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42 CFR Part 2: Understanding addiction treatment privacy protections

Published May 20, 2025 · 7 min read · Updated April 2026
Reviewed for accuracy by licensed clinical professionals.

42 CFR Part 2 is the federal regulation that provides extra privacy protections specifically for substance use disorder treatment records, beyond what standard HIPAA provides.

What it protects

Records created by programs that specialize in substance use disorder treatment. Diagnosis, treatment information, counseling notes, and testing results related to SUD. Any information that would identify you as being in SUD treatment.

How it differs from HIPAA

Standard HIPAA allows information sharing for treatment, payment, and healthcare operations. 42 CFR Part 2 requires your specific written consent for almost any disclosure, including to other healthcare providers, insurance companies (with exceptions), and family members.

Practical impact

Your addiction treatment records are not visible in standard health information exchanges. A new doctor cannot see your SUD treatment history without your consent. This protects against discrimination but can complicate care coordination.

Recent changes

The CARES Act modified some Part 2 provisions, aligning certain aspects more closely with HIPAA. Treatment records may now be shared for treatment, payment, and healthcare operations once initial consent is given, while maintaining protections against use in criminal proceedings.

Authoritative sources

This article references guidelines from: SAMHSA · NIDA · ASAM

Frequently asked questions

Are my addiction treatment records protected?
Yes. 42 CFR Part 2 provides stronger protections than standard HIPAA, requiring your written consent for most disclosures.
Can my employer see my treatment records?
No. 42 CFR Part 2 prevents disclosure without your consent, and employers cannot access your treatment records.
Can police access my treatment records?
Only with a court order meeting specific requirements. Standard subpoenas are insufficient under 42 CFR Part 2.

Disclaimer: Informational only. Not medical advice. SAMHSA: 1-800-662-4357.