Discrimination against Patients with Substance Use Disorders Remains Prevalent and Harmful: Health Affairs Blog Post by LAC Attorneys

April 13th, 2017: In response to recent critiques against the confidentiality law that protects patients with histories of substance use disorders (42 CFR Part 2), Legal Action Center’s Senior Health Policy Attorney, Deborah Reid, and Senior Staff Attorney, Karla Lopez,  penned a piece that was published today by Health Affairs. The post outlines numerous reasons that the confidentiality law, designed to ensure that that people with substance use disorders are not made more vulnerable to discriminatory practices and legal consequences as a result of seeking treatment, is as important today as it was when it was enacted in the 1970s.

The unfortunate reality is that patients with substance use disorders can face enormous consequences associated with disclosure, including loss of employment, housing, child custody, and benefits, and even arrest, prosecution, and incarceration. Although scientific advances over the past decades have shown that addiction is a chronic medical illness, stigma remains persistent, and at LAC we routinely see clients who have experienced significant negative consequences as a result of prejudice and ignorance.

Reid and Lopez write, “It is not confidentiality protections that undermine the message that addiction is a chronic medical illness. Rather, it is arresting, prosecuting, and incarcerating people because of their illness; it is removing parents’ children from their care because of their illness; it is laws that make it legal to fire someone or deny them housing because they suffer from this illness; it is the lived experience of patients who face discrimination from their healthcare providers, insurers, and communities on the basis of their illness – that actually weakens the perception of substance use disorder as a chronic disease. The confidentiality law (42 CFR Part 2) is often the only shield between an individual in recovery from addiction and these many forms of discrimination and prejudice that could destroy their lives.

The post points out that the law does not “block the integration into medical care” as some have asserted – it “simply adds patient consent to the process.” Reid and Lopez present a compelling case as to why the heightened confidentiality protections for substance use disorder treatment are so critical, given the long-term and often devastating consequences of disclosure. They also note the significant differences between 42 CFR Part 2 and HIPAA, particularly in the level of protection against re-disclosure of information.

LAC is committed to fighting for the rights of people with substance use disorders and working to end the epidemic that is devastating families and communities. Through direct legal services, impact litigation, and policy advocacy, we will continue to build on our decades of work to protect the privacy of patients seeking substance use disorder care, expand access to and coverage of treatment and recovery services including medication-assisted treatment, and combat discrimination against those struggling with addiction to break down barriers that hinder individuals and families from rebuilding their lives with dignity. Click here to learn more about LAC’s work to protect the rights of people with histories of substance use disorders and expand access to coverage and treatment.

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