Division of Law, Ethics, and Psychiatry (Aoun and Appelbaum) and Center for Research on Ethical, Legal, and Social Implications of Psychiatric, Neurologic, and Behavioral Genetics (Appelbaum), Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York.
Psychiatr Serv. 2019 Jul 1;70(7):596-603. doi: 10.1176/appi.ps.201800574. Epub 2019 Apr 17.
Title I of the Americans with Disabilities Act (ADA) provides protection against discrimination on the basis of disability. This article explores how the courts have dealt with provisions limiting these protections for persons with substance use disorders. Specifically, the ADA allows employees with substance use disorders to be held to the same standards as other employees, suggesting that employers may not be required to provide reasonable accommodations. Moreover, employees "currently engaging in the illegal use of drugs" are excluded from ADA coverage.
This article reviewed all published federal appellate court opinions involving cases in which a substance use disorder was the basis for a claim of employment-related discrimination in violation of the ADA.
In 26 cases identified, the lower courts ruled in favor of the employer 25 times, and the appellate courts reversed four of these rulings. The cases highlight three important limitations of ADA protections for persons with substance use disorders: the dilemma of needing to prove that one's substance use disorder limits major life activities while simultaneously arguing that one is qualified for the job; expansive interpretations of "current" drug use and the period of sobriety needed to qualify for ADA protections; and restrictions on the extent to which a qualifying disability can serve as a legal excuse for substance use-related misconduct.
The protections afforded by the ADA for individuals with substance use disorders are restricted by what appears to be the statute's moralizing on drug and alcohol use and those who use these substances.
《美国残疾人法案》（ADA）第一编为基于残疾的歧视提供了保护。本文探讨了法院如何处理限制这些物质使用障碍患者保护措施的规定。具体来说，ADA 允许物质使用障碍患者与其他员工一样遵守相同的标准，这表明雇主可能不必提供合理的便利。此外，“目前正在非法使用毒品”的员工被排除在 ADA 覆盖范围之外。
本文回顾了所有涉及因物质使用障碍而违反 ADA 提出的就业相关歧视索赔的联邦上诉法院意见。
在所确定的 26 个案例中，下级法院 25 次支持雇主，上诉法院推翻了其中 4 个裁决。这些案例突出了 ADA 对物质使用障碍患者保护的三个重要限制：需要证明自己的物质使用障碍限制了主要生活活动，同时又要证明自己有资格从事这项工作的困境；对“当前”吸毒和获得 ADA 保护所需的清醒期的广泛解释；以及对能够成为与药物使用相关的不当行为的合法借口的合格残疾的限制程度。
ADA 为物质使用障碍患者提供的保护受到该法规对药物和酒精使用及其使用者的道德规范的限制。
