Referral
When and how to refer
Refer when needs exceed your scope or the current level of care: medical detox, psychiatric evaluation, medication management, housing, legal aid, vocational services, or specialized cultural and language services. Referral is a process, not an event-assess, discuss options, obtain consent, share only necessary information, make a warm handoff, and follow up.
Confidentiality
Substance use records are protected by 42 CFR Part 2, which is stricter than HIPAA. A valid consent is written, specific about the program and recipient, states the purpose, is time-limited, revocable, and signed by the client or authorized representative. Do not confirm or deny that a person is in treatment without consent.
Traps
Questions test whether you share information “to help” without a release, or whether you consider a referral complete once a phone number is given. Giving a list is not a referral. Failing to follow up is client abandonment. Also consider practical barriers: transportation, insurance, childcare, language, and stigma.
Worked example
A client with cirrhosis and daily drinking needs detox. You do not simply hand over an outpatient schedule. You arrange medical evaluation, obtain a release for the detox facility, share only relevant history, confirm the appointment, and document the follow-up call.