Once they are in treatment, what will the program tell me?

Why the program may say so little

HHS explains that federal Part 2 rules protect the confidentiality of records from many federally assisted substance use disorder programs. HIPAA, the broader health privacy law, also applies to many providers. Together they limit what a program can share, and with whom, without the patient's permission.

That can include whether the person is a patient there at all. A program that will not confirm someone is attending is not necessarily hiding bad news. It may simply be following the rules that protect every patient, including the person you care about.

HHS also explains how HIPAA applies to family members and friends: being involved in someone's care does not automatically give you access to their health information. What can be shared depends on the person's permission, the provider's professional judgment in some situations and any legal role you hold.

Consent is the main route

If the person wants you to know how they are doing, they can usually sign a consent form allowing the program to talk with you. A consent form can be specific. It might allow the program to confirm attendance and discuss discharge plans, but not to share what is said in counseling. It might name you, but not other relatives.

You can ask the person, before they go or when you next speak: “Would you be willing to let the program talk to me? What would you be comfortable with them sharing?” Accept their answer. Some people want privacy while they are in treatment, and that is their decision.

If they agree, ask the program how the consent process works and what the form will cover. Consent can usually be changed or withdrawn, so check with the program if your access seems to have changed.

What you can usually still do

Even without consent, you can often give information to the program. If you have noticed something important, such as a medication the person takes, a safety concern or a recent change, you can ask how to pass it on. The program may listen without being able to respond or confirm anything.

You can ask general questions that are not about the person, such as the program's visiting policy, what family programming it offers or how discharge planning usually works. You can also ask the program to pass on a message, knowing that it may not be able to tell you whether it did.

If you are paying

Paying for someone's treatment does not, on its own, give you access to their clinical information. You may be able to discuss billing matters, depending on the arrangements and what the person has agreed to. Ask the program which information you can receive as the person paying and which requires the patient's consent.

Family sessions and programs

Some programs offer family sessions or education. Taking part can be a way to learn about treatment and about how to support someone, even when you cannot receive updates about their care. If the person agrees, a family session may also be a place to talk together with a counselor present. The guide on the part family plays in treatment covers this in more detail.

If you are worried about their safety

If you believe the person is in immediate danger, call 911. If you are worried about suicide or a mental health crisis, call or text 988. Privacy rules include limited exceptions for emergencies, and you can still tell the program about an urgent concern.

If you have a legal role, such as guardian or someone holding a relevant power of attorney, tell the program and ask what documentation it needs. This guide cannot tell you what a particular legal role allows.

Looking after yourself while you wait

Not knowing is hard. It can help to agree with the person, before treatment starts, how and when you will be in touch, and what you will each do if that does not happen. It can also help to have your own support, from friends, a counselor or a group for family members, so you are not carrying the worry alone.