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SEP obtained syringes. "PWID who utilized pharmacies as their primary source of syringes 8 were 1.5 times as likely to have disposed of used syringes unsafely in the past 12 months." Rather than ban the single most effective tool against syringe litter, the Santa Ana City Council should do everything they can to support the proper operations of multiple accessible SEP sites. II. Similar Bans and Restrictions Have Been Struck Down as Violations of the ADA In bringing forth a facial challenge under Title II of the ADA, the plaintiff must establish that (1) qualified individuals with a disability (2) have been subjected to discrimination by a public entity (3) by reason of their disability. Past litigation successfully challenging discriminatory zoning ordinances establishes the applicability of this framework to treatment facilities serving patients with SUD. Numerous courts have held that laws that single out opioid treatment programs are facially discriminatory under the ADA and the RA; below is only a brief overview of this line of jurisprudence. Twenty years ago, the Ninth Circuit established that the ADA and the RA apply to restrictions targeting substance use treatment facilities because zoning “is a normal function of 9 a governmental entity.” The Court reasoned that the “sweeping language \[of the ADA\] — most noticeably Congress’s analogizing the plight of the disabled to that of discrete and insular minorit\[ies\]’ like racial minorities— strongly suggests that §12132 should not be construed to allow the creation of spheres in which public entities may discriminate on the 1011 basis of an individual’s disability.” Since then, the Third and Sixth Circuits have followed suit. In its seminal decision, the Ninth Circuit struck down an emergency moratorium prohibiting the operation of methadone clinics within 500 feet of residential areas as facially discriminatory on the basis of the plaintiff’s disability and a per se violation of Title II of the Americans with 12 Disabilities Act. Three years later, the Sixth Circuit invalidated an ordinance limiting the number of all SUD treatment clinics to one facility for every 20,000 persons in the city, finding that “the blanket prohibition of all methadone clinics from the entire city is discriminatory on its face” in violation of 13 the Americans with Disabilities Act. Similarly, the Third Circuit struck down a state statute imposing a ban on the establishment of SUD treatment clinics within 500 feet of schools, churches, and residential housing developments, holding that the statute “facially singles out methadone clinics, and thereby methadone patients, for different treatment, thereby rendering 14 the statute facially discriminatory.” There are a number of other cases where the ADA and RA 8 Zlotorzynska, M., Weidle, P. J., Paz-Bailey, G., & Broz, D. (2018). Factors associated with obtaining sterile syringes from pharmacies among persons who inject drugs in 20 US cities. International Journal of Drug Policy, 62, 51–58. https://doi.org/10.1016/j.drugpo.2018.08.019 9 Bay Area Addiction Research & Treatment, Inc. v. City of Antioch, 179 F.3d 725, 731 (9th Cir. 1999). 10 Id. 11 New Directions Treatment Servs. v. City of Reading, 490 F.3d 293 (3d Cir. 2007); MX Group, Inc. v. City of Covington, 293 F.3d 326, 342 (6th Cir. 2002). 12 Bay Area Addiction Research & Treatment, Inc. v. City of Antioch, 179 F.3d 725, 737 (9th Cir. 1999). 13 MX Group, Inc. v. City of Covington, 293 F.3d 326, 345 (6th Cir. 2002). 14 New Directions Treatment Servs. v. City of Reading, 490 F.3d 293, 304, 307 (3d Cir. 2007).