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Support is Growing to Lift Barriers to Opioid Treatment


WASHINGTON, DC – 39 state attorneys general recently asked Congress to lift barriers to opioid treatment. We agree. There is more work to be done, first and foremost, Congress needs to pass the Overdose Prevention and Patient Safety Act, which would put the protection of substance use disorder records under HIPAA instead of 42 CFR Part 2.


Protecting patients’ confidentiality is critical, but substance use disorders treatment must be carefully managed and coordinated. Part 2 poses a serious threat to anyone with a SUD because providers can be unaware of the risks to their patient from potential drug interactions and other medical challenges.

  • Note: the bill passed alongside the SUPPORT Act 357-57 but was dropped by the Senate; the bill, the Overdose Prevention and Patient Safety Act, was reintroduced this Congress by Reps. Earl Blumenauer (D-OR) and Markwayne Mullin (R-OK).

As POLITICO Pulse reported, 39 state attorneys general wrote a letter and pointed to three main barriers to opioid treatment: 

  • 1) privacy rules restricting the disclosure of patients’ substance use disorder treatment records, 2) a requirement that practitioners get a separate DEA waiver to prescribe buprenorphine, a medication to treat opioid addiction, and 3) restrictions on Medicaid funding for residential treatment facilities with over 16 beds.”

Our Take

1.) On Point 1 – We agree completely, it is critical we reform 42 CFR Part 2. Let’s go!

2.) On Point 2 – This is an important discussion, but as the AG letter makes clear—reforming 42 CFR Part 2 first is imperative.

  • “This regulatory scheme also sets up a strange situation in which office-based MAT providers do not have to follow the specialized requirements of 42 CFR Part 2 unless they advertise to the public that they provide MAT. So, in an era when we are trying to promote access to MAT, we are encouraging office-based MAT providers to keep secret the fact that they provide this lifesaving service so they can avoid the cumbersome 42 CFR Part 2 rules,” write the state AGs.

3.) On Point 3 – We agree, more work remains on the Medicaid Institutions for Mental Diseases (IMD) exclusion. In fact, from the beginning Congress said the SUPPORT Act was never the final solution for combatting the opioid epidemic. But we should be proud of the SUPPORT Act—it was the first real work on the IMD issue. It is a start, and we agree with the state attorneys general, important work remains.

Inside Health Policy brings up some important news and gives reform efforts a jolt of momentum – the American Medical Association now supports reforming 42 CFR Part 2.

  • Advocates for aligning the scheme told Inside Health Policy in June that there is optimism that legislation will pass this congressional session after the American Medical Association reversed course on its previous opposition to aligning the schemes and support from lawmakers has grown.

Read the full story here.