Health Justice Clinic: Working to end discrimination against people in recovery
A new medical-legal partnership between the clinic and Duke Hospital seeks to remove barriers to care for those with Opioid Use Disorder
Health Justice Clinic students Avery Lewis JD ’25, Brendan Genaw JD ’26, and Jillian Baggett JD ’25
Duke Law’s Health Justice Clinic was founded to provide legal assistance to people with HIV/AIDS, then a poorly-understood condition that carried great social stigma. Thirty years later, the clinic is helping a new set of marginalized clients — people recovering from Opioid Use Disorder (OUD).
The clinic is developing a new medical-legal partnership with a team of healthcare providers at Duke University Hospital to understand — and work to remove — barriers to medical treatment and discrimination these patients face in accessing services in the community after discharge.
Individuals with OUD, including those taking prescribed medication, are protected by the Americans with Disabilities Act (ADA), yet many face difficulties when applying for housing and long- and short-term rehabilitation.
Students in the clinic are documenting the experiences of patients with OUD in a one-year research project that adds a new dimension to existing studies, which primarily focus on overdose, death, and hospital readmission data. Qualitative analysis of their work will both inform the clinic’s legal advocacy for such patients and help medical providers understand how to better meet their needs.
“There are myriad issues that this population is experiencing, not unlike the population impacted by HIV/AIDS back in the 1990s,” said Clinical Professor Allison Korn, who directs the clinic.
“I think that the data, once analyzed, will show us all kinds of ways in which we can have a real positive impact in the lives of individuals living with OUD as well as what our docket looks like going forward. It represents, to me, the evolution of the clinic.”
The clinic’s new research project helps to address the persistent opioid overdose crisis that continues to claim about 80,000 lives a year, according to CDC data, and impact countless others. Of the 9.3 million people needing OUD treatment in 2022, only about a quarter received medications such as buprenorphine, methadone, and naltrexone that are safe and effective at treating the disorder.
Barriers to treatment include the shame and social stigma associated with drug use, lack of training among medical providers, and difficulties navigating the fragmented health care system itself. Korn says those who do get medication-based treatment face additional challenges after discharge, including being turned away by skilled nursing and other continuing care facilities despite their legal obligation to admit persons with OUD under the ADA, and obtaining safe housing that will allow them to continue receiving their prescribed medications.
Clinic students in the OUD research project began interviewing patients in spring 2025 about their experiences with discrimination. Students had to undergo Duke Hospital’s internship training and learn about trauma-informed advocacy prior to conducting these interviews. Working in a hospital setting was especially meaningful for those with a background or interest in medicine or science, Korn said.
“It’s a very deep and rich experience for them, even aside from the patient interaction,” Korn said. “It is a true medical-legal partnership.”
"The clinic was one of the most rewarding and challenging parts of law school. I was able to combine professionalism with empathy. I was able to see how small changes can ripple out and affect not only clients, but also their families and communities.”
As the partnership progresses, Korn sees opportunities to help patients with legal needs such as advance directives, living wills, powers of attorney, and standby guardianships, particularly for those who go into inpatient recovery or may become incapacitated. It could also lead to collaborations with other Duke Law clinics on access to housing issues and criminal justice interventions.
Korn hopes the qualitative data students collect eventually will be used by health care and legal organizations across the country to better serve people in recovery and support systemic policy reform. Their findings have already generated ideas for new research on provider bias; many patients said they were reluctant to go to doctors over fear of how their history of drug use would be viewed, and all reported discrimination by providers.
“We’ve already identified that a lot of discrimination, misperception, and stigma manifests in the acute care or skilled nursing facility setting,” Korn said. “We want to understand from the provider perspective what their fears are, what they don't understand, where misinformation is coming from, and where there might be some common goals or understandings. I think that this creates a real opportunity for provider training.”
Fighting for health care rights for clients on the margins
The OUD project fits with the clinic’s rich history of advocating for members of marginalized communities facing discrimination because of their health status. Under the direction of Korn and supervising attorney Hannah Demeritt JD ‘04, student also work with clients with disabilities applying for Social Security benefits and appealing denials, as well as incarcerated people seeking compassionate release on medical grounds.
Such cases expose students to interactions between the legal and health care systems that don’t get much visibility, said Jillian Baggett ’25.
“It was a very valuable experience to work on both of those projects at the same time and learn how to best advocate for clients when their doctors might not necessarily understand what the ultimate end goal was,” she said.
“It really brought out the fact that sometimes the medical system isn't necessarily geared to help clients in the way that they really need through certain legal systems.”
Brendan Genaw ’26, who previously served as a Peace Corps public health volunteer, said working in the Health Justice Clinic brought relevance to his legal studies.
“One reason people go to law school is because they want to help other people and figure out their legal issues with them. Clinic is the only time when you actually are on the ground doing that kind of work rather than being in the library just reading about it,” he said.
“It’s lot easier when you're given random tasks that have to be done in three hours and you think, ‘This is important for this particular person I met.’ It doesn't quite feel like work because you're doing something for someone — and for a bigger goal.”
"Our professors really guided us through the entire process and gave us that confidence, both with interviewing clients and also with our legal writing and drafting the brief. I really feel like I can go out into the field now and be a fantastic lawyer, because I've done it in clinic and gotten that experience."