C.F.R. » Title 42 » CHAPTER I—PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES › SUBCHAPTER A—GENERAL PROVISIONS › PART 2—CONFIDENTIALITY OF SUBSTANCE USE DISORDER PATIENT RECORDS › Subpart A—Introduction

42 C.F.R. § 2.2

Purpose and effect

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(a) Purpose. Pursuant to 42 U.S.C. 290dd-2(g), the regulations in this part impose restrictions upon the use and disclosure of substance use disorder patient records (“records,” as defined in this part) which are maintained in connection with the performance of any part 2 program. The regulations in this part include the following subparts:

(1) Subpart B: General Provisions, including definitions, applicability, and general restrictions;

(2) Subpart C: Uses and Disclosures With Patient Consent, including uses and disclosures that require patient consent and the consent form requirements;

(3) Subpart D: Uses and Disclosures Without Patient Consent, including uses and disclosures which do not require patient consent or an authorizing court order; and

(4) Subpart E: Court Orders Authorizing Use and Disclosure, including uses and disclosures of records which may be made with an authorizing court order and the procedures and criteria for the entry and scope of those orders.

(b) Effect. (1) The regulations in this part prohibit the use and disclosure of records unless certain circumstances exist. If any circumstance exists under which use or disclosure is permitted, that circumstance acts to remove the prohibition on use and disclosure but it does not compel the use or disclosure. Thus, the regulations in this part do not require use or disclosure under any circumstance other than when disclosure is required by the Secretary to investigate or determine a person's compliance with this part pursuant to § 2.3(c).

(2) The regulations in this part are not intended to direct the manner in which substantive functions such as research, treatment, and evaluation are carried out. They are intended to ensure that a patient receiving treatment for a substance use disorder in a part 2 program is not made more vulnerable by reason of the availability of their record than an individual with a substance use disorder who does not seek treatment.

(3) The regulations in this part shall not be construed to limit:

(i) A patient's right, as described in 45 CFR 164.522, to request a restriction on the use or disclosure of a record for purposes of treatment, payment, or health care operations.

(ii) A covered entity's choice, as described in 45 CFR 164.506, to obtain the consent of the patient to use or disclose a record to carry out treatment, payment, or health care operations.

[89 FR 12618, Feb. 16, 2024]
Notes of Decisions
Cited in 6 cases (5 in the last 5 years), 2019–2025 · leading case: State v. Dalton, 2019 Ohio 4364 (Ohio Ct. App. 2019).
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State v. Dalton, 2019 Ohio 4364 (Ohio Ct. App. 2019). · cites it 6× “The trial court did not err for that additional reason. {¶ 16} Moreover, 42 C.F.”
Lighthouse Behavioral Health Solutions, LLC v. Milestone Addiction Counseling, LLC (Del. Ch. 2023). · cites it 2× “Instead, Defendants contend Lighthouse acquired Milestone, 37 42 C.F.R. § 2.2 (a) (2022). 38 Id. § 2.2(b)(2).”
Daybreak Youth Servs., V. Clark Cnty. Sheriff's Off. (Wash. Ct. App. 2021). “42 C.F.R. § 2.2 (b)(1). Here, the 42 C.F.”
DeVargas v. Bd. of Cnty. Commissioners for Santa Fe Cnty. (D.N.M. 2022). “64 provides procedures for disclosure of substance abuse disorder patient records, 42 C.F.R. §§ 2.2 , 2.64, but only applies to “[r]ecords of the identity, diagnosis, prognosis, or treatment of any patient which are maintained in connection with the performance of any program or…”
Ray W. Mettetal, Jr., M.D. v. Virginia Bd. of Med. (Va. Ct. App. 2024). “42 C.F.R. §§ 2.2 (a), 2.11. In general, a Part 2 program may not disclose records that “[w]ould identify a patient as having or having had a substance abuse disorder” absent patient consent or court order.”
Gonzalez v. Guevara (N.D. Ill. 2025). “See 42 C.F.R. § 2.2 . Moreover, CCSAO’s characterization of 42 C.”
— 42 C.F.R. § 2.2(a) — 1 case
State v. Dalton, 2019 Ohio 4364 (Ohio Ct. App. 2019). “The trial court did not err for that additional reason. {¶ 16} Moreover, 42 C.F.”
— 42 C.F.R. § 2.2(b) — 1 case
State v. Dalton, 2019 Ohio 4364 (Ohio Ct. App. 2019). “The trial court did not err for that additional reason. {¶ 16} Moreover, 42 C.F.”
— 42 C.F.R. § 2.2(b)(1) — 1 case
State v. Dalton, 2019 Ohio 4364 (Ohio Ct. App. 2019). “The trial court did not err for that additional reason. {¶ 16} Moreover, 42 C.F.”
— 42 C.F.R. § 2.2(b)(2) — 1 case
State v. Dalton, 2019 Ohio 4364 (Ohio Ct. App. 2019). “The trial court did not err for that additional reason. {¶ 16} Moreover, 42 C.F.”
— 42 C.F.R. § 2.2(b)(3) — 1 case
State v. Dalton, 2019 Ohio 4364 (Ohio Ct. App. 2019). “The trial court did not err for that additional reason. {¶ 16} Moreover, 42 C.F.”
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