B.C. pharmacist wins $8K in human rights complaint over use of opioid replacement meds

A B.C. pharmacist who filed a human rights complaint after he was initially barred from practising, due to his intent to take opioid replacement medication while on the job, has won a partial victory at a tribunal.

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

When he attempted to return to work in 2017, he was given an independent medical examination by Dr. Mandy Manak, who determined the pharmacist was not fit for duty in a "safety-sensitive" job — such as a clinical pharmacist who handles opioids — if he continued to take Suboxone. 

The pharmacist then took his case to the B.C. Human Rights Tribunal, alleging Manak and the College of Pharmacists of B.C. discriminated against him on the basis of his disability, referring to his opioid addiction. The pharmacist is not named in the tribunal decision, which was posted late last month.

He subsequently got a second opinion from another addictions specialist, Dr. Evan Wood, who testified that Suboxone was aiding in the pharmacist's addiction recovery. Following that, the complainant managed to find a full-time job as a pharmacist, returning to the role he had worked in for over 15 years.

In making his 2019 complaint, the pharmacist became one of many health-care workers recovering from addiction who say returning to work is very challenging amid stigma against those who use illicit substances.

He alleged that the college's decision not to reinstate him was discriminatory, and that Manak made comments and conclusions in her assessment that were "based on negative stereotypes about people with substance use disorders."

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

However, the tribunal also found that some of Manak's comments in her medical examination were discriminatory. The addictions doctor has now been ordered to pay the pharmacist over $8,100 for the comments, including $7,500 as compensation for injury to the pharmacist's dignity and feelings.

"The Discriminatory Comments said or implied that some of the Pharmacist's routine behaviours — including his fitness, access to health care, and financial management — were suspicious or untrustworthy," reads a decision from tribunal member Beverly Froese.

"They also made negative judgments about the Pharmacist's character that were not based on the facts he presented to [Manak], which, in my view, were based on discriminatory stereotype," Froese added.

Suboxone made 'huge difference'

According to the tribunal decision, the pharmacist became addicted to opioids after he was prescribed them for hip pain and migraine headaches in 2009. He struggled with substance use for numerous years, at one point diverting oxycodone from the pharmacy for himself, before he left work and went into treatment in 2014.

He was in recovery and on a return-to-work plan the following year, but relapsed. The pharmacist voluntarily suspended his licence and returned to in-patient treatment.

He was prescribed Suboxone, a medication used to curb craving for opioids and ultimately taper opioid use, in 2016.

The pharmacist reported Suboxone helped him live a normal life, and told the tribunal he left a treatment centre "feeling very positive because he knew the Suboxone was working well and would make a 'huge difference' in his life." 

He then sought an independent medical examination from Manak, who is among a list of college-approved specialists who assess pharmacists as part of the regulatory college's policies around discipline and return-to-work guidelines.

After the assessment, the pharmacist described feeling "hurt and shocked" when the doctor asked if a return to work would make him feel "like being a kid in a candy store" since he would be near so many drugs.

In its decision, the tribunal also found that Manak called the pharmacist's weight loss a "red flag" and his regular exercising a "compulsive behaviour."

Froese wrote that those assertions were based on a discriminatory stereotype that the pharmacist was not being honest about his reasons for the weight loss, and a "suspicion that he was still using illegal substances."

In her examination, Manak also seemed to cast doubt on the pharmacist's claim that he had been able to live off of savings while unemployed, saying it "defie[d] logic" that he could afford drugs, rehab and everyday expenses. 

"These comments strongly suggest that Dr. Manak believed he was earning money nefariously, specifically by drug dealing," the tribunal decision reads.

While Froese found that the "kid in a candy store" comment did not constitute discriminatory treatment, she said other comments by Manak did.

"Even though I have dismissed part of the complaint against Dr. Manak, there is no question in my mind that the Pharmacist acted in good faith and from a sincere belief that he had been discriminated against," the decision read.

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