Since its inception in 1999, the National Association for the Advancement and Advocacy of Addicts (N4A)^1,2 has been attempting to no avail to network with supportive and sympathetic groups to enlist their help with: 1) changing public attitudes through education about the disease of addictions leading to decriminalization of addiction related behavior and improved recovery, 2) changing laws against addicts that are inherently discriminatory, and 3) suing discriminators, be they a state or federal government or private, based on the Americans with Disabilities Act (ADA) or various state laws specifically written to be antidiscriminatory. This approach has been unsuccessful despite these various groups' philosophies being consistent with such changes and actions. (Despite this lack of success, we will continue our legal and educational efforts.) Generally, these groups are anti-drug war and for decriminalization of drug addiction, physician addictionology groups who believe addiction is a disease, legal advocacy groups, treatment advocacy groups, mental health advocates, foundations supporting family health and values, various national and local councils on drugs and alcohol, groups defending constitutional rights, and other pro-addict groups of all kinds. Yet addicts are swinging in the wind on invisible ropes, alone and ignored.

Discriminated-against addicts are finding it hard to live under the financial, no less criminal, burdens imposed by current discriminatory practices. The ADA, for instance, is being read by the Supreme Court as not applying to state governments despite clear wording in the statute to the contrary. My belief is that there is a deep fear of retaliation amongst groups supportive of recovering addicts by state and federal authorities if they happen to act on their pro-addict philosophies, especially in court. An example of this is the American Society of Addiction Medicine (ASAM) who showcases its antidiscrimination stance protective of recovering physicians on its web site, yet they take no discernible action against this discrimination. The following is one such statement backed with no action whatsoever except for appeasement and acquiescence. The insight is there but is absent the necessary action. The N4A promises action instead of words and committees.
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At the request of a significant number of ASAM members, the Physician's Health Committee is preparing an "Action Response". This action response is related to inquiries of discriminations against physicians who are in recovery from substance abuse or psychiatric disorders.

Discrimination problem areas discussed by the committee are multiple:

1. Discrimination was occurring in various states in current licensure restrictions as related to inordinate length of time or unjustified recovery periods for consent orders or restrictions on the licensure.

2. Discrimination was also occurring in those recovering physicians who were not admitted to panels of managed care or who were being removed from such panels.

3. Discrimination was occurring with the severance or reactivation of DEA numbers which in some cases were a critical possession if the individual was to receive hospital or clinic privileges.

4. Discrimination was occurring in recovering physicians who were being fired from clinics, hospitals, or partnerships based upon their recovery status.

5. Confusion exists in the light of New Jersey Court decisions concerning the licensure questionnaires of whether a physician had ever had a substance abuse problem as opposed to whether he or she were currently in treatment. These confusions were secondary to the issues of the ADA (Americans with Disability Act).

The consensus of the committee participants was that "action response" of ASAM would involve the following measures:

A. Each participant of the Physicians Health Committee would act as a regional representative to receive discriminatory calls from physicians in that area. I will contact each of you, individually, for further details of that responsibility.

B. A central 1-800 number would be disseminated to all of our members of ASAM and all non-member physicians who have been discriminated against because of their recovery from substance abuse or psychiatric disorders. This number would be published in the ASAM NEWS and sent by mailings to our membership and other memberships.

C. If you are a regional representative of ASAM's Physicians Health Committee, these calls would be re-routed to you for a response.

D. A "response packet" is being prepared for each of you to send to the discriminated physician.

E. The 1-800 number would be available to you for further consultation with me or members of our staff. The 1-800 number will be included with the "response packet" which you will receive in the near future.

F. Some of the members of the PHC are requested to assume specific tasks (i.e. computer communications, a lawyers list, meetings with AMBA, NIQUA, licensing boards).

G. Dr. Peter Mansky is our liaison with the Federation of Physicians Health Committee.

H. A request to forward data from each regional section in detail on each discriminatory inquiry to the 1-800 number and address.

Please call me if you have any further questions or suggestions.

G. Douglas Talbott, M.D.³

Chairman, Physicians Health Committee

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This notice to all members of ASAM says a lot, but in actuality, does nothing. The committee takes no action. It takes couragous and decisive action in the face of potential retribution to end the hypoic genocide. Talk is cheap. In fact, when I joined ASAM and requested involvement in helping to organize their legal action committee, I was dismissed from the society for not having a medical license. "Oops, so sorry," they told me, "we have this silly rule. Too bad. Goodbye." They well know that I'm one of the discriminated. They know that’s why I have no license, yet they are too afraid to be involved with someone like me who might demand action as well as interfere with their outdated paradigm of addictions. Absurd? They are documenting (and committing) discrimination but doing absolutely nothing about it. Many other seemingly pro-addict groups are following ASAM’s lead. The N4A finds this behavior irresponsible and cowardly. This is not how to confront discrimination. We need action, not good intentions that only turn sour and enable the discrimination to continue.

Moreover, you can discern from Dr. Talbot’s statement (above), ASAM plans to do behind the scenes, closed door, negotiating for discriminated doctors. This paternalistic position allows discrimination to remain intact while giving more power to their group. This must never be allowed to occur. No discriminated minority group would stoop to deal with bias against them in this secretive manner. The dealings with the authorities must be out in the open where the public can see and hear the process. Of course, that’s what courts are for - the public disclosure of public decision-making. Only in courts of law will all discriminated addicts get fair and unbiased treatment, and, most importantly, DUE PROCESS, something that only rarely occurs today under the administrative law process dealing routinely with most of these discriminations.

In my personal experience, the AMA and state medical societies have likewise taken no action against state licensing bodies who currently discriminate arbitrarily against recovering doctors, although they say they are aware of and against this discrimination, with many recovering addicts among them. Maybe fearful behavior by these groups is realistic, "politics has strange bed fellows," but it lacks integrity. Although discrimination is difficult to prove and retaliation can be quite secretive and insidious, it's just been going on for too long and is no longer a tenable way to ignore the problem. I hope fear is not their excuse. I hope its closer to disorganization and confusion. I don't think so. We'll see. In the mean time, addicts are being persecuted and it's time for someone to act.

In order to beat the discriminators without necessarily winning the legal battles (for the time being) there is another possibility. There is an alternative to changing laws and fighting law suits against powerful discriminators especially in the area of state governments who seem to be immune to the ADA and even their own state laws against addict discrimination. This alternative is to provide financial and occupational assistance to discriminated against addicts to either a) fight their own lawsuits, b) to provide for day to day living expenses necessary to sustain their previous life styles at a minimal but similar level, and/or c) assist the discriminated addict in finding financially equivalent employment while waiting to re-enter their fields. These alternatives would allow the legal process to be followed while the discriminated addict has the where-with-all to support himself and his family and do recovery without massive disruption in his living conditions, loss of house, car, children's school district, medical insurance, etc. Active and early-recovering addicts are too confused and frightened to manage these issues without unconditional support. This support does not exist for them today except in the N4A. But the N4A doesn't have the resources yet, only the desire to help and the will to do whatever is necessary, no matter what the personal risk. Financial support can be derived from donations from foundations, large groups of people with similar occupations such as unions, trade groups, or societies such as the AMA, and state medical, lawyer, pharmacist, nursing societies, etc., through insurance (disability and others) policies, annuities, or other financial tools.

Groups can finance these tools in advance to secure adequate funds down the road as the need arises. Because the number of long term discriminated addicts in need of financial stabilization tends to be small, the funds' donations or dues required by the membership of particular groups would be minimal while the benefits of the moneys would be substantial - quite supportive and loving⁴ to the otherwise ostracized addict. Of course, these financial stipends would be dependent on the recovery of the addict, but wouldn't punish small relapses along the road to recovery as current programs tend to do (the carrot and stick method). These financial supports would allow sympathetic groups to act on their pro-addict philosophies without stimulating the wrath of powerful and touchy authorities. Because most of these supportive groups are made up of recovering addicts, or have members who are at risk of future addiction themselves, I believe they would be eager to form such financially supportive programs. Please don't say, "It can't happen to me."

The N4A therefore makes the following suggestion or challenge (if need be) to groups whose members are at risk of addiction and professional discrimination and purport to be supportive of their addicted and recovering brethren:

• Set up programs as suggested in this letter.
• Assist discriminated addicts in their legal battles.
• Seek out discriminated members of your particular group in order to assist them through their travails and keep them in the fold, unostracized and destigmatized, as active members despite licenses or other credentials having been removed by the discriminators.
• Seek out funding from supportive foundations, members of your group, and other sources.
• Set up employment consultations for discriminated addicts to provide for reasonably equivalent employment positions that utilize their talents and aren't degrading.
• Begin to act on your beliefs to stop the damage occurring to your members.
• Lastly, we need an advocacy organisation, like the N4A, to advocate and advise vigorously for addicts in all areas, including legal and credentialing, unrelated to addiction monitoring. Let the monitoring people do only that.