British Columbia Pharmacist Wins $8,000 in Opioid Substitute Human Rights Claim

A British Columbia pharmacist who filed a human rights complaint after he was initially barred from practicing because of his intention to take opioid substitutes while on the job has won a partial victory in a tribunal.

A pharmacist who voluntarily quit in 2015 was prescribed Suboxone in 2016. The drug is used to help people struggling with opioid addiction by curbing cravings and neutralizing withdrawal symptoms.

When he tried to return to work in 2017, he underwent an independent medical examination by Dr. Mandy Manak, who found the pharmacist unfit for “safety-sensitive” work — such as a clinical pharmacist working with opioids — if he continued take Suboxone.

The pharmacist then took his case to the British Columbia Human Rights Tribunal, alleging that Manak and the British Columbia College of Pharmacists discriminated against him based on his disability, citing his opioid addiction. Pharmacist not indicated the decision of the tribunalwhich was published late last month.

He later got a second opinion from another addiction specialist, Dr. Evan Wood, who testified that Suboxone helped the pharmacist overcome his addiction. The complainant subsequently managed to find full-time employment as a pharmacist, returning to a position he had held for over 15 years.

By filing a complaint in 2019, the pharmacist became one of the many medical professionals recovering addicts who say it is very difficult to return to work because of the stigma attached to those who use illegal substances.

He argued that the college’s decision not to reinstate him was discriminatory and that Manak made comments and conclusions in her evaluation that were “based on negative stereotypes about people with substance use disorders.”

The tribunal ultimately found that Manak’s decision not to recommend the pharmacist’s return to work was based on her expert medical opinion and the college’s decision not to reinstate him was based on its established policy.

However, the tribunal also found that some of Manak’s comments during her medical examination were discriminatory. The narcologist has now been ordered to pay the pharmacist more than $8,100 for the comments, including $7,500 in punitive damages to the pharmacist.

“Discriminatory comments state or imply that some of the pharmacist’s routine actions, including physical fitness, access to health care and financial management, are suspect or untrustworthy,” tribunal member Beverley Froese said in the ruling.

“They also made negative judgments about the Pharmacist’s character that were not based on the facts that he (Manak) presented, which I believe were based on a discriminatory stereotype,” Frese added.

Suboxone made a ‘big difference’

The pharmacist became addicted to opioids after being prescribed them to treat hip pain and migraines in 2009, the tribunal ruled. He struggled with substance use for years, at one point diverting oxycodone from a pharmacy for himself before quitting his job. and went to treatment in 2014.

He recovered and planned to return to work the following year, but relapsed. The pharmacist voluntarily revoked his license and returned to inpatient treatment.

In 2016, he was prescribed Suboxone, a drug used to curb opioid cravings and ultimately reduce opioid use.

The pharmacist said Suboxone had helped him live a normal life and told the tribunal he left the treatment center “feeling very positive because he knew Suboxone was working well and would make a ‘big difference’ in his life”.

He then sought an independent medical review from Manac, who is on a list of college-approved specialists who assess pharmacists under the regulatory college’s policy on discipline and return-to-work guidelines.

After the assessment, the pharmacist described feeling “insulted and shocked” when a doctor asked if going back to work would make him feel “like a kid in a candy store” because he would be around so many drugs.

In its ruling, the tribunal also found that Manak described the pharmacist’s weight loss as a “red flag” and his regular exercise as “compulsive behaviour”.

Frese wrote that the allegations were based on a discriminatory stereotype that the pharmacist was not being honest about the reasons for the weight loss, as well as “suspicion that he was still using banned substances.”

In her review, Manak also appeared to question the pharmacist’s claim that he was able to live on unemployment savings, saying it “doesn’t make sense” that he could afford medication, rehab and day-to-day expenses.

“These comments strongly suggest that Dr. Manak believed that he was dishonestly making money, particularly from drug dealing,” the tribunal’s decision said.

While Froese found the “baby in the candy store” comment not to be discriminatory, she said Manak’s other comments were.

“Although I dismissed the portion of the complaint against Dr. Manak, I have no doubt that the pharmacist acted in good faith and genuinely believed that he had been discriminated against,” the ruling said.

CBC News has reached out to Manak and her lawyer for comment for this story.