Doctors can’t fully treat a patient with only half of a medical record. Without access to crucial information in a patient’s medical record, such as a history of drug and alcohol misuse, doctors face difficulties safely treating their patients. My legislation, H.R. 3545, the Overdose Prevention and Patient Safety Act updates an outdated law to give doctors the whole story on their patient’s medical history. H.R. 3545 ensures that patients struggling with substance use disorder have access to health care providers who have the information they need to give them the highest care possible.
In 1972—a quarter of a century before the Health Insurance Portability and Accountability Act (HIPAA) was created—President Nixon signed the Drug Abuse Prevention, Treatment and Rehabilitation Act into law. More than 45 years later, it continues to govern how doctors and health care professionals share alcohol, substance use disorder treatment, and some mental illness records despite the rise of electronic health records, the passage of the modern day privacy law known as HIPAA, and integrated care models.
This outdated law and its subsequent regulations, 42 CFR Part 2 (Part 2), keeps a patient’s substance use disorder records separate and segregated from the patient’s general medical record. Not only does this segregation stigmatize the patients Part 2 was designed to protect, but in the modern day digital world it creates a dysfunctional maze of bureaucratic rules that are impossible for physicians and administrative staff to navigate and even more impossible to enforce. Part 2 has created an inconsistent patchwork, where the level of care and privacy a patient receives depends upon the interpretation of Part 2 by the provider.
The Substance Abuse and Mental Health Services Administration (SAMHSA) has said about Part 2 that “healthcare providers must have secure access to patient information, including substance use disorder information, in order to provide integrated and effective care. The practice of requiring substance use disorder information to be any more private than information regarding other chronic illnesses such as cancer or heart disease may in itself be stigmatizing.” We cannot afford to be stigmatizing patients with substance use disorder any longer. It’s time to bring parity to mental health and substance use disorder records and treatment.
In 2014 in Oklahoma, there were more people who died of drug overdoses than car crashes. Two of the five counties in Oklahoma that have the highest rates of unintentional painkiller overdoses–Coal and Muskogee—are in the district I represent. Failure to modernize Part 2 has limited our nation’s ability to respond to the ongoing opioid crisis and is contributing to the record number of drug overdose deaths.
In the case of Jessie Grubb, this outdated law proved fatal. Jessie was in substance use recovery when she had a routine surgery. Providers were informed by her parents that she should not be given opioids except under strict supervision. However, when she was discharged from the hospital, Jessie was prescribed 50 oxycodone pills. The hospital pharmacy filled the prescription because they were not able to see her history of substance use in her medical record. On that night in 2016, Jessie passed away from an overdose.
The opioid epidemic isn’t a partisan issue. It touches every family regardless of gender, age, race or socioeconomic class. Lives are on the line and families are counting on Congress to update existing law to ensure the tragic story of Jessie Grubb doesn’t happen again.
Congressman Mullin represents the 2nd District of Oklahoma. He is a member of the House Energy and Commerce Committee.