Protecting those being treated for addiction

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No one who suffers from addiction should be subjected to sexual harassment or abuse as a condition of getting help. In Maryland, this fundamental principle has been violated because women themselves have been violated in addiction treatment facilities.

Regrettably, the examples are many.  In spending time in the industry and researching court filings, I learned of numerous alarming incidents. At a facility, an employee demanded oral sex from patients in exchange for clean urinalysis reports. At another, a woman was groomed by an employee who used flattery and contraband to gain trust and coerce her into having a sexual relationship.

One woman has alleged that a treatment employee made sexual advances and pressed her for intimate pictures. A colleague described such sexual misconduct as “rampant,” identifying 10 incidents at one Maryland facility alone.

This reality is no secret in the treatment community. The Maryland General Assembly seems to be taking notice, too. A bill under consideration in Annapolis would require treatment facilities to report complaints of sexual misconduct to state regulatory authorities and to develop policies and procedures regarding these complaints.

As the founder and CEO of an outpatient addiction facility in Maryland, I commend Maryland legislators for giving attention to this important issue. For any such legislation to be meaningful, however, at least three amendments are necessary.

Extending protections

First, the bill applies only to residential treatment facilities. While opportunities for sexual misconduct may be greatest in residential facilities, this behavior occurs in outpatient settings as well. Indeed, the aforementioned example in which clean urinalysis results were traded for oral sex happened in an outpatient facility.

Accordingly, any legislation concerning sexual misconduct in addiction centers should extend to outpatient programs.  Without this amendment, there would be a significant gap in patient protection.

Second, the bill requires facilities to disclose complaints of harassment or abuse to state regulatory authorities. But facilities have every incentive to avoid such reporting and to narrowly construe what constitutes prohibited harassment or abuse.

Accordingly, patients should be able to report objectionable actions directly to the state, in order for the regulatory authorities to then objectively and independently determine whether the relevant actions qualify as prohibited misconduct. Patients should be made aware of this alternative reporting option, in writing and verbally, at intake.

Third, and frankly, without any sort of penalties neither facilities nor employees will take this bill seriously. It will be added to, and buried in, the avalanche of administrative requirements already imposed on treatment facilities. To avoid the bill becoming an empty formality, penalties should attach to facilities and employees.

Any facility that becomes aware of misconduct and fails to take corrective action should face license suspension or revocation.

Preventing misconduct

Even if all facilities discipline or terminate employees who cross the line, these employment decisions will be taken after a patient has been harmed and possibly left treatment. The question therefore becomes how to better prevent such misconduct from occurring in the first place. Criminal and professional consequences should be on the table. As to criminal liability, it should be unlawful for any employee to engage in sexual abuse or harassment of a patient.

Some jurisdictions prohibit any sexual contact between a treatment employee and patient, on the theory that such patients are incapable of providing consent, much like a nurse-patient or guard-inmate relationship.

This model — which reflects the isolation and vulnerability of the patient as well as the inherent caretaking function of the provider — should be adopted in Maryland. As to professional consequences, any employee who engages in sexual misconduct should be disciplined, if not barred from working in the human health service field.

I hope that the legislature will consider these amendments and thereby better address predatory behavior in addiction facilities.  With problematic substance use and overdoses on the rise, effective safeguards must be designed and implemented with utmost urgency and dispatch. Doing so will provide a truly safe environment for recovery, eliminate a noxious barrier to treatment, and save lives.

Dawinder S. Sidhu is a professor at the University of Maryland, attorney with Hopwood & Singhal PLLC, and founder of Second Chance Addiction Care.