Drug Alcohol Abuse and Addiction Assessment

Congress passed legislation, and the Department of Health and Human Services issued a set of regulations to protect information about clients’ substance use disorder treatment. The law is codified at 42 U.S.C. _290dd-2.

The implementing Federal regulations, Confidentiality of Alcohol and Drug Abuse Client Records, are contained in 42 C.F.R. Part 2 (Vol. 42 of the Code of Federal Regulations, Part 2).

The Federal law and regulations severely restrict communications about identifiable clients by “programs” providing substance use/abuse diagnosis, treatment, or referral for treatment (42 CFR _2.11).

The purpose of the law and regulations is to decrease the risk that information about individuals in recovery will be disseminated and that they will be ostracized or subjected to discrimination.

 

Contact Information



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Drug and Alcohol History



What is the Primary Drug of Abuse?

Method of Intake

What is the Secondary Drug of Abuse?

Method of Intake

At what age did the user first take drugs?

How old is the user now?

At what age did user's life begin to be unmanageable?

Presently, what are the problems relating to user's addiction?

Presently, what is family's attitude toward the user's addiction?

Does the user admit to having a problem?

Does the user want help?

Treatment History



How many times has this user been in treatment for their addiction?

How many of these involved the 12-step (AA/CA/NA model) approach to recovery?

Was there any success with any of these treatment episodes, and if so, what was the length of sobriety achieved?

Medical History



Is the user on any medication?

If so, please specify medications taken?

Has the user ever had seizures for any reason in the past?

Is the user on medication for a psychiatric disorder?

If so, please specify medications taken?

Supplemental Background



Does the user have legal issues?

If so, please describe?

Please provide us with any other information or any questions you have?

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