Confidentiality for Teens in Drug Treatment

Suppose you provide alcohol and drug treatment to teens.
What do you do if the mother of an adolescent patient is demanding to see her son’s treatment records, but the son doesn't want your program to discuss his treatment with his mother or to share any records with her?
How do you deal with the relapse of a young teen-age patient? Can your program contact the patient's parents?  Must you?

In general, how much should parents and guardians know? 
And what about other institutions involved in the lives of adolescents, such as the courts and schools? 
Confidentiality of alcohol and drug treatment and prevention information can be a very sensitive topic when it comes to adolescents.  How can programs balance the need for adolescents to feel comfortable coming forward to seek treatment with the interests of parents and guardians to know what’s happening to their children?
Confidentiality in these matters is governed by a federal statute, 42 U.S.C. § 290dd-2, and the federal regulations that implement it, 42 C.F.R. (Code of Federal Regulations) Part 2, as well as by the federal Health Insurance Portability and Accountability Act, more commonly known as “HIPAA.” The Legal Action Center, a national non-profit law and policy organization specializing in anti-discrimination and privacy laws affecting people with alcohol/drug histories, criminal records, and HIV/AIDS, has written a book for non-lawyers that explains how to apply these confidentiality laws in the day-to-day world of treatment and prevention services.
 
Confidentiality and Communication: A Guide to the Federal Drug & Alcohol Confidentiality Law and HIPAA is written for the treatment/prevention field as well as for all of the agencies that work with people receiving treatment and prevention services, including schools, the juvenile justice system, child welfare system, and the courts. The book also contains an extensive discussion of how the criminal justice and child welfare systems can communicate with alcohol/drug programs without violating confidentiality laws.
 
You can find Confidentiality and Communication for sale on the Legal Action Center’s website. The book may be revised in 2010 to include additional discussion about electronic health information. 


[Sally Friedman is the Legal Director at the Legal Action Center. --Ed.]