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Seeking treatment for a drug or alcohol abuse problem can be frightening. It can be difficult for someone struggling with addiction to admit to a problem. Additionally, many people are afraid of others outside their immediate family circle – coworkers, supervisors, and casual acquaintances – learning that they have a substance abuse problem. They worry that getting treatment could have an adverse effect on their professional or social life.
How Confidential Are Patient Records for Drug and Alcohol Rehab?
Whatever the case, if you or a loved one is suffering from alcohol or another drug addiction, seeking treatment is the right thing to do.
The federal government has a number of laws and regulations in place to protect the safety and confidentiality of anyone who seeks treatment for drug or alcohol addiction.
Origins and Purpose of the Law
Laws dealing with the confidentiality of drug and alcohol addiction patients trace their origins back to two statutes:
- The Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment, and Rehabilitation Act (1970)
- The Drug Abuse Prevention, Treatment, and Rehabilitation Act (1972)
In 1975, the Department of Health, Education, and Welfare issued federal regulations in accordance with these two laws, and the Department of Health and Human Services revised them in 1987. Congress recently reaffirmed these statutes and reorganized them under the Public Health Service Act.
The laws are based on the idea that an individual suffering from a substance abuse problem is more likely to seek and succeed at treatment if he or she is confident that information about that treatment will not be disclosed to other people unnecessarily. This makes sense, given the stigma that often accompanies drug and alcohol addiction.
Scope of the Law
The federal confidentiality regulations around drug and alcohol abuse relate specifically to “patient-identifying” information. This term refers to any information that identifies a specific individual as having received treatment for drug or alcohol abuse. Federal law greatly restricts the disclosure of such information without the patient’s consent.
To Whom Does the Law Apply?
Any person or treatment program that holds patient-identifying information about interventions for drug and alcohol addiction is subject to federal regulations. The law also applies to other organizations and individuals who seek and/or receive patient-identifying information from these programs. For example, a patient’s primary care physician may send or receive records from a federally funded drug treatment program as part of the patient’s care, but the physician’s office would be restricted from releasing that information to anyone else under federal regulations for confidentiality.
How Strict Are the Regulations?
The federal regulations surrounding drug and alcohol confidentiality are extremely strict, more so, in fact, than most other federal confidentiality regulations.
In the majority of cases, the restrictions apply in cases of court and administrative proceedings and extend to law enforcement officials as well as spouses, parents, other relatives, friends, or employers of the patient receiving treatment. In other words, it is far more difficult for someone to obtain information about a patient’s treatment for drug and alcohol abuse than it is to obtain even other types of restricted and confidential information.
What Are the Consequences for Violating the Law?
Penalties for violating federal confidentiality laws are severe. Anyone who violates the federal restrictions regarding drug and alcohol confidentiality is subject to criminal penalties in the form of fines. Generally, the fine is up to $500 for a first offense and can be as high as $5,000 for successive offenses.
A licensed or state-certified violator could lose his or her license or government certification. A patient whose confidentiality has been breached would likely be entitled to take legal action in the form of a lawsuit.
How Does State Law Factor In?
State laws cannot take priority over federal regulations around drug and alcohol confidentiality. State regulations may be stricter than federal laws, but if they are more lax, federal law takes precedence.
General Rules Regarding the Confidentiality of Patient Records for Alcohol and Drug Rehab Programs
In the simplest terms, federal regulations prohibit a federally assisted program for the treatment of substance addiction from revealing the identities of former, current, and potential patients. However, it’s important to be aware of the many exceptions to the rule. But in most cases, information released under an exception would fall under other confidentiality restrictions, such as doctor-patient confidentiality.
The Extent of the Rules
Any federally assisted organization that provides treatment for drug and alcohol addiction, or individual practitioners, such as doctors or psychiatrists, are subject to these federal regulations. The law applies equally to freestanding organizations and those that are part of a larger institution, such as a detox program located inside a major hospital.
The regulations apply to all program staff, whether volunteer, part-time, full-time, administrative, clinical, or support. Essentially, the regulations are far-reaching enough to ensure patient protection in virtually every instance – aside, of course, from the provided exceptions.
Exceptions to the Patient Rehab Confidentiality Rule
Although the federal confidentiality regulations are strict, they do allow for exceptions, as explained below. However, these exceptions often come with confidentiality restrictions of their own, so patients still shouldn’t worry that someone will release their treatment information unnecessarily and without their permission.
Organizations may share patient-identifying information within the program or with an overseeing organization (such as the administrative offices of a hospital that contains a detox unit within it). Information can be shared with other departments in the organization, such as the billing department. However, information sharing within organizations is still restricted, and confidentiality restrictions apply to anyone working in the organization.
If a patient signs a valid consent or release form, the treatment program may disclose patient-identifying information. However, there are strict requirements for what constitutes a valid consent form in these circumstances, including the patient’s right to revoke consent – either in written or oral form – at a future time. Again, the law generally falls on the side of protecting patient confidentiality first.
It’s important to understand what patient-identifying information means. The term refers to information that identifies not only the individual but also the type of treatment that he or she received. This means that a program may disclose a patient’s name, address, or other “identifying” information so long as it doesn’t reveal the nature of the treatment the patient received.
Qualified Service Organizations
Federally assisted treatment programs may disclose patient identifying information to organizations that provide them with professional services, such as laboratory or counseling services, as part of the course of the treatment the program provides its patients. These qualified service organizations must meet the same federal regulations for patient confidentiality.
Crimes on The Program Premises
If a patient either threatens or commits a crime on program premises, federal regulations allow the program to release patient-identifying information to the police as part of the ensuing investigation.
Programs may also release patient-identifying information without patient consent in the case of a medical emergency. This exception only applies to medical personnel who are providing immediate medical care, not to the patient’s family or friends.
Every state requires individuals who work in certain capacities to report suspected cases of child abuse or neglect. This is known as mandated reporting.
The federal government revised regulations in 1986 to address mandated reporting laws, and staff in treatment programs must report any suspected child abuse. However, the regulations are still quite strict about how information from a mandated report may be used. For example, patient treatment records for drug or alcohol abuse cannot be used in court proceedings for child abuse charges.
Treatment programs may receive research access to patient-identifying information as part of their research, but only if the researchers meet a strict set of requirements. Researchers may not disclose patient-identifying information except back to the treatment program that provided it.
In cases where authorities are auditing or evaluating a treatment program, they may release patient-identifying information as part of the audit process. In this case, government entities may not re-disclose the information to anyone else except under a court order.
It is possible for a local, state, or federal court to issue an order requiring a treatment program to release confidential patient information. However, there are specific procedures the court must follow.
Subpoenas and warrants alone, even with a judge’s signature, are not alone enough to require the disclosure of information. Both the program and the patient must receive notice of the request, and the court must issue a finding of “good cause” for the disclosure. In most cases, the law makes obtaining a court order for the release of confidential patient information quite difficult.
Getting the Help You Need
Drug and alcohol addictions are serious public health concerns, and treatment is necessary and often lifesaving. The law is clear regarding patient protection of confidentiality. The fear of someone discovering that you are undergoing treatment for addiction should not prevent you from getting the help you need.
Get in contact with Family First Intervention if you have a loved one who is abusing drugs or alcohol and who needs help being convinced to enter a formal addiction treatment program.