YOUR RIGHTS IN RECOVERY

There is no “right” way to recover. Treatment and recovery don’t look the same for everyone. People with opioid use disorder (OUD) must be able to get accurate and unbiased information about the effectiveness of different treatment pathways. Accurate information allows you to choose what’s right for you, which might change over time – and that’s okay. Your route to recovery might be made up of different services and supports from clinical and non-clinical pathways. 

Treatment and Recovery General Resources 

• The Massachusetts Department of Public Health’s Bureau of Substance Addiction Services (BSAS) provides a complete description of each service type on their website. 
• You can learn more about the levels of care created by the American Society of Addiction Medicine on the Recovery Research Institute’s website. 
• You can learn more about Harm Reduction as a set of practical strategies and a social justice movement on the national Harm Reduction Coalition website. 

As you navigate treatment and recovery, you have rights and protections with your health care and health insurance. Health insurance can be hard to navigate, but state and private health insurance policies cover a variety of services for people with opioid use disorder (OUD). The Mental Health Parity and Addiction Equity Act, for example, requires health insurers provide the same level of benefits for OUD treatment and services than they do for physical health care. And for those without health insurance, Overdose Education and Naloxone Distribution (OEND) sites offer many clinical services for people in recovery for free, and they won’t take any insurance information. 

• If you are working, you may be offered health insurance as a benefit through your employer. If your employer doesn’t offer a health insurance benefit, you can find a health insurance plan through the Massachusetts Health Connector. The plans offered through the Health Connector by different carriers meet state and national coverage standards, and you can compare plans and see costs to find the plan that will work best for you. 
• Types of plans: The most common types of health insurance plans in Massachusetts are Health Maintenance Organization plans (HMOs), Preferred Provider Plans (PPPs), and Indemnity Plans. 
  • HMOs cover hospital, medical, and preventive care within a network of providers. Care that you get from a provider outside of the provider network is not covered. You usually pay a portion of the cost of each service (called a co-pay) and the HMO pays the rest of the cost. 
  • Like HMOs, PPPs usually cover hospital, medical, and preventive care within a network of providers. In a PPP, you can also get care from providers outside of the network and the PPP will still pay a portion of the cost, but it may be a smaller amount. 
  • Indemnity Plans cover hospital and medical expenses for an accident or illness. Some also cover preventive care. These plans will pay a part of the cost and you are responsible for the rest. 
  • MassHealth: If you meet certain income requirements, you may be eligible for MassHealth. MassHealth is a Medicaid program paid for by state and federal taxes. There are different types of coverage available through MassHealth based on your age, living and family situation, disability status, and certain health information. 
  • Copays: There is no copay for substance use disorder (SUD) treatment covered by MassHealth   
  • Medicare: Medicare is the federal health insurance plan for people age 65 or older and people with certain disabilities or health conditions. Both original Medicare and Medicare Advantage provide coverage for SUD, ranging from screening to inpatient and outpatient treatment by a Medicare-approved provider. However, a person who receives treatment must still pay deductibles, copayments, and coinsurance. 
  • Other subsidized plans (ConnectorCare): You may be able to get a ConnectorCare plan if you: have a household income at 300% of the Federal Poverty Level or lower; you don’t qualify for MassHealth, Medicare, or other public health insurance programs; and you meet other eligibility requirements. ConnectorCare plans offer comprehensive coverage and have low monthly premiums, low out-of-pocket costs, and no deductibles. 
  • No insurance: If you do not have health insurance, you can still receive treatment in Massachusetts. There are some programs funded by the state that offer free treatment to people without insurance. You can learn more about state-funded services and how to find them by calling the Helpline at 800-327-5050 or on the Helpline website. When you search for services on the Helpline website, you can choose “Only show BSAS-funded programs” to see free treatment options. 

Rights, Protections, and Tips for Advocacy 

• The Massachusetts Mental Health Parity Law makes it illegal for insurers to put smaller annual or lifetime limits on coverage of care for mental health and substance use disorders than on physical disorders.  
  • Under this act, patients are allowed 14 days of inpatient care and $500 worth of outpatient benefits. When a person gets treatment for mental health and substance use disorders, the patient has the right to more coverage.  
• Your right to fill your prescription for medication for opioid use disorder (MOUD) at a pharmacy is protected, but people may still experience discrimination in pharmacy settings. A pharmacist can refuse to fill your prescription because it is against their religion or the pharmacist believes the prescription is not appropriate. If that happens, you have a right to ask for a pharmacist who will fill your subscription. You cannot be denied your medication if the pharmacist serving you will not fill it.  
• Know what else to look for when it comes to discrimination in pharmacy settings. Here are some examples:  
  • A pharmacy worker refusing to fill your prescription and refusing to refer you to someone who will. A pharmacist may have the right to refuse to fill your prescription if it is against their religion, or they believe the prescription is not appropriate, but they must find another pharmacist or technician who will fill your prescription.  
  • Pharmacists asking you who the medication is for or asking why you were prescribed MOUD. The pharmacist may ask if you have any questions about your prescription, but not any personal probing questions.  
  • Receiving a lower dose or fewer pills than what your doctor prescribed. If you believe the pharmacist gave you less than you were prescribed, you can ask to see what your doctor prescribed you.  
  • Saying anything negative about the medication you are prescribed and telling you a different form of MOUD is better. You know what treatment works best for you.  
  • If you are a loved one picking up a prescription for someone on MOUD, and the pharmacist refuses to give it to you. The pharmacist does not need written or oral notice by the patient before picking up and does not need any additional documentation or identification.  
• You have a right to health care and certain protections even if you are undocumented. 
  • You have the right to health care regardless of your immigration or health insurance status. Healthcare providers, including emergency rooms, can give you care without asking for your immigration, citizenship, or insurance status. 
  • Applying for government subsidized health insurance will not affect your immigration status. But you will be asked to disclose your immigration status to apply for health insurance. 
  • Immigration and Customs Enforcement (ICE) usually cannot detain (take) you at hospitals or at other places that provide care, and your health information is protected information no matter what your immigration status is.  

Resources for Health Care 

• Learn more about how to get treatment without health insurance on the Helpline website. 
• Find health insurance on the MA Health Connector website.  
• Find out if you are eligible for MassHealth.  

Seeking treatment while balancing family, especially a new or growing family, can feel hard but there are resources available to help you. If you are pregnant and are looking for treatment options, the MA Substance Use Helpline can point you in the right direction. Medication for opioid use disorder (MOUD) is effective and safe during pregnancy. Treatment with MOUD during pregnancy improves both the health and safety of the birthing person and of the fetus. 

Treatment Options for Pregnant People 

• People who are pregnant can access the same services as the general population. This includes clinical and non-clinical treatment options, including MOUD. 
• Pregnant and post-partum people (people who have recently given birth) are federally identified priority populations. If you need residential treatment and can’t receive it right away because a bed is not available, you have the right to interim supportive services until a bed becomes available.  
• You have options and people to turn to as you seek treatment and stay connected with your family. The Institute of Health and Recovery offers family residential treatment services to help support your recovery and your family.  

Rights, Protections, and Tips for Advocacy 

• You cannot be denied medication for opioid use disorder in the child welfare system or if you are pregnant and breastfeeding – this a violation of your rights under the Americans with Disabilities Act (ADA).  
• If you are on MOUD, you will not automatically be involved with the Massachusetts Department of Children and Families (DCF).  
• Know what to look for when it comes to facing discrimination. It can be subtle and difficult to name. A few examples are: 
  • Being denied visitation rights to your child because you are on MOUD like methadone or buprenorphine (Suboxone or Subutex). Unless you are using non-prescribed substances, you cannot be denied visitation rights while on MOUD.  
  • Having your infant taken from your custody after the hospital where you gave birth reported you for having legally prescribed MOUD in your system. Social services cannot take your child if the only reason is that you are on legally prescribed MOUD.  
  • Having your child taken away because your recovery status is automatically seen as making you unfit to care for your child. You can be on MOUD and stay with your child if you are otherwise providing your child with the care that they need.  
  • Your caseworker, lawyer, or advocate making any negative statement to you about your ability to be a good parent because of your recovery status, race, ethnicity, class, marriage status, age, sex, or sexual orientation.  
• You have a right to access your recovery plan, often called a Plan of Safe Care (POSC). The document is made between a pregnant or parenting woman and her provider. This document helps women to think about what services or supports they might find useful, to record their plans for being a parent, and to organize the care and services they are receiving.  

Supporting Recovery While Working with DCF 

• The reunification process can be difficult and painful. You have a right to access mental health and social support services throughout every step of the process.   
• You have a right to see your child. You may ask DCF to see your child as soon as possible after your 72-hour hearing, and DCF must set up a visit within 5 business days, so long as the visits will not be harmful to the child. 
• You have a right to an interpreter during your court hearing. Your lawyer will ask the judge for this. 
• Document your case at every step of the process. Keep a notebook with you at all times and record communications with DCF, questions, and notes from child visits.  
• If you feel your lawyer doesn’t listen to you, you can ask the judge for a different lawyer. You can also file a complaint with the Committee for Public Counsel Services at 617-482-6212. 
• You have a right to see your Service Plan, which is the list of services and action items written by DCF that you must complete to be reunified with your child. This could include counseling, substance use treatment, or parent education classes. The Service Plan needs to explain what the services are, and why you are asked to comply with them.  
• You can ask a judge for a Court Appointed Special Advocate or a Guardian ad Litum (GAL). 

Resources for Families

• Learn to Cope is a non-profit support network that offers education, resources, peer support and hope for parents and family members coping with a loved one addicted to opiates or other drugs.
• Parents Helping Parents is a resource made by parents working with DCF for other parents working with DCF.  
• The Massachusetts Organization for Addiction Recovery (MOAR) provides a list of resources for parents and families in their mini guide. 
• The Journey Recovery Project provides advice, information, and resources for parents at all stages in their recovery and family journey.  
• The Children and Family Law Division provides attorneys to work with parents navigating family court.  
• The Parental Stress Line (1-800-632-8188) is a 24-hour helpline staffed by trained volunteer counselors who are available to help you.  
• The Family Engagement Project is an in-home treatment and case management program for mothers with SUD who also have an open case with DCF.  
• Moms Do Care is a peer-based recovery support program in ten communities across Massachusetts for mothers with substance use disorder (SUD).  
• IHR has an interactive resource map that spans housing, employment, and treatment services for pregnant people and parents.  
• National Advocates for Pregnant Women (NAPW) is a legal and advocacy organization which works to advance the equal rights of all pregnant people.  
• If you are a grandparent caring for a child involved with DCF, you can connect with Grandparents Raising Grandchildren, a support group for grandparents in Massachusetts.  
• Pregnancy and substance use: A harm reduction toolkit  

Everyone in recovery has the right to safe and livable housing in Massachusetts, whether you are looking to rent or own, or to live in certified sober housing. In any phase of recovery, housing is important in making a person feel safe and connected to their community. You have rights and protections through all stages of getting and keeping your housing. 

• Sober Homes, also known as alcohol- and drug-free housing, can offer people in recovery a safe and positive environment where they pay rent. These group living homes ensure that people in recovery are not alone, and they can share their success and support with others reaching for the same goal. See the list of accredited Sober Homes here.  
• The Massachusetts Fair Housing law prohibits discrimination in housing because of race, religion, nationality, age, ancestry, military background or service, gender, gender identity, sexuality, marital status, familial status (for example, if you have children), source of income (for example, a Section 8 voucher or RAFT), or disability. Under this law, a person in treatment and on medication for opioid use disorder (MOUD), for example, cannot be denied housing. 

Rights / Advocacy Tips 

• A landlord cannot evict you, only a judge can. You may receive a “Notice to Quit,” but that does not mean you need to leave your housing. This also applies to certified sober housing units.   
• Know what to look for when it comes to housing discrimination. It can be subtle and difficult to name. Some examples can include: 
  • You call and get an appointment to look at a house, but when you get there, you are told that the house was just sold or rented. 
  • You are told that the apartment you are looking at has been rented, but you see the posting still active on housing sites. 
  • You are told a higher selling price than what was advertised, or what you hear others being told. 
  • You are given different terms or conditions for signing a lease than other applicants. 
  • You are only shown homes in certain parts of town. 
  • You are not given the opportunity to negotiate. 
  • You are told that housing vouchers are not accepted by the landlord, or you see an advertisement that says, “people with vouchers cannot apply.” 
  • You face harassment, intimidation, or questions about your ability to pay rent on time.  
• If you believe you are being discriminated against, you have the right to file a claim to the Massachusetts Commission Against Discrimination (MCAD), the U.S. Department of Housing and Urban Development (HUD), the  Massachusetts Attorney General’s Office Civil Rights Division, or your local Fair Housing Task Force. 
  • If you were convicted before on drug-related charges, you may be told you are not eligible for public, or federally assisted housing. This ineligibility usually lasts for 3 years after you leave incarceration. A public housing agency can lift or shorten that time period if you successfully complete a rehabilitation program. However, depending on the charge, some individuals may still not qualify for federally assisted housing unless they can present an argument for changed behavior. This includes: 
    • Individuals who have been convicted of drug-related criminal activity involving the manufacture or production of methamphetamine on the premises of federally assisted housing.   
    • Individuals charged with violence-related activity that may pose a risk to the safety or well-being of other tenants. 

Resources 

• City Life/ Vida Urbana has a hotline for people who are facing evictions and a list of resources for those looking for housing support.  
• Find certified sober homes in Massachusetts. If you are in sober housing already and need to file a grievance (complaint), you can do so here.   
• If you believe you have been discriminated against, Mass Access can help you file a claim, investigate the realtor, and link you to further resources.  
• The Massachusetts Commission Against Discrimination also has resources for people who experience discrimination.  
• The Attorney General’s Civil Rights Division has a Know Your Rights resource for income-based housing discrimination.  

• The Massachusetts Attorney General’s Office also has resources about  fair housing law, and about  tenants’ rights, including specific information about  eviction-related rights. 
• If you are experiencing homelessness, you can find shelters in Massachusetts through the Massachusetts Coalition for the Homelessness database.  
• The Massachusetts Housing Partnership is working to make affordable housing more accessible to potential Massachusetts homebuyers across identities and experience through resources and trainings.  

Navigating college and higher education can be hard for anyone but navigating while in recovery can bring new challenges. Many colleges now offer student support groups and resources to help people pursuing degrees while in recovery. Wherever you are in your recovery process, you have support and tools to be successful in your education.  

Rights, Protections, and Tips for Advocacy 

• You are still eligible for federal financial aid. Your financial aid cannot be taken away if you are prescribed medication for opioid use disorder (MOUD).  
  • What if I have a drug possession charge on my record? If you are convicted as an adult for drug possession and your Free Application for Federal Student Aid (FAFSA) is suspended, you can become eligible again by 1) successfully completing an approved drug rehabilitation program, or 2) by passing two unannounced drug tests done by an approved drug rehabilitation program.  
• Every college campus has its own policy regarding The Good Samaritan law, even if it’s different than the state Good Samaritan law. Students for Sensible Drug Policy created a spreadsheet outlining campus policies if a student overdoses on campus and calls 911. Check with your Dean of Students and ask what the policy is if an overdose occurs on campus.  
• Many colleges provide peer-based recovery groups, but do not prescribe MOUD. If you are interested in exploring MOUD services, you have a right to ask your campus provider for a referral to a community-based prescriber.  
  • If you are on a University Health Plan, call your university’s health insurance office to ask about coverage for mental health and substance use services.  

Resources for Education

• The Association of Recovery in Higher Education (ARHE) is the only association that represents collegiate recovery programs (CRPs) and collegiate recovery communities (CRCs). The website provides a list of universities with active recovery programs. 
  • The Association of Recovery in Higher Education provides education, resources, and community connections for students in recovery, and the faculty, staff, and peers who support them. 
• For information around eligibility for financial aid, FAFSA has created this FAQ.  
• Sober Living has compiled a list of undergraduate universities that offer sober, substance-free housing options on campus.  
• The Massachusetts Organization for Addiction Recovery (MOAR) provides information on additional ways to fund your education or vocational training in their Mini Guide.  

All workers have a right to a fair wage, a safe workplace, respect, and dignity. For people in recovery, it’s especially important to feel supported and empowered at their place of work. All workers have a right to advocate for themselves for the treatment supports they need and any accommodations that can help them return to work safely.  

Rights, Protections, and Tips for Advocacy 

• You cannot be discriminated against in the hiring process or on the job for having a history of opioid use disorder (OUD) or for receiving medication for OUD (MOUD). The Americans with Disabilities Act (ADA) and the Massachusetts Anti-Discrimination Act protect the rights of people with substance use disorder (SUD) in all stages of employment. This includes the application and interview, after a job offer, and on the job.  
• Advocate for the workplace you need for a successful recovery. Federal law and state laws require that employers provide “reasonable accommodations” when needed to allow employees with a disability to perform their job duties. Reasonable accommodations can include:  
  • Job restructuring.  
  • Flextime for counseling, doctors’ appointments, and attending a treatment clinic.  
  • Permitting a leave of absence, such as for residential treatment programs.  
• Know your privacy information. An employer or interviewer cannot ask questions about past illegal drug use, participation in a rehabilitation program, or extent and frequency of substance use. But employers can ask about current use of alcohol or illegal drugs.  
• Keep your employment while getting treatment. Massachusetts recently updated the Paid Family and Medical Leave Act. As of January 1, 2021, most Massachusetts workers will be eligible to take up to 26 weeks of paid leave per year. Here are some of the qualifying reasons for leave:   
  • Up to 20 weeks for a worker’s own serious health condition, like a SUD.   
  • Up to 26 weeks for the worker to care for a family member who is a covered service member with a serious health condition. 
  • Beginning July 1, 2021, eligible workers may also take up to 12 weeks to care for a family member with a serious health condition. 
• Know your workplace rights about drug testing. The National Labor Relations Act (NRLA) requires that drug-free workplaces must work with unions to negotiate how drug testing programs work, such as when tests are given and what the penalties would be.  
• Know what to look for when it comes to discrimination in the workplace. It can be subtle and hard to name. Here are some examples: 
  • Being asked about substance use in your past during interviews.  
  • You are pressured to share medical information or previous substance use during the interview process or on the job.  
  • The person interviewing you pressures you to explain time gaps in your resume. If you have gaps in your resume due to time in treatment, the person interviewing you can ask questions about the gap, but you do not have to share that you were in treatment.  
  • Being asked by your employer or the person interviewing you about the frequency of past substance use. For example, they cannot ask, “How much alcohol or illegal drugs did you consume? How often do/did you drink alcohol or use illegal drugs?” 
  • Having a manager or supervisor change the work you do after you share information about a disability or your recovery if you did not ask for those changes.  

Resources for Employment

• The Grayken Center has an Employer Resource Library for employers to help understand and support people in recovery from SUD.  
• The U.S. Department of Health and Human Services offers the Know Your Rights toolkit for people on medication for opioid use disorder.  

The legal system can be difficult to navigate, whether you are waiting for a trial, held in corrections, on probation, or in the process of re-entering the community. You have rights in every entry or exit point in the system, and people to help you navigate. Maintaining your recovery after being justice-involved is key, and there are resources to help.