Privacy and Anonymity in Recovery

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Often, substance users question how many others are struggling like they are to manage their drug or alcohol addiction. Results from 2010 government research notes that 23.5 million Americans are addicted to drugs and/or alcohol.[1] You’re not alone, but illicit substances and depressants like alcohol can often make you feel like you are. It is human nature to desire the company and comfort that being engaged with others brings. We learn to connect with others, share experiences, and build lasting relationships from a very young age. Addiction preys on those closely held friendships and unions that you’ve spent years piecing together. It can bring the strongest of people to their knees.

For most, the depth to which their addiction has brought them isn’t something they’re proud of. For this reason, the majority of people seeking treatment for substance abuse want to do so with a certain amount of privacy. An approximate 20.4 million Americans have used an illicit drug in the past month.[2] This isn’t to say they’re all addicts, but 2010 statistics point out that of the 23.1 million Americans aged 12 and older who are abusing drugs or alcohol badly enough to warrant the need for treatment, only 2.6 million actually received such help, leaving 20.5 million untreated.[3] Are you avoiding treatment out of fear of people finding out?

Sure, the average person is no celebrity; there’s no concern of their life being splashed across tabloids at the newsstand tomorrow morning. However, there are important factors to consider when it comes to whom to make privy to your problems. Not everyone can be trusted to keep your personal affairs to themselves. Further, the effort to keep things hushed isn’t merely to protect one’s ego, but also an attempt at holding your life together while you’re getting help.

Who Is Abusing What?

Children

Perhaps the worst case scenario is that your young children find out you’re abusing drugs or alcohol. In many cases, by the time you’re ready for treatment, they’ve already figured it out. Nonetheless, if they haven’t, there are precautions you can take to ensure they won’t know about your addiction problems until you’re clean and sober and ready to tell them yourself. A 2012 report attested to 7.5 million American minors living with at least one parent who abused alcohol in the preceding year.[4] You’re not the only one.

Friends

In the United States alone, alcohol use disorder affects around 17 million people.[5] With that many Americans abusing booze, it’s undeniable that someone you know — maybe even a close friend — is struggling with alcoholism. There may never be a greater time to weed the flock than when you’re entering a substance abuse treatment program. Some people are inclined to be fairly open with their friends about their problems, and you might find your peers confessing their stories of alcoholism to you. Generally, you’ll find out who your true friends are at this point.

The loss of a few friends isn’t something to be ashamed of. Additionally, it can be difficult to prevent yourself from feeling angry with trusted peers who may abandon you during treatment. It is in your best interest to try and remind yourself that not everyone is cut out for this kind of battle. While we now know that these problems are genuine mental health disorders, many still look at drug and alcohol abusers merely as people who make poor choices. The same stigma plagues many with mental health disorders, and one recent study points out that this very stigma against mental illness is one of the primary reasons that mentally ill individuals chose to bypass getting treatment in an analysis of 144 studies by the Institute of Psychiatry at King’s College London.[6]

The Boss Man

Another common concern when addicts enter treatment is whether or not they should tell their employer. In today’s world, alcoholism and drug abuse are not atypical problems. In fact, it’s likely your superior is well-prepared for such a discussion. Most businesses today take these health matters into account. Some provide health insurance with substance abuse coverage, because it’s in the best interest of the company to make sure its employees are in tip-top shape. In 1998, 10 percent of US workers were having trouble with chemical dependency.[7] Many businesses now have protocols in place for how to handle substance abuse by employees.

If you truly feel you cannot tell your boss about your addiction, then you’re going to have to come up with an alternate explanation for the time you require off from work. Sometimes this can be handled with the assistance of a physician who can prescribe you the time off and talk directly with your employer if necessary. Likewise, the doctor is required to maintain your privacy while explaining that your need for an extended period of time away from work is authentic.

Workplace Woes

Of course, sometimes you are the boss. What then? Are you supposed to tell your employees that you’re an alcoholic or drug addict? There is a certain level of stress that comes with along with managing employees and running a business; likewise, stress is significantly linked with substance abuse. A 2012 study found that 60 percent of respondents attributed their high stress levels to their jobs, and 44 percent admitted to being more likely to drink after a stressful day.[8] Thus, it’s natural to worry that such a declaration on your part will taint the superior management persona you’ve worked so hard to obtain, and you surely don’t want anyone to lose respect for you. There are ways we can help you to deliver this news to employees that will maintain the level of professionalism you desire while letting everyone know that your absence truly is necessary.

The downside to not opening up about your time away is obviously that many could get the impression you’re flaking on them or simply on vacation. Often, those who work under you won’t see eye-to-eye with you unless you humanize yourself a little more, something that a confession about your substance abuse struggles would convey, but the choice of whether to open up or not is entirely yours. The same goes for relationships with coworkers. If you feel the individual in question may lose respect for you or look at you as less competent, it might be best to keeps your private business to yourself.

Extended Family

A three-year study of patients with both substance abuse disorders and co-occurring severe mental illness reported results that aligned economic assistance from family members with a greater chance at recovery as well as associations between the length of time spent with family members caring for a patient correlating with a decrease in substance use.[9] Beyond the scope of your job and those living with you, like your partner and children, most people have an extended family to think about when they decide to enter drug or alcohol rehabilitation.

It is far more likely that many of your family members know you’ve been abusing drugs and/or alcohol and trying to conceal it than you’re aware of. Your level of comfort is important. The last thing you need is to let loved ones in on your personal battle only for them to reject you or put you down. If you are fairly sure ahead of time that certain aunts, uncles, cousins, grandparents, or others won’t be supportive of you or your decision to get help, bypass a discussion with them altogether. Entering treatment is a scary thing for many, and you only need people in your corner who want to be there.

Treatment Options

In 2012, 5.9 percent of deaths across the globe were due to alcohol consumption.[10] Additionally, 113 people die every day due to drug overdose.[11] Going untreated isn’t the way to go. As a patient, you’ll undergo extensive screening to assure that no underlying illness goes undiagnosed. Some patients will present with one or more disorders accompanying their substance abuse habit, such as bipolar disorder or post-traumatic stress disorder. One 2010 report attested to 45.1 percent of 20.3 million adults with substance abuse disorders also having a diagnosable mental illness.[12] Likewise, only 17.6 percent of adults without a substance abuse disorder had any mental illness, reinforcing the link between the two.[13]

Most patients do well with a combined treatment approach of therapy techniques like Cognitive Behavioral Therapy and medication — when necessary. Of course, simultaneous treatment of your alcohol or drug abuse problem is vital to delivering a successful outcome. Additionally, research has pointed toward drug abuse being more popular among the mentally ill population than alcohol abuse with 53 percent of drug addicts having at least one diagnosable mental health disorder, whereas only 37 percent of alcoholics do.[14]

The Importance of Privacy

When choosing a rehabilitation facility, you should be able to trust that the institution you use will maintain high standards when it comes to privacy and the security of your records. A professional facility will only release documents pertaining to your substance abuse treatment and medical health to designated individuals that you have given the facility written permission to communicate with, like a spouse or your family physician.

If there are certain people you purposefully decide not to divulge you rehab details to, you do run the risk of them finding out on their own. For some, like family members and friends who are close to you, they may feel hurt that you didn’t trust them. Children of addicts who are blindsided with this news often feel the sting of betrayal. Adult children of parents with alcohol use disorders might show signs of specific problems like poor relationships, trouble managing money, and a heightened risk of developing a substance use disorder of their own.[15] With over 28 million Americans having watched alcohol seriously impact a parent, it’s important to keep in mind that while your intentions are good, they may not matter to the emotionally injured party, and they may not protect them in the long run either.[16]

Privacy Laws

The Health Insurance Portability and Accountability (HIPAA) was put into motion in 1996 as a means of protecting patient information. Four years later, the “Standards for Privacy of Individually Identifiable Health Information” was issued as a provision to the act and dubbed “the privacy rule.”[17] Many people are aware of HIPAA, but don’t understand what it does for them, despite signing the paperwork for it every time they visit a doctor’s office.

In short, any information that could be used to identify you is protected under the aforementioned provisions, such as:[18]

  • Claim submissions
  • Benefit coordination
  • Requests regarding eligibility, claims status, benefits, or coverage
  • Payment information for health plans
  • Enrollment transmission
  • Certifying and authorizing of referrals

Substance abuse treatment facilities that do not obey the federal regulations of the Confidentiality of Alcohol and Drug Abuse Patient Records code can be fined a maximum of $500 for their first offense and a maximum of $5,000 for each offense thereafter.[19] Since some facilities that do not receive any form of federal assistance are exempt from having to abide by these standards, it’s always best to inquire with the facility you are interested in.

Doctor-Patient Confidentiality

In extreme cases and emergency situations where the facility may be required to report information to legal authorities or there is a threat to one’s health, an institution is permitted to disclose information regarding your medical records, inclusive of your substance abuse treatment enrollment. Since 2009, 29.2 million patients have been the victim of HIPAA data breaches, thereby compromising their health records, making researching the facility you’re targeting an important step in the treatment process.[20]

Aside from emergencies, the only way your information can be revealed to anyone is if you permit it. Very specific forms must be signed for the release of your health records and information pertaining to your treatment, which must include the following:[21]

  • Name of the treatment program you’re in
  • Name of recipient
  • Name of patient
  • Reason for the disclosure
  • How much and what type of information will be revealed
  • A statement regarding the patient’s right to take back their permission for disclosure at any time, with an exception for any actions the program has already taken
  • Date, event, or presenting situation in which the disclosure becomes invalid
  • Dated patient signature


Insurance Assurance

Many patients are fearful of their employers finding out about a hidden substance abuse problem whenever using their employer-provided health insurance coverage. With 62 percent of HIPAA data breaches involving a business associate, it’s possible your superior could question your need for time off without just cause to, even if they’re unaware they’re doing anything wrong; be aware of your rights prior to requesting a leave of absence for treatment.[22]

Your employer is privy to some claims information, including why treatment is rendered and if it is to an employee, spouse, or child, but they aren’t privy to your name or other identifying information.[23] However, be mindful of the fact that many companies require more information regarding your absence if you are seeking worker’s compensation, a leave of absence, and, in some cases, even for health insurance purposes.

Security

It’s a common concern that one might lose their job due to circumstances surrounding drug and alcohol abuse. It should be noted that it is both illegal and unethical to fire someone on the basis of past addiction unless you are currently using drugs or alcohol, and it is interfering with your productivity, attendance, and behavior on the job. Alcoholism takes a major toll on the economy, bringing with it a bill to the tune of $186 million annually.[24]

It can be costly for your employer too, because drug and alcohol abuse can breach the amount of trust an employer has in you. If it is deemed that your substance abuse could compromise the work you are completing and hinder the company in any way, you could be fired. Likewise, if you are required to pass drug screening and fail, that poses a risk of losing your job as well. Data from 2007 and 2008 showed that three million uninsured full-time employees needed substance abuse treatment, but only 12.6 percent received it.[25] Don’t let concerns over your job take priority over your health.

Those with addictions that warrant disability may also have the upper-hand when seeking treatment. Under the American Disabilities Act, you are protected from discrimination for past drug or alcohol abuse that is no longer present after successful rehabilitation.[26] The Rehabilitation Act of 1973 also protects you from losing your job while you’re seeking treatment for an addiction as long as your disorder will not inhibit you from performing safe and adequate work.[27]

Most employers are required to work with you in allowing your participation in treatment as long as it doesn’t cause them undue hardship, and they’re required to keep your substance abuse and consequence treatment attendance to themselves.[28] The Family and Medical Leave Act permits most employees who have held their position for at least a year, among other requirements, to take up to 12 weeks off for treatment, prohibiting employers from firing you for such a request.[29]

Post-Rehab

In 2008, 23.1 percent of admissions to publicly funded substance abuse treatment programs were for alcohol abuse alone; another 18.3 percent were for alcohol combined with another drug.[30] In 2008, 37 percent of treatment admissions were for solely for drug abuse, up from 26 percent in 1998.[31] How many of these patients end up in long-term recovery is hard to say, but your chances of maintaining sobriety are proven to be higher with treatment than without it. After treatment, most patients who remain successfully sober and drug-free continue treating their addiction on an outpatient basis via support groups or 12-Step programs.

Of course, patients still do relapse sometimes. It’s an issue that is best dealt with when prepared for it rather than pretending you’re exempt because it just happens to others. In one study, dual diagnosis patients who were suffering from both mental illness and substance abuse and living in a community setting had almost double the risk of needing hospitalization again within the following year.[32] On the upside, 10 percent of American adults claimed to be in recovery in 2012, admitting to having a problem with substance abuse in the past that is no longer an issue.[33]

You can be part of the success story. Call our toll-free number listed above to speak with an admissions coordinator and start your journey to a drug-free and sober life.


Citations

[1] Join Together Staff. (2010 September 28). “New Data Show Millions of Americans with Alcohol and Drug Addiction Could Benefit from Health Care R.” Partnership for Drug-Free Kids. Accessed August 13, 2014.

[2] Buddy T. (2014 June 2). “Rates of Illicit Drug Abuse in the U.S.” About.com Accessed August 13, 2014.

[3] “Results from the 2010 National Survey on Drug Use and Health: Summary of National Findings.” (2011 September). Substance Abuse and Mental Health Services Administration. Accessed August 13, 2014.

[4] “Report shows 7.5 million children live with a parent with an alcohol use disorder.” (2012 February 16). Substance Abuse and Mental Health Services Administration. Accessed August 13, 2014.

[5] “Alcohol Use Disorders.” (n.d.). National Institute on Alcohol Abuse and Alcoholism. Accessed August 13, 2014.

[6] Krans, B. (2014 March 2). “Stigma Still a Major Hurdle in Getting People the Mental Health Care They Need.” Healthline News. Accessed August 13, 2014.

[7] Benderly, B. and Hafer, F. (1998). “Substance Abuse Prevention in the Workplace: An Employer’s Guide.” Thirteen wnet. Accessed August 13, 2014.

[8] Daily Mail Reporter. (2012 July 6). ”Two thirds ‘hit the bottle’ to relax after a stressful day at work.” Daily Mail. Accessed August 13, 2014.

[9] Clark, R.E. (2001). “Family support and substance use outcomes for persons with mental illness and substance use disorders.” Schizophrenia Bulletin. Accessed August 13, 2014.

[10] “Alcohol.” (n.d.). World Health Organization. Accessed August 13, 2014.

[11] “Prescription Drug Overdose in the United States: Fact Sheet.” (2014 July 3). Centers for Disease Control and Prevention. Accessed August 13, 2014.

[12] “Co-Occurrence of Mental Illness and Substance Abuse.” (2012 January). Substance Abuse and Mental Health Services Administration. Accessed August 13, 2014.

[13] Ibid.

[14] “Substance Abuse and Co-occurring Disorders.” (n.d.). National Alliance on Mental Illness. Accessed August 13, 2014.

[15] “Treatment Improvement Protocol (TIPS) Series, No. 39: Chapter 2: Impact of Substance Abuse on Families.” (2004). Center for Substance Abuse Treatment. Accessed August 13, 2014.

[16] Gold, M.S. (2006). “Children of Alcoholics.” Psych Central. Accessed August 14, 2014.

[17] “The Confidentiality of Alcohol and Drug Abuse Patient Records Regulation and the HIPAA Privacy Rule: Implication for Alcohol and Substance Abuse Programs.” (2004). Substance Abuse and Mental Health Services Administration. Accessed August 13, 2014.

[18] Ibid.

[19] “Treatment Improvement Protocol (TIPS) Series, No. 36: Appendix B – Protecting Clients’ Privacy.” (2000). Center for Substance Abuse Treatment. Accessed August 13, 2014.

[20] Ouellette, P. (2014 February 5). “Health data breach report: 137 percent breached record uptick.” HealthITSecurity. Accessed August 13, 2014.

[21] “Treatment Improvement Protocol (TIPS) Series, No. 36: Appendix B – Protecting Clients’ Privacy: Figure B-1.” (2000). Center for Substance Abuse Treatment. Accessed August 13, 2014.

[22] “What is a HIPAA Violation?” (n.d.). OnlineTech. Accessed August 13, 2014.

[23] Luhby, T. (2014 February 12). “What does your employer know about your health?” CNN Money. Accessed August 14, 2014.

[24] FreeAdvice Staff. (n.d.). “Firing Employees with a Drinking Problem.” FreeAdvice. Accessed August 14, 2014.

[25] “Health Care Assistance for Uninsured” (n.d.). LiveStrong. Accessed August 14, 2014.

[26] Carter Batiste, L. (2013 March 11). ”Accommodation and Compliance Series: Employees with Drug Addiction.” Job Accommodation Network. Accessed August 14, 2014.

[27] “Are You in Recovery From Alcohol or Drug Problems? Know Your Rights.” (n.d.). Substance Abuse and Mental Health Services Administration. Accessed August 14, 2014.

[28] Ibid.

[29] Ibid.

[30] “DrugFacts: Treatment Statistics.” (2011 March). National Institute on Drug Abuse. Accessed August 13, 2014.

[31] “Changes in Admission Patterns over a Decade.” (n.d.). Substance Abuse and Mental Health Services Administration. Accessed August 14, 2014.

[32] Drake, R. and Wallach, M. (1989). “Substance Abuse among the Chronic Mentally Ill.” American Psychiatric Association. Accessed August 13, 2014.

[33] Feliz, J. (2012 March 6). “Survey: Ten Percent of American Adults Report Being in Recovery from Substance Abuse or Addiction.” Partnership for Drug-Free Kids. Accessed August 13, 2014.

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