Historically, substance use disorder has been viewed as a crime rather than a chronic disease. While some drugs like alcohol, tobacco, and prescription drugs are considered licit (or legal), many commonly misused drugs are illicit, or illegal to purchase. Therefore, screening populations for substance use disorders is accompanied by various legal implications and raises ethical concerns.
Federal law protects information about individuals' substance misuse. The Confidentiality of Alcohol and Drug Abuse Patient Records regulation provides statutory authority for the confidentiality of patient records. This helps encourage people to seek treatment given they will not be discriminated against in their future endeavors. State law may also provide protection of medical and mental health information. The level of protection varies by state.