42 CFR Part 2 still under siege

Editor's note: Many people breathed a sigh of relief when H.R. 6082 was not included in the opioid legislation that went through Congress this summer and was passed by the full Senate last week. But it's too early to stop fighting. Observers say that those who want to decimate the regulation are determined to find a way, whether it's through Congress or through the administration. Last week, Pamela Greenberg, executive director of the Association for Behavioral Health and Wellness (ABHW), posted on Twitter that Elinore McCance‐Katz, M.D., Ph.D., had said at the Oct. 3 launch of Patrick Kennedy's Don't Deny Me campaign that there would not be parity for mental illness and substance use disorders (SUDs) unless 42 CFR Part 2, the confidentiality regulation requiring patients to consent to the release of their SUD data, was replaced by the Health Insurance Portability and Accountability Act (HIPAA). Indeed, despite the passage of the opioid package by the full Senate on May 3, without any revisions to 42 CFR Part 2, what remains at the top of the ABHW webpage is the report of last spring's vote by the House of Representatives to replace it with HIPAA. Many in the field think the proponents of erasing 42 CFR Part 2 are pressing on to make this happen. Below is commentary from H. Westley Clark, M.D., J.D.