Federal Confidentiality Law 42CFR Part 2


42CFR Part 2 is a federal law that protects confidentiality of the identity, diagnosis, prognosis, or treatment of any patient records maintained in connection with the performance of any federally assisted program or activity relating to substance abuse education, prevention, training, treatment, rehabilitation or research.

The law and regulations were written during a time of great concern about the potential use of substance use disorder information against an individual.

The purpose of 42 CFR Part 2 is to ensure that a patient receiving treatment for a substance use disorder in a Part 2 program is not made more vulnerable than an individual with a substance use disorder who does not seek treatment.

Applies to federally assisted “alcohol and drug abuse” programs.

Patient consent must be obtained before sharing information from a program that is subject to 42 CFR Part 2.

Once this information has been disclosed, no redisclosure is permitted without the patient’s express consent to re-disclose or unless otherwise permitted under Part 2.

We Advocate for Protecting Your Rights

In the News

Patient Confidentiality Campaign Launched in 42 CFR Part 2 Battle, Alison Knopf, Alcoholism & Drug Abuse Weekly, October 2, 2017

"Headed by the Legal Action Center, more than 100 treatment and recovery organizations have joined a “Campaign to Protect Patient Privacy Rights,” focused on maintaining the confidentiality of substance use disorder (SUD) patients. The campaign, launched last week, comes on the heels of legislative attacks on confidentiality. The first attack came in the Overdose Prevention and Patient Safety Act (H.R. 3545), which would place all SUD patient records under the much looser protections of the Health Insurance Portability and Accountability Act (HIPAA) and was proposed by Rep. Tim Murphy (R-Pennsylvania) (see ADAW, Aug. 7). The second attack came last week in a “bill to amend the Public Health Service Act to protect the confidentiality of substance use disorder patient records” (S. 1850) proposed by Sen. Joe Manchin (D-West Virginia). Also this summer, a group that includes the Hazelden Betty Ford Foundation and the American Society of Addiction Medicine emerged to repeal 42 CFR Part 2 (see ADAW, Aug. 7)."

“Many of us would not have gone to treatment or accepted services if we thought that our information would have been shared with other entities without our permission. We would not have put our careers, reputation or families at risk of stigma and discrimination if we were not assured that information about our substance use disorder was safe and would only be shared with our consent," Patty McCarthy Metcalf, Executive Director of Faces & Voices of Recovery, person in long-term recovery, recovery advocate

Our Statement Opposing the Overdose Prevention and Patient Safety Act (HR 3545)

We are Faces & Voices of Recovery, the nation’s leading recovery advocacy organization since 2001. We aim to reduce the discrimination that keeps people from seeking recovery or moving on to better lives once they achieve it; and we support recovery-oriented policies and programs. We represent the voice of the over 23 million Americans in long-term recovery from alcohol and other drug addiction, and their families.

As an organized voice protecting the rights of individuals with substance use disorders, we are adamantly opposed to the dismantling of our critically important 42 CFR Part 2 confidentiality protections and we are opposed to the dismantling of the existing Public Health Law- which authorizes 42 CFR Part 2. 

We are opposed to the Overdose Prevention and Patient Safety Act (HR 3545) and the exceptions it would make to the current public health law related to confidentiality of our health information. We do not want our information shared for purposes of treatment, payment, health care operations or for any other purpose beyond current rule without our express written consent.

Campaign to Protect Patient Privacy Rights

The Legal Action Center recently developed and circulated CONSENSUS PRINCIPLES on the continuing importance of the federal regulation for the confidentiality of substance use disorder patient records, 42 C.F.R. Part 2 ("Part 2"), in protecting the privacy of individuals in substance use disorder treatment. This regulation is particularly crucial in guarding against criminal prosecution, discrimination and other negative consequences; and supporting people entering and sustaining treatment and recovery.

We, the undersigned national, state, and local organizations, support maintaining the core protections of the federal substance use disorder patient confidentiality law (42 U.S.C. § 290dd-2) and regulations (42 C.F.R. Part 2), referred to collectively as “Part 2,” to effectively protect the confidentiality of patients’ records, for the following reason.