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Center for Substance Abuse Treatment. The Tuberculosis Epidemic: Legal and Ethical Issues for Alcohol and Other Drug Treatment Providers. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 1995. (Treatment Improvement Protocol (TIP) Series, No. 18.)

  • This publication is provided for historical reference only and the information may be out of date.

This publication is provided for historical reference only and the information may be out of date.

Cover of The Tuberculosis Epidemic

The Tuberculosis Epidemic: Legal and Ethical Issues for Alcohol and Other Drug Treatment Providers.

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Chapter 1—Introduction

This TIP is the culmination of a process that began with the convening of a Federal Resource Panel composed of State and Federal public health officials and alcohol and other drug (AOD) treatment providers. That Federal resource panel identified the basic issues to be discussed in this document, namely, screening for TB, methods for communicating with State public health officials regarding AOD patients with active TB, and guidelines for educating AOD program staff about TB. In May 1994, a second panel -- a consensus panel -- met to discuss the issues identified by the Federal resource panel and to develop practical guidelines for helping AOD treatment providers and public health officials prevent the transmission of TB in the AOD setting. The consensus panel consisted of representatives of State agencies, AOD treatment providers, and State TB control officials. Consensus panel work groups focused on the effect of TB on AOD treatment programs as providers of patient services, the effect of TB on AOD treatment programs as employers, and the effect of TB on the relationship between AOD providers and the public health field. This document is the product of the consensus panel's deliberations.

Purpose of the TIP

The purpose of this TIP is to give practical ethical and legal advice to AOD treatment providers about cooperating with public health officials and others in preventing the transmission of TB in AOD treatment facilities. Given that not all AOD programs are alike -- physically, demographically, or in terms of the services they provide -- and given that the risk of TB varies from one program to the next, it is not assumed that everything in this document will be relevant or useful for all treatment providers. Nevertheless, to the extent that all AOD providers have an interest in stemming the spread of TB in their facilities, and to the extent that all AOD providers operate under similar ethical and legal obligations, it is hoped that this document will

  1. Illuminate some of the more important issues raised by the threat of TB in the AOD setting
  2. Promote collaboration between AOD treatment providers and others in the fight against TB
  3. Lead to a safer AOD work place.

Toward that end, this TIP will set forth basic information about tuberculosis, explain how AOD treatment providers and others can collaborate without violating Federal laws regarding the confidentiality of alcohol and other drug abuse treatment records, outline the TB-related services required of most substance abuse treatment providers, and discuss steps that substance abuse treatment providers can take to promote safety in the workplace. In keeping with the demanding ethics of the substance abuse treatment field, this document attempts to tell the reader not just what must be done, but what should be done.

Audience

This document is intended for policymakers, the staff of State agencies that fund and regulate substance abuse treatment programs, corrections officials, administrators and employees of substance abuse treatment programs, clinicians serving special care populations, and infectious disease officials.

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