Mind Over Substance
4 minutes
Confidentiality of Substance Use Treatment Records
Confidentiality means keeping what a person tells you private unless they agree to share it or the law requires it. Substance use information needs extra care. If people fear their use will reach an employer, a landlord, or the police, many will hide it or skip treatment. In many places the law gives substance use treatment records more protection than other health records. In the US, for example, a federal rule called 42 CFR Part 2 adds protection on top of the main health privacy law, HIPAA. The general rule is to get the person's written consent before you share. The consent should say what you will share, with whom, and why. Share only what is needed. There are limits. Most places allow or require sharing in a medical emergency, when you must report child abuse or neglect, or under certain court orders. Tell the person these limits at the start, so there are no surprises. Laws differ by country and state, and they change. Follow your agency's policy and local law, and ask your supervisor when you are unsure. After this Concept you can explain to a client what stays private, what you can share with their consent, and when the law may require you to share.