House of Representatives
and Senate
U.S. Congress
Capitol Hill
Washington, D.C.
Dear Congresspersons and Senators:
The National Alliance for Medication
Assisted Recovery is an organization of medication assisted treatment (MAT)
patients and health care professionals supporting quality health care.
Currently the United States is in
the midst of a serious opioid epidemic. Every
attempt should be made to encourage individuals with a Substance Use Disorder
(SUD) to enter treatment. Patients
concerns about entering treatment such as privacy are not being considered. Instead,
insurance companies, EHR vendors, profit hungry health care networks and
others interested in whose interest is
in profit from individuals suffering from alcohol use disorders and drug use
disorders propose to make substance use disorder treatment unappealing by
gutting 42 USC 290dd-2 and 42 CFR Part
2, the federal substance use disorder confidentiality law and regulations.
You will be asked to vote for
legislation that will diminish a person’s confidentiality and that MAT patients
take very seriously. Please do not take
this protection from us.
The opponents of the current 42
USC 290dd-2 and 42 CFR Part 2, claim that the Health Insurance Portability and
Accountability Act (HIPAA) is sufficient. But, they know that HIPAA offers less
confidentiality protection than the current federal substance use disorder
confidentiality law and regulations.
Less protection means a greater risk of harm from disclosure for those
in treatment or in Recovery.
In fact, the
limitations to confidentiality protection offered by HIPAA’s exceptions to
confidentiality will certainly discourage those with a substance use disorder
to postpone, delay or refuse to acknowledge that they have a substance use
disorder.
Most MAT
patients are not aware of the attack on their confidentiality that they have
trusted and believed in since entering treatment. We do not have powerful
lobbyists in Washington to make inaccurate arguments (i.e. 1. health care will
be safer, 2. patients are not concerned with confidentiality, 3. it is
necessary to be able to know if a patient is in SUD treatment).
Vote No On Changing
42 USC 290dd-2 and 42 CFR Part 2
Aligning 42
CFR Part 2 with HIPAA and by ignoring the potential harm caused by weakening 42
CFR Part 2, only those with the most severe substance use disorders will seek
treatment. It will also force many currently in treatment to leave resulting in
placing them at great risk of relapse and adding to current opioid overdose
epidemic. The more stability a MAT patient attains the more they have to lose
if there SUD is known.
In 2017, 20
million people met criteria for SUDs, BUT only 2.5 million of these received
treatment. Why?
Not because of
42 CFR Part 2, but because 94% of those who needed SUD treatment but did not
receive treatment did not feel they needed treatment.
This
percentage will rise even higher when it becomes known that those receiving SUD
treatment will not be able to decide who has access to their SUD treatment
information. Upon admission to SUD
treatment the program explains the many exceptions to confidentiality that
HIPAA permits. This information go out to the streets and many people will decide
that help for their SUD is not worth it. They will believe they can “kick it”
on their own, but if that were true they would not need help.
Because of
discrimination, stigma, and negative attitudes about those with SUDs, people in
Recovery have enough barriers to employment that pays a living wage, housing
that protects against the elements, and social support that does not alienate
them for having suffered the disease of SUD. Even decent medical care is difficult and once
their treatment for a SUD is known they are often treated as second class
citizen patients. Allowing a person’s history of SUD treatment to be disclosed
without their consent increases their social disadvantage. HIPAA permits such
an unconsented disclosure to a broad range of entities.
Congress has
appropriated billions of dollars to address the opioid crisis and to promote SUD
treatment. Please do not waste this
investment by scaring away the very people those dollars were meant to help!
Insurance companies, EHR vendors and profit hungry health care networks claim a
need for better care coordination; they aren’t treating the vast majority of
people with substance use disorders. And from our experience they do not want
to treat persons with a SUD. A change in
42 USC 290dd-2, and they’ll be treating even fewer people.
There are
technological fixes already in existence that would allow health information
sharing while protecting the ability of those who need treatment to determine who
should have access to their health information.
Software
vendors have argued that there are no financial incentives to incorporate these
patient centered fixes into proprietary platforms. In fact, the federal
government sponsored the development of just such fixes. The software market place finds it cheaper
and easier to sacrifice the autonomy of the unpowerful and the poor, rather
than make the necessary change to their software.
An estimated
20 million Americans have recovered from alcohol and drug related
problems. With the proposed changes in
42 USC 290dd-2 and 42 CFR Part 2, many people in Recovery will find themselves
subject to inappropriate information disclosures; no longer will People in Recovery
have to be consulted before their SUD histories be disclosed to entities with
the power to harm the affected individuals.
While insurers
and cost-cutting health networks are attempting to deny people in Recovery the
ability to determine who gets the information about prior alcohol or drug use
disorders, the rest of society is marshalling resources to protect their
personal information against misuse. An
example of privacy vigilance can be found in the New York Times “The Privacy
Project”, which acknowledges that companies and governments “are gaining new
powers to follow people across the internet and around the world, and even to
peer into their genomes.”
Creating a new
path to stigmatize people in Recovery or in SUD treatment is unconscionable.
Effective SUD treatment requires trust between provider and patient; in the
absence of trust, full disclosure of such issues as trauma, rape, abuse,
depression, anxiety, anger, discrimination or other sensitive issues that may
be linked to substance use is not possible.
Without trust, there will be no truth.
Men and women
bring a host of highly sensitive personal issues into treatment. Without the assurance of confidentiality that
the current 42 USC 290dd-2 and 42 CFR Part 2 promises, it will become very
difficult for treatment to progress; such treatment will become adversarial at
worse and a game at best. As a result,
treatment will be hindered and Recovery delayed.
The current opioid
crisis is being used as a justification for gutting 42 USC 290dd-2 and 42 CFR
Part 2. More people, currently misuse
alcohol than currently misuse opioids. While it is estimated that 3.5 million
people currently misuse opioids, 2.2 million misuse cocaine, 774,000 are
current users of methamphetamine, 16.7 million are heavy alcohol users, and
66.6 million are binge alcohol drinkers. More people are in treatment for
alcohol use disorders than for all illicit drug use disorders. While opioid
overdose deaths are an important public health issue, promoting person centered
SUD treatment that involves patient consent to disclosure is also important.
Protect Our
Confidentiality Keep 42 CFR Part 2 As Is
Protect Patient
Autonomy - Nurture Patient Clinician Trust
Encourage
Treatment Seeking
Preserve Patient’s Right To Decide
Using the current opioid crisis as a reason
to change federal substance use disorder confidentiality laws and regulations is
merely an excuse to reduce the cost and effort of treatment a goal they have
been after for after a decade. These anti
42 USC 290dd-2 and 42 CFR Part 2
entities do not care about the difficulties that persons in Recovery face.
Neither are they concerned with the further discrimination against people who
need help recovering from their substance use.
Please use your vote to encourage people to
enter treatment, Vote NO on legislation that would weaken 42 USC 290dd-2 and 42
CFR Part 2.
Sincerely,
Joycelyn Sue Woods, M.A., C.A.R.C., C.M.A.
Acting President
Download PDF Letter
http://www.methadone.org/downloads/namaletters/2019 0726NAMAR congress.pdf
Posts
