In response to the opioid epidemic, states and the federal government have sought to increase the availability of substance use disorder (SUD) treatment. Through medication-assisted treatment (MAT) programs and other efforts, primary care practices have taken a more prominent role in providing SUD care. Primary care practices are stepping up to treat addiction due to many factors — recognition of the role of the medical system in driving opioid overuse and addiction, shifting of attitudes about addiction with acceptance of SUD as a chronic disease, and insufficient specialized treatment resources to address growing demands, especially in rural areas. However, common roadblocks for primary care practices are the inability to efficiently and effectively communicate with SUD providers and a lack of clear guidance about how to share SUD and primary care treatment information.

This paper summarizes the requirements of the federal SUD confidentiality rules set forth under 42 Code of Federal Regulations (CFR) Part 2, discusses the steps that primary care practices currently take to effectively coordinate SUD care without violating the rules, suggests additional compliance strategies that might enhance data sharing, and offers for consideration modest revisions to the rules that could promote the integration of care without undermining patient privacy. The key findings of the paper are as follows...

Originally published in California Health Care Foundation on July 18, 2018.