Just about anyone who has received medical care has heard of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), the law that regulates the use and disclosure of Protected Health Information (PHI) held by “covered entities” such as health plans. But far fewer are familiar with the unique privacy protections afforded to alcohol and drug abuse patient records by 42 Code of Federal Regulations (“C.F.R. “) Part 2.

The privacy provisions in 42 C.F.R. Part 2 were motivated by the understanding that stigma and fear of prosecution might dissuade persons with substance use disorders from seeking treatment. To add an extra layer of protection to these records, the regulations outline under what limited circumstances information about a patient’s treatment may be disclosed with and without the patient’s consent. Who and what is covered can be confusing, though.

In the early 1970s, Congress enacted legislation that gave patients the right to confidentiality. For almost four decades since the Federal confidentiality regulations (42 C.F.R. Part 2 or Part 2) were issued, confidentiality has been a cornerstone practice for substance abuse treatment programs across the country.