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Opinion | Antiquated Privacy Rule Blocks Treatment of Opiate Addiction, Puts Lives at Risk

Opioid misuse has reached epidemic proportions in the United States; and for the first time since the 1960s life expectancy in the U.S. has dropped for two years in a row. To combat the opioid crisis, health care providers must have access to substance use disorder records of their patients to ensure each person is provided with safe, effective treatment and care.

However, a federal regulation, written in 1972 and known as 42 CFR Part 2, separates a patient’s history of addiction from the rest of their health record, making it difficult for providers to deliver the care a patient may need. When this law was enacted more than four decades ago, it was done so for the purpose of ensuring that those who sought addiction treatment were able to do so privately. At that time, long before enactment of the Health Insurance Portability and Accountability Act, which provided patient privacy protections, this rule was critical in ensuring those seeking to overcome addiction received the care they needed.

However, in today’s health care landscape – of electronic health records and extensive patient privacy laws – this 1972 law adds an additional layer of consent. In laymen’s terms, this means that unless a patient expressly provides additional consent for their record, a treating provider cannot view that record or share that information with other treating providers.

As a provider of behavioral health, we’ve had patients referred to us by a physician for treatment of depression or anxiety. However, in some of these cases, we identify that this patient also is struggling to overcome addiction. Even though we may have consent to share information from that patient’s health record, if it’s related to addiction we need a separate consent. If a patient does not want to consent, that can put them at risk for receiving dangerous amounts or combinations of prescriptions.

Director Elaine McMillion Sheldon explains the importance of her Oscar nomination in raising awareness to the opioid crisis gripping the United States.

Ultimately, this antiquated rule slows the coordination of treatment, inhibits provider collaboration and can put patients’ lives at risk. Without transparency, providers may accidentally pose safety threats to their patients with substance use disorders because of risk of multiple drug interactions.

Because of this, Centerstone has joined the Partnership to Amend Part 2. The Partnership is a coalition of more than 40 diverse organizations committed to aligning 42 CFR Part 2 with HIPAA for the limited purposes of health care treatment, payment and operations and to strengthen existing protections against the use of substance use disorder records in civil and criminal proceedings to ensure patient privacy is upheld. A bill known as the “OPPS Act,” or the Overdose and Patient Safety Act (H.R. 3545), can accomplish this much-needed objective of disclosing patient information for limited means – associated with their treatment – while simultaneously protecting privacy.

In the midst of the nation’s largest drug crisis, modernizing our nation’s health IT infrastructure is a critical step in delivering timely, lifesaving care. In doing this, along with shoring up protections for patient privacy, providers will be better equipped to deliver safe, whole-person care.

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