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Rural Health Information Hub

Legal Issues

Historically, substance use disorder (SUD) has been viewed as a crime rather than a chronic health condition. While some drugs like alcohol, tobacco, and prescription drugs may be legally accessed, many commonly misused drugs are illicit, or illegal to purchase or use. Therefore, screening populations for SUDs 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. These protections may help encourage people to seek treatment by preventing future discrimination due to history of substance misuse. State law may also provide protection of medical and mental health information; however, the level of protection varies by state.

States have also enacted Good Samaritan laws, which protect individuals experiencing or witnessing an overdose from arrest or prosecution by law. Good Samaritan laws vary by state.

Rural SUD treatment programs can also partner with local law enforcement to help people who may be misusing substances. However, program planners may need to understand law enforcement's perspective on SUD in order to create a successful, respectful, and sustainable partnership. In Kentucky, the Angel Initiative allows individuals experiencing addiction to go to any Kentucky state police post and ask for help accessing addiction treatment care, without fear of arrest. As part of this initiative, individuals who seek help can also turn in any drugs or drug paraphernalia and will not be charged or prosecuted for possession. Engaging with law enforcement will allow for a more integrated and holistic approach to helping individuals with SUD.

Rural programs may need to advocate for policy changes at the state or local level to implement program activities. Some policy changes may include policies to legalize syringe services, drug courts, drug take back programs, provider and pharmacist naloxone distribution, and naloxone administration training for law enforcement and the general public.

Resources to Learn More

Legal Action Center: Substance Use
Describes the Legal Action Center's Addiction and Substance Use Project designed to encourage prevention and treatment of substance use disorders. Provides information on policy advocacy, technical assistance for providers, trainings, and other resources.
Organization: Legal Action Center