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Setting the Record Straight: ASAM’s Position on 42 CFR Part 2

August 11, 2017

In the wake of the introduction of the Overdose Prevention and Patient Safety (OPPS) Act, a bill that would amend the federal statute underlying the addiction treatment privacy regulations known as 42 CFR Part 2 (“Part 2”), ASAM has received many questions about our support for the bill and our position on changing Part 2.


To be clear, ASAM holds patients’ privacy rights in the highest regard. ASAM’s decision to support changes to Part 2 was debated at length with the implications for patients’ well-being at the heart of the discussion. Consideration was given to the dramatic changes that have occurred both in our healthcare system and in our understanding of the disease of addiction since Part 2 was promulgated in 1975, when addiction treatment was predominantly provided separately from the treatment of other illnesses in settings isolated from the broader healthcare system.


The advent of integrated health systems and electronic medical records has improved the safety, quality, and coordination of care for patients with any other health condition. Part 2 requirements prevent patients with addiction from sharing in these benefits, even though electronic exchanges of other health information are governed by strict privacy and security standards set by the Health Insurance Portability and Accountability Act (HIPAA) and the Health Information Technology for Economic and Clinical Health (HITECH) Act.


Even more importantly, we have learned much about the disease of addiction in the past 40 years. Research has shown that we cannot effectively treat addiction in isolation from other medical conditions. Many psychiatric disorders, infectious diseases, and other chronic conditions frequently co-occur with addiction; untreated addiction exacerbates these other conditions, and untreated infectious or other chronic diseases complicate addiction treatment.


Ultimately, it was decided that the barriers that Part 2 currently presents to coordinated, safe, and high-quality medical care cause significant harm, and that thoughtful changes to the law are necessary to mitigate this harm while protecting patients’ privacy. Accordingly, ASAM joined other provider associations, patient groups, and health plans to support the OPPS Act, which would align Part 2 with HIPAA for the purposes of health care treatment, payment, and operations. Such a change would allow for the sharing of patients’ addiction treatment records within the healthcare system under HIPAA’s well-established and modern privacy and security protections, while leaving in place Part 2’s prohibition on disclosure of records outside the healthcare system. Moreover, the bill includes a provision to strengthen protections against the use of addiction treatment records in criminal proceedings, a further improvement to Part 2 that we welcome.


ASAM will continue to advocate for the highest treatment standards and the most compassionate care for patients with addiction, and seeks to hasten the day when all our patients can easily access state-of-the-art treatment in a healthcare system and world that do not stigmatize their disease. ASAM believes it is time to make targeted changes to Part 2 to realize this goal.


Email questions and comments to advocacy@asam.org