If you are considering outpatient treatment for substance use disorder, you have probably heard the phrase “42 CFR Part 2” — sometimes called “Part 2” — without much explanation. Here is the plain-English version.

What 42 CFR Part 2 is

42 CFR Part 2 is a federal regulation that protects the privacy of records held by a substance use disorder treatment program. It is stricter than HIPAA. It applies to any program that holds itself out as providing SUD treatment and is federally assisted.

What it covers

Part 2 protects any information that would identify you as someone seeking or receiving SUD treatment:

Your name and the fact that you are in treatment
The fact that you have been diagnosed with a substance use disorder
The notes your counselor writes about your sessions
Your drug test results
Your attendance records
Your billing records related to SUD treatment

This protection follows the records. If your records are shared with another provider, the protection travels with them.

What Part 2 does not do

Part 2 is not a guarantee against all disclosure. There are specific, narrow exceptions:

You, with a signed consent. You can authorize release of your records to a specific recipient for a specific purpose. The consent must be in writing, must be time-limited, and can be revoked.
A medical emergency. If you are incapacitated and another provider needs the information to treat you.
A court order. A judge can order disclosure in very specific circumstances, with strong protections against further disclosure.
A crime committed on the program premises or against program staff. The program does not have to be a silent witness to a serious crime on site.

Part 2 does not protect you if you voluntarily disclose your own treatment to someone. The protection is on the program, not on you.

What Part 2 does not cover

Part 2 is specific to federally assisted SUD treatment programs. Records from your primary care doctor, your psychiatrist (for non-SUD treatment), or your general hospital stay are governed by HIPAA, not Part 2. If you are in treatment for both depression and alcohol use disorder, your depression notes are HIPAA, your alcohol use disorder notes are Part 2.

What to ask before you start treatment

Before you share anything with a treatment program, ask:

“Are you a 42 CFR Part 2 program?” The program must answer truthfully.
“What happens if I give you a consent to release records to my primary care doctor?” You should get the consent in writing, with a clear expiration date and a clear description of what can be shared.
“How do I revoke a consent if I change my mind?” You have the right to revoke in writing at any time.
“What happens if I owe you money?” Treatment cannot be conditioned on a broad release of records as a debt-collection tool.

What Agape does

Agape Counseling Services is a Part 2 program. We do not release information about your treatment without your written consent, except in the narrow circumstances the regulation allows. We will give you a copy of any consent form before you sign it. We will tell you, in plain language, what each consent lets us share and with whom.

If you have questions about how your information is handled before you call us, the federal Substance Abuse and Mental Health Services Administration (SAMHSA) publishes a plain-language guide to Part 2 at samhsa.gov.

If you are ready to talk to someone, call us at (609) 242-0086. The intake call is confidential and free.

Understanding 42 CFR Part 2: what it means for your privacy