On October 26, 2017, President Donald Trump declared the opioid crisis a national public health emergency. According to the National Institute on Drug Abuse, over 100 people die every day in the United States from overdosing on opioids. Hundreds more suffer due addiction to opioids, which include drugs such as pain relievers, heroin, and fentanyl (a synthetic opioid). According to the Centers for Disease Control and Prevention, the opioid crisis costs the American economy $78.5 billion per year.
One year from President Trump’s declaration, a new opioid bill signed into law in the form of the Substance Use–Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act – or “SUPPORT for Patients and Communities Act” for short. The bill received bipartisan approval in the House and Senate.
It is hoped that the Act will help strengthen the government’s response to the opioid crisis by improving access to addiction treatment services, and expand data sharing in cases of opioid abuse so that robust strategies can be created to confront the issue head-on.
“This bill is a major victory for Ohio and for the country because it will strengthen the federal government’s response to the opioid crisis,” Sen. Rob Portman (R-OH) said in a statement after the Senate vote. “Importantly, this bill will increase access to long-term treatment and recovery while also helping stop the flow of deadly synthetic drugs like fentanyl from being shipped into the United States through our own Postal Service.”
As the bill hopes to increase the amount of data shared between healthcare professionals, the Health Insurance Portability and Accountability Act (HIPAA) must be consulted to ensure that this process maintains the integrity of protected health information and ensure the patients’ privacy rights are respected. There have been calls for changes to be made to 42 CFR Part 2 to align the legislation with the HIPAA Privacy Rule and allow the sharing of information about a patient’s substance abuse treatment, without consent, for the purposes of treatment, payment or healthcare operations.
The SUPPORT for Patients and Communities Act does allows for information relating to opioid use disorder and treatment – and details of treatment for abuse of other substances – to be displayed on a patient’s medical record, if consent is obtained from a patient.
The SUPPORT for Patients and Communities Act calls for the HHS to consult with stakeholders on the development of best practices that cover how that information can be prominently displayed in a patient’s medical record, how consent should be obtained from patients, and the process and methods that should be used.
The stakeholders must include a patient with a history of opioid use disorder, an expert in the confidentiality patient health information, an electronic health records expert, and a healthcare provider. The best practices should be issued within a year of the passing of the SUPPORT for Patients and Communities Act.
Following the signing of the SUPPORT for Patients and Communities Act, the HHS’ Office for Civil Rights (OCR) launched a public education campaign which highlights the efforts being made by the HHS to combat the opioid epidemic. The campaign hopes to inform the public about the “civil rights protections regarding evidence-based opioid use disorder treatment and recovery services”, according to HHS.gov.
OCR has also released guidance about the role of HIPAA in the opioid crisis. The guidance explains that healthcare providers are allowed to share information with a patient’s loved ones in certain emergencies or dangerous circumstances. This may include when the patient is incapacitated or in danger of harm. However, patients that have the capability of making decisions for themselves retain the right to decide if their healthcare providers can share information with their loved ones, except for certain circumstances. Finally, a patient’s “personal representatives” may request and obtain information on behalf of patients. Further information is available on HHS’s website.
“Persons getting help for an opioid use disorder are protected by our civil rights laws throughout their treatment and recovery,” said OCR Director, Roger Severino. “Discrimination, bias, and stereotypical beliefs about persons recovering from an opioid addiction can lead to unnecessary and unlawful barriers to health and social services that are key to addressing the opioid crisis.”
