Confidentiality is a fundamental aspect of the physician-patient relationship, and it is especially important for patients with addiction. Unfortunately, because of the legal and social ramifications associated with addiction, patients are often reluctant to tell their doctor that they may have an addiction or consent to the disclosure of information about their addiction treatment for fear of prosecution. This is an unfortunate aspect of the stigma that surrounds this disease, and it exacerbates the addiction treatment gap that exists in this country.
To address this issue, the federal government has implemented 42 CFR Part 2, regulations that protect the confidentiality of addiction treatment records of any person who has sought treatment for or been diagnosed with addiction at a federally assisted program. 42 CFR Part 2 aims to encourage people to seek treatment without fear of legal or social consequences. Improper sharing of a patient's addiction treatment information can lead to: negative perceptions and discrimination; criminal legal consequences, such as probation or jail time; and civil legal consequences, such as loss of child custody, employment or housing.
ASAM appreciates the heightened need for confidentiality protections of a patient's addiction treatment records as well as the need for complete and accurate medical information to be shared among a patient's treating clinicians. ASAM strives to strike this critical balance in its advocacy activities and will continue to call for needed privacy protections as 42 CFR Part 2 regulations and the underlying statute are updated.
Public Policy Statements
ASAM has a sample Appendix D Consent to Release of Information under 42 CFR Part 2 form for physicians for educational and informational purposes only.
Appendix D Consent to Release of Information Under Title 42
SAMHSA has a FAQ regarding the Substance Abuse Confidentiality Regulations 42 CFR Part 2.
Applying the Substance Abuse Confidentiality Regulations
It is permissible for state laws, for the disclosure of confidential information on substance use disorder care, to be more restrictive than these federal regulations. However, state laws may not override them. If a state law is not stricter and conflicts with federal regulations, then the state law must yield to the federal regulations. The below resources from the George Washington University’s Hirsh Health Law and Policy Program and the Robert Wood Johnson Foundation's website, Health Information and the Law, can help treatment clinicians know if their state laws are more restrictive than the federal regulations.