According to an article published in Stat, a health-oriented news website produced by the same company as the Boston Globe, nursing homes in the Boston area are turning away patients on medication-assisted treatment (MAT). MAT, often called the gold standard of addiction care, is the use of FDA approved medications in combination with counseling and behavioral therapies for the treatment of opioid use disorders.  There are currently only two facilities in the Boston area that accept MAT patients, meaning the wait lists are extremely long.

One of the reasons for this is the stigma behind MIT. When nursing homes or other facilities label themselves as drug free, they are hesitant to accept people taking these medications. Some of the FDA approved medications include buprenorphine, naloxone, and methadone. Buprenorphine is a semi-synthetic opioid that causes many of the side effects of opioids, only at lower levels. Methadone is an opioid that is prescribed to treat severe pain in addition to being used to prevent withdrawal symptoms, and it has the potential for abuse itself. Many people, despite the proven effectiveness of MAT, still view it as substituting one addiction for another.

It’s not just nursing homes that are a problem, either. Currently, Rhode Island is the only state that provides all three FDA-approved addiction medications to prison inmates. The U.S. Department of Justice is currently investigating prison systems that refuse to provide MAT to addicted inmates. Massachusetts correctional facilities don’t provide methadone or buprenorphine to inmates, and they actually force inmates who were taking these medications upon entrance to prison to stop taking them. This is despite the fact that, according to the journal JAMA Psychiatry, opioid overdose deaths dropped by nearly two-thirds among recently incarcerated people in the first year after the establishment of the Rhode Island program.

DISCRIMINATION AGAINST PEOPLE RECEIVING MAT

Despite the fact that the use of MAT in prisons is finally being addressed, nursing homes remain a major problem area. Because addiction is considered a chronic medical problem, legal experts say that denying entrance to people on MAT violates the Americans with Disabilities Act (ADA), which mandates that individuals with disabilities shall have access to jobs, public accommodations, government services, public transportation, and telecommunications. Nursing homes actually fall under two different titles, or sections, of the ADA. Title II covers state and local governments, as well as organizations that provide services on their behalf, such as state and city hospitals and clinics, regardless of whether or not they receive federal funding. Even if the nursing home is a private facility, Title III covers all “places of public accommodation,” which are places that are open to the public where an individual may obtain goods and services. It includes, among other things, private doctors’ offices, hospitals and clinics, and nursing homes.

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