Local laws restricting addiction treatment facilities threaten to prolong the crisis of widespread drug addiction.
Only days before this year’s Thanksgiving holiday, a Kentucky county approved a controversial ordinance placing strict limits on where many new addiction treatment facilities can operate. The law, which confines new facilities to shopping centers, raises important issues about the legality and prudence of such decisions that target addicted populations or organizations that serve them.
Breathitt County arrived at the new legislation after a previous version was struck down by a circuit court judge, who found the original ordinance to be in violation of the Americans With Disabilities Act. That ordinance from 2015 had brazenly barred any new drug treatment centers from opening in the county. The revised ordinance backs away from out-and-out banning of new treatment centers. Instead, it requires facilities that provide medications like methadone or Suboxone to be situated in shopping centers. Although it’s easy to see this as an improvement on the wholesale outlawing of addiction treatment, is it really more defensible? At best, the ordinance is a counterproductive measure that will likely have negative consequences for all involved.
While local governments can and often do enact laws limiting the ability of drug treatment companies to find a siting location, these laws can be on shaky legal ground. Federal anti-discrimination laws, including the Rehabilitation Act, the Fair Housing Act, and the Americans With Disabilities Act, offer protections against this practice. Drug addiction is considered in federal law to be a disability, which qualifies it for protection under anti-discrimination laws. Local governments can be sued for zoning laws or other legislation that may violate these protections. And in fact, that’s just what happened in this case.
Apparently the only reason that the revised ordinance is not also being challenged in court is that the local fiscal court amended the ordinance to grant an exception to the company that would have been the plaintiff. So it certainly seems likely that it’s only a matter of time before the ordinance could be overturned in another circuit court ruling, as many similar laws have been. It is hard to see the advantage in bottle-necking addiction treatment facilities during a drug addiction epidemic—especially when future rulings have the distinct likelihood of overturning such laws on the basis of discrimination.
It is hard to see the advantage in bottle-necking addiction treatment facilities during a drug addiction epidemic.
When passing legislation like this one, people might reason that they are looking out for the community’s best interests. Although they might argue this in good faith, their reasoning may be flawed. In fact, such ordinances are more likely to do the opposite.
Some argue that requiring drug treatment facilities to be in shopping centers makes it easier for the police the keep an eye on things. They worry about illicit behavior around drug clinics and figure that strip malls are more easily patrolled by law enforcement. But what kind of message does this send to the community? Clearly, the message is that people seeking help for addiction are likely criminals. This is a step backwards in a country that has embraced the understanding that addiction is a medical condition that requires professional treatment. Incidentally, it would be hard not to notice some irony in cracking down on illicit behaviors like “doctor shopping” by moving drug clinics into strip malls.
This is a step backwards in a country that has embraced the understanding that addiction is a medical condition that requires professional treatment.
Others reason that it’s best for addiction treatment facilities to be located far away from residential areas. They feel that this will bring more drug users into their neighborhoods, and with them, an increase in illegal behavior or impaired drivers on the road. This reasoning is understandable, but there are problems with it too. For one, it likewise defines people in treatment first of all as potential criminals rather than sick people obtaining treatment for their health problems. But it also defers the real problem of drug addiction in their own backyards.
What will happen when a local community makes it so hard for addiction treatment facilities to operate that there are no resources for their own residents? The problems they feared from the opening of treatment facilities will spring up twofold in the absence of such facilities. Even when there are still options for those seeking help, but those options are severely limited, fewer people in the area will get the treatment they need. This means more impaired drivers on the road, not less. It means more illicit drug activity in the area, not less. It means a community that is still sick, not one that is recovering from an addiction epidemic.
Recognizing that addiction is a chronic, relapsing brain disease, and that it killed more than 47,000 Americans in 2014 alone, entails a certain responsibility. The “not in my backyard” approach of building barriers to expanded treatment resembles something that people with or around addictions know well—denial. Denying that addiction will remain in our backyards until we allow evidence-based treatment centers in will only prolong the addiction epidemic and the other social problems connected to it.