In response to “Privacy protection for patients with substance use problems”,1 there is indeed a compelling reason to worry about loosening of the Federal confidentiality regulation, 42 CFR Part 2, which requires special protection for patient information maintained by addiction treatment facilities. This concern is not so much based on fear of misuse and/or unauthorized further disclosure by the recipient of such information. Rather, confidentiality is essential because of the nearly universal bias that exists against addiction treatment and those who receive it. Sadly, this bias is prevalent among health care providers as well as society at large, and it would be naïve to think that quality of patient care will not be affected adversely by knowledge that a patient is, or has a history of having been, addicted—especially to illicit substances.Patients who wish to authorize disclosure of addiction history and/or current receipt of care can do so. In addition, treatment programs (just as all other health care providers) should encourage every patient to designate a health-care proxy to permit (and to withhold) disclosure in the event of incapacitation.