of employment on the basis of illegal drug use.

If the results of a drug test indicate the presence of a lawfully prescribed drug, such information must be kept confidential in the same way as any medical record. If the results reveal information about a disability in addition to information about drug use, the disability-related information is to be treated as a confidential medical record.

Can an employer refuse to hire an applicant who has a history of illegal drug use?

Yes, in some situations. An employer can refuse to hire a person with a past history of illegal drug use, even if the person no longer uses drugs, in specific occupations, such as law enforcement, when an employer can show that this policy is job-related and consistent with business necessity.

An employer also may refuse to hire an individual with a history of illegal drug use if the employer can demonstrate that the individual poses a "direct threat" to health or safety because of the high probability that s/he would return to the illegal drug use. The employer must be able to demonstrate that such use would result in a high probability of substantial harm to the individual or others that could not be reduced or eliminated with a reasonable accommodation. Examples of accommodations in such cases might be to require periodic drug tests, to modify job duties, or to provide increased supervision.

Does the ADA restrict workplace programs to combat the use of drugs?

No. The ADA does not interfere with programs to combat the use of drugs in the workplace. The Act specifically provides that an employer may prohibit the use of drugs in the workplace and require that employees not be under the influence of drugs in the workplace.

Accommodating Employees with Drug Addiction

People with drug addiction may develop some of the limitations discussed below, but seldom develop all of them. Also, the degree of limitation will vary among individuals. Be aware that not all people who are addicted to drugs will need accommodations to perform their jobs and many others may only need a few accommodations. The following is only a sample of the possibilities available. Numerous other accommodation solutions may exist.

Accommodation Ideas:

Situations and Solutions:

The following situations and solutions are real-life examples of accommodations that were made by JAN customers. Because accommodations are made on a case-by-case basis, these examples may not be effective for every workplace but give you an idea about the types of accommodations that are possible.

A production worker in recovery from substance abuse needed to attend counseling that was only available in the evenings.

His employer excused him from overtime on the days he attended counseling.

A nurse with drug addiction was restricted from dispensing medication after she was caught using illegal drugs.

Her employer had a policy allowing employees to participate in drug rehabilitation and return to work with a last chance agreement. When the nurse returned to work after rehabilitation, she was reassigned to a job that did not require her to dispense medication and given periodic drug tests.

A call center employee with a history of drug addiction was having difficulty dealing with stress, especially face-to-face discussions with her supervisor about her job performance.

Her supervisor agreed to change her management style, giving performance information in writing.

A substance abuse counselor with a history of drug addiction was having difficulty working with clients while dealing with family problems.

Her employer allowed him to take leave time to deal with his family problems.