Professional Ethics and Legal Requirements
Professional ethics and legal requirements
This domain tests the NAADAC/NCC AP Code of Ethics, federal confidentiality rules, informed consent, boundary management, and mandated reporting. Expect scenarios on record requests, dual relationships, and duty to protect.
Core rules
- 42 CFR Part 2 protects substance use disorder records and is stricter than HIPAA: written, specific, time-limited consent is generally required before disclosure, and redisclosure is prohibited without consent.
- Exceptions include medical emergencies, court orders meeting Part 2 requirements, audits/evaluation, and child abuse reporting as required by state law; a subpoena alone is not patient consent.
- Informed consent covers diagnosis, treatment, fees, telehealth, risks, alternatives, and the right to withdraw.
- Avoid dual relationships that impair objectivity; document boundary decisions and consult a supervisor.
- Know state duty-to-warn/protect statutes and mandated reporting categories; follow the jurisdiction's standard.
Worked example
A probation officer calls requesting a client's attendance and drug test results without a signed release. The counselor confirms the program is a federally assisted SUD program. Because the officer is not the client and no Part 2-compliant consent or court order exists, the counselor discloses only that the person is not confirmed as a client, offers to obtain consent, and documents the request. The reasoning: Part 2 applies to identifying information, and a subpoena would still need a court order or valid consent.
Traps
Treating HIPAA as sufficient; accepting a subpoena as consent; discussing cases in shared spaces; using a general medical release for SUD records; and failing to document consultations.