More than three years ago, a group of physicians and lawyers tried to do away with 42 CFR Part 2, as the Confidentiality of Alcohol and Drug Abuse Patient Records regulation is known. The 40-year-old rule does not allow substance abuse treatment programs to give any identifying information about patients to anyone unless the patient gives individualized, written consent.
For decades, the regulation was considered an ironclad protection against law enforcement in particular, but also employers, the media, healthcare providers and anyone else, finding out whether someone was in substance abuse treatment. Congress enacted it because without such protections, people would not go to treatment — e.g., law enforcement in New York City went into methadone clinics after patients, a practice that was stopped by 42 CFR Part 2, which gave treatment providers the authority to block such intrusions (see ADAW, March 8, 2010).
Protecting those and other intrusions is still the mission of 42 CFR Part 2 — it is not going away. The physicians and lawyers who wanted it eliminated three years ago have either given up or taken their fight behind the scenes, along with other players. The Substance Abuse and Mental Health Administration (SAMHSA), which promulgates the rule, views confidentiality as important to the person seeking recovery, and especially so at a time when treatment is expanding and people need to be encouraged to engage in it, H. Westley Clark, M.D., director of SAMHSA’s Center for Substance Abuse Treatment (CSAT), told ADAW last week. Clark is the government-wide spokesman for 42 CFR Part 2; he has met with stakeholders and consistently stood up for the rights of patients to privacy.