PRIVACY IN TREATMENT VS. RIGHT TO KNOW

Like many other people, I am following with great interest the media
coverage of Noelle Bush. However, my interest is different from other
people's. First of all as an addictions therapist, my interest is focused on
Bush and her struggle with recovery. It is difficult to be in treatment for
the disease of addiction, without being in a fishbowl.

Second of all, as the chairman of the ethics committee of the Florida
Certification Board, my interest is focused on the counselors who are
attempting to comply with the federal laws of confidentiality for people in
treatment. The difficulty is the pressure from law enforcement vs. the
individual's right to privacy. In the event that the therapists violate the
confidentiality of the client, they are subject to disciplinary action by
the Certification Board.

Confidentiality of patients in substance-abuse treatment is governed by the
Code of Federal Regulations' Title 42, which states in a pertinent part that
the identity of any patient in treatment be confidential except under
circumstances expressly authorized. One of those exceptions is for
communication to law-enforcement officers regarding crimes committed on the
program premises. Such communication, however, is limited to the
circumstances of the incident and the patient's name and address.

However, the real issue is not the criminal possession of cocaine or whether
or not the staff is cooperating with the police. It is the treatment and
recovery of individuals struggling to recover from the disease of addiction.
As Gov. Jeb Bush stated, the process of recovery is not a smooth
progression. There are lapses and relapses. Treatment is an ongoing process.
As in recovery from any disease, there are successes and failures. Whenever
I say that addiction is a disease, people become offended and make the
distinction that people take drugs voluntarily. While this is true
initially, at some point it is no longer voluntary but habitual, which is
why it is referred to as an addiction. I am pleased to read that Gov. Bush
understands that addiction is better served with treatment than with jail.

It is hard enough to recover from this disease without people watching your
every move and publicizing your failures. If it were Mary Smith and not
Noelle Bush, would anyone care? If it were your daughter, would you want her
treatment to be public? The fact that she is the daughter of Gov. Bush does
not make her fair game for the media.

Like any other patient, Noelle Bush deserves the right to deal with her
disease privately and in the best way that she can.

Kerry D. Wilensky is an addiction psychotherapist in Orlando. He is the
chairman of the ethics committee for the Florida Certification Board.