A federal law, formally known as the Kristin Evans and Jessica Grubb Act, has reshaped patient privacy for individuals with substance use disorders (SUD). This legislation modernizes how providers handle sensitive health information by addressing barriers created by older, more stringent regulations. The law aims to better integrate substance use treatment with general medical care by updating the rules governing the confidentiality of patient records.
The Privacy Barrier Before The Law
Previously, the confidentiality of substance use disorder records was governed by a federal regulation known as 42 CFR Part 2. Enacted in the 1970s, Part 2 established privacy protections more restrictive than the Health Insurance Portability and Accountability Act (HIPAA). The regulation was created to address stigma and encourage patients to seek treatment without fear of their information being used against them.
Under Part 2, a patient had to provide specific, written consent for each disclosure of their SUD information. For example, a primary care physician could not access records from an addiction specialist without a separate authorization. This fragmented the care process, placed an administrative burden on patients and providers, and hindered the delivery of integrated health services.
The strict consent requirements also created difficulties for families, especially during a health crisis. If a patient was incapacitated, providers and family members were often left without the information needed for informed decisions. This privacy barrier could prevent a provider from seeing a patient’s full medical history, complicating treatment and patient safety.
How The Law Aligns Patient Record Sharing
The Evans Law aligns the privacy rules of 42 CFR Part 2 with HIPAA standards for treatment, payment, and healthcare operations. Instead of requiring separate consent for each disclosure, the new framework allows patients to provide a single, upfront consent for all future uses of their SUD information for these purposes. This change removes barriers to communication between a patient’s different healthcare providers.
Under the revised structure, a patient’s single consent is more comprehensive, covering the sharing of records with doctors, hospitals, and insurers. This approach is modeled after the standard HIPAA consent process for other health information. The goal is to ensure a patient’s SUD history can be safely shared to support integrated care, treating addiction alongside other conditions.
Patient autonomy is still protected. Patients retain the right to revoke their consent at any time and can request a list of who their information has been disclosed to. The law also strengthened penalties for unauthorized disclosure and prohibits using SUD records in legal or administrative proceedings against the patient without a court order. This balances medical communication with protection from discrimination.
Impact on Patients and Families
By enabling easier sharing of SUD records, the law fosters better care coordination. A primary care physician, psychiatrist, and substance use counselor can now collaborate on a unified treatment plan with the patient’s initial consent. This integration helps manage co-occurring disorders and prevent adverse drug interactions, as providers have a more complete view of the patient’s health history.
The new regulations also allow families to be more involved in a loved one’s recovery. With the patient’s permission, providers can share information with family members, helping them understand the treatment plan and provide informed support. This is a change from the old system, where families could be shut out during a crisis due to rigid consent rules.
For the patient, the law balances enhanced support with the right to privacy. The single-consent mechanism reduces the administrative burden of signing multiple forms, while the patient remains in control of their information. By treating SUD records more like other medical records, the law helps reduce the stigma associated with addiction and encourages people to seek integrated care.