George Karway1, Julia Ivanova, Anweysha Bhowmik, Anita Murcko, Michael Saks, Dennis McCarty, Aimee Campbell, Maria Adela Grando. 1. From the College of Health Solutions, Scottsdale, Arizona State University, Phoenix, AZ (GK, AB, AM, MAG); School of Human Evolution and Social Change, Arizona State University, Phoenix, AZ (JI); Sandra Day O'Connor College of Law, Arizona State University, Phoenix, AZ (MS); School of Public Health, Oregon Health & Science University, Portland, OR (DMcC); Department of Psychiatry, Columbia University, New York, NY (AC).
Abstract
OBJECTIVES: Title 42 Code of Federal Regulations Part 2 (42 CFR Part 2 or Part 2) was enacted in 1975 to protect patients receiving treatment for substance use disorders. A scoping review on Part 2 characterized published work. METHODS: Seven databases were searched. Studies were categorized based on date of publication, primary objectives, methods, and findings. A thematic analysis was conducted using article titles and abstracts. RESULTS: Of the 36 studies identified, the majority (78%) were opinions or legal reviews, (22%) employed quantitative and/or qualitative methods to study the impact of Part 2, and over half (58%) were published in the past 5 years. Only 8% of studies reported stakeholder involvement in Part 2 studies and no study included patients or patient advocates. No study discussed the efforts to align Part 2 with Health Insurance Portability and Accountability Act or provided evidence of the benefit of this alignment. Three main themes emerged from the review: care delivery (46.6%), law and ethics (27.6%), and technology (25.9%). There were no studies focusing on stigma and its effect on substance use treatment and Part 2. CONCLUSIONS: Despite the significance of Part 2, the literature is sparse. It is time to initiate a new era of scholarly research that focuses on the impact of statutes and policies that govern substance use disorder data sharing. Specifically, we recommend research on Part 2 and Health Insurance Portability and Accountability Act alignment, the effects of Part 2 on patients, as well as providers and other stakeholder perceptions on the regulation.
OBJECTIVES: Title 42 Code of Federal Regulations Part 2 (42 CFR Part 2 or Part 2) was enacted in 1975 to protect patients receiving treatment for substance use disorders. A scoping review on Part 2 characterized published work. METHODS: Seven databases were searched. Studies were categorized based on date of publication, primary objectives, methods, and findings. A thematic analysis was conducted using article titles and abstracts. RESULTS: Of the 36 studies identified, the majority (78%) were opinions or legal reviews, (22%) employed quantitative and/or qualitative methods to study the impact of Part 2, and over half (58%) were published in the past 5 years. Only 8% of studies reported stakeholder involvement in Part 2 studies and no study included patients or patient advocates. No study discussed the efforts to align Part 2 with Health Insurance Portability and Accountability Act or provided evidence of the benefit of this alignment. Three main themes emerged from the review: care delivery (46.6%), law and ethics (27.6%), and technology (25.9%). There were no studies focusing on stigma and its effect on substance use treatment and Part 2. CONCLUSIONS: Despite the significance of Part 2, the literature is sparse. It is time to initiate a new era of scholarly research that focuses on the impact of statutes and policies that govern substance use disorder data sharing. Specifically, we recommend research on Part 2 and Health Insurance Portability and Accountability Act alignment, the effects of Part 2 on patients, as well as providers and other stakeholder perceptions on the regulation.
Authors: Constance M Weisner; Cynthia I Campbell; Thomas G Ray; Kathleen Saunders; Joseph O Merrill; Caleb Banta-Green; Mark D Sullivan; Michael J Silverberg; Jennifer R Mertens; Denise Boudreau; Michael Von Korff Journal: Pain Date: 2009-07-05 Impact factor: 6.961