Report: Emergency Departments Denying Necessary SUD Care Can Violate Federal Law

Emergency departments that deny necessary care for substance use disorders could be in violation of multiple federal laws, according to a new report released on Tuesday by the advocacy organization the Legal Action Center.

The project was funded by Johns Hopkins Bloomberg School of Public Health.

>> READ the Legal Action Center’s full report

As a primary point of access to care, hospital emergency departments play a key role in helping SUD patients survive and access further treatment. LAC identifies three key evidence-based practices in this venue:

• SUD screening and diagnosis (including a brief intervention for at-risk alcohol use)
• Administration of opioid agonist medications, as appropriate
• Treatment referral facilitation (along with naloxone distribution or prescription for patients who use drugs that can contain opioids)

By failing to provide these services, emergency departments could be in violation of the Emergency Medical Treatment and Labor Act (EMTALA), as well as multiple federal civil rights laws that prohibit discrimination based on disability and/or race. The report concludes that failing to conduct medical screenings with tools validated for ER use to identify substance use disorders and stabilizing patients is a violation of EMTALA. Further, because substance use disorders can be classified as a disability, emergency departments who deny SUD patients who are qualified or eligible for such services “could be liable for discrimination under two legal theories: disparate treatment and failure to provide a reasonable modification,” according to the report. Further, denying the provision of evidence-based practices for SUD on the basis of race, color or national organization also is potential grounds for liability.

Sika Yeboah-Sampong, LAC staff attorney and one of the report’s authors, said in a news release that the findings “should be a wakeup call for emergency departments across the country.”

“With more than 19 million U.S. adults currently living with a substance use disorder, and amidst an escalating overdose crisis, emergency departments not only have the role and resources to address life-threatening emergencies, but, as our report shows, the legal obligation to do so,” Yeboah-Sampong said.