The opioid epidemic has prompted efforts across the country to increase the availability of substance use disorder treatment. Through medication-assisted treatment programs and other efforts, primary care practices have taken a more prominent role in providing care for patients with substance use disorder (SUD). The opioid epidemic comes at a time when the delivery system for SUD care overall is evolving, as states and providers aim to break down treatment silos and encourage care to be coordinated among different providers and integrated with other forms of health care, including physical and mental health services.

But a common roadblock for these practices are federal confidentiality rules, which can make effective information sharing a challenge. SUD providers and primary care practices must balance the privacy protections in 42 CFR Part 2 (generally referred to as “Part 2”) with their efforts to integrate and coordinate care.

This paper, Overcoming Data-Sharing Challenges in the Opioid Epidemic, is national in scope and reviews recent changes to the Part 2 regulations. The paper analyzes how Part 2 applies to primary care practices that seek to expand access to SUD treatment, and how providers in different parts of the country are navigating these rules. While focusing on care for opioid use disorder, the paper is applicable to all SUD care.

CHCF believes that appropriate information sharing is an essential underpinning of integrated care. This paper follows another paper by two of the same authors published in 2015 that analyzed the rules for sharing mental health and SUD patient information under California law.