British Columbia

Pharmacist fights for right to take opioid replacement medication on the job

B.C. pharmacist claiming he faced discrimination because he was banned from using addiction treatment medication on the job will be heard by the B.C. Human Rights Tribunal.

First doctor who assessed him asked if return to work would feel 'like being a kid in a candy store'

A B.C. Pharmacist says he faced discrimination based on his addiction-related mental disability and his religion. He initially faced a pre-condition to kick his medication before returning to full duties as a clinical pharmacist, but a second doctor cleared him to apply to return to work. (Shutterstock)

B.C.'s Human Rights Tribunal will hear the case of a pharmacist who claims restrictions on opioid replacement medication for working healthcare professionals is discriminatory — even though he's been cleared to re-apply for his licence.

The 16-year pharmacist, who is not named or identified in any way by the tribunal, is now free to return to work following a second opinion from an addictions specialist. It's unclear if he has applied to do so and he argues his screening process took too long.  

The pharmacist argues there's no scientific reason to restrict healthcare workers from using medications that curb drug cravings and withdrawal in order to aid addiction recovery.

He was initially denied his license when he tried to return to work two years ago after a voluntary suspension due to an "addiction-related disability" that led to a $1,300-per-week heroin habit.

He wanted to use Suboxone — a medication that curbs opioid cravings — and be allowed to return to his job dealing with high-risk drugs. Doctors and nurses in many U.S. states and Quebec are permitted to take Suboxone, and in some cases methadone, while working.

Suboxone allowed him to live 'a normal life'

According to an  Aug. 22  tribunal decision, the pharmacist struggled with opioid addiction, including heroin, for several years, then returned to work. But he relapsed in 2015, despite a return-to-work plan that included monitoring. The pharmacist voluntarily suspended his license, returning to in-patient treatment.

He was prescribed Suboxone, a medication used to curb craving for opioids and ultimately taper opioid use, in 2016. The pharmacist reported Suboxone helped him live a normal life.

But when he attempted to return to work in 2017, the addictions specialist who evaluated him determined the pharmacist was not fit for duty in a "safety-sensitive" job — such as a clinical pharmacist who handled opioids — if he continued to take Suboxone. 

The pharmacist who launched the complaint to the B.C. Human Rights Tribunal did get a second opinion when he balked at abstinence as having no scientific basis as successful. That doctor agreed. (Shutterstock/Atstock Production)

The doctor also recommended he enter a 12-step program, faith-based treatment program that requires abstinence from all drugs. He objected because he is an atheist and claimed the drug-free rule wasn't based on scientific evidence.

The pharmacist sought a second doctor's assessment and the college eventually accepted new recommendations in August 2018 which allow him to submit an application to register as a full pharmacist.

The first doctor and the College of Pharmacists of B.C. then requested his human rights complaint be dismissed. But the tribunal ruled Aug. 22 that the hearing will proceed, in part.

'Hurt and shocked'

In the pharmacist's initial complaint to the Human Rights Tribunal he argued that he was discriminated against because he was referred to a religious-based treatment program when he's an atheist, and he wasn't allowed to return to work unless he stopped using medication needed for his disability.

That precondition prevented his return to work in a "reasonable time frame," he argued.

The pharmacist said the first doctor who assessed him "demonstrated unfair and offensive stigma and stereotyping of people with addiction issues."

He described feeling "hurt and shocked" when the assessing doctor asked if a return to work would make him feel "like being a kid in a candy store" since he would be near so many drugs.

Tribunal Member Emily Ohler said she read more than 1,300 page of submissions from all parties before determining a hearing was needed.

Ohler denied the pharmacist's claim of discrimination based on religion, as the 12-step treatment program was not mandatory. She did order a hearing into the discrimination claim based on mental disability.

In her ruling Ohler cited an expert who confirmed past workplace addictions policies in this province restricted healthcare workers from using drugs like Suboxone, but said that practice needed more study.

In Quebec, doctors overcoming addiction can use methadone. An American study published by the Mayo Clinic in 2012 reported dozens of healthcare worker discipline programs permitting nurses and doctors to return to work while using similar addiction treatments.

Suboxone is a long-acting opioid medication used to replace shorter-acting opioids like heroin, oxycodone, fentanyl or hydromorphone. It can prevent withdrawal symptoms and reduce cravings. (Sally Pitt/CBC)

About the Author

Yvette Brend is a CBC Vancouver journalist. Yvette.Brend@CBC.ca @ybrend

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