Drug Policies and Ethics: NASW Substance Use Standards
Two standards, and confidentiality in substance use work is stricter than the general code. Knowing why is the difference between a general ethics post and this one.
Editorial process
Last reviewed · August 16, 2026
Competence and confidentiality are the two standards named
The prompt names two standards and they are worth taking separately. Competence means being knowledgeable about evidence-based interventions for substance use disorders, which is a stronger claim than familiarity: motivational interviewing, contingency management, cognitive behavioural approaches and medication for opioid use disorder all have evidence behind them, and a social worker who cannot say what any of them involves is not competent in the sense the standard means. That has an ethical edge, because the most common failure is not incompetence but an outdated model — a practitioner who believes abstinence is the only legitimate goal, or who treats medication for opioid use disorder as substituting one drug for another, is applying a moral position where the standard asks for evidence. Name two interventions you could describe to a client in plain language, and say which of them your own setting actually offers. If the answer is neither, that gap is worth writing about.
Confidentiality is where substance use practice genuinely differs, and this is the technical content worth getting right. Federal rules governing substance use disorder treatment records are stricter than the general health privacy rules: disclosure typically requires specific written consent even where other health information could be shared for treatment purposes, and that protection exists because the consequences of disclosure — employment, custody, immigration, criminal exposure — are unusually severe. That protection then collides with other duties. Mandated reporting for child welfare, duty to warn, coordination with a treatment team, and family who want information all pull the other way, and the standards do not resolve those conflicts for you. Take one collision, name the competing obligations, and say how you would decide — including what you would tell the client before the situation arose, since informed consent about the limits is the one move that works in advance rather than in the crisis.
Likely learning objectives
Inferred from the brief — check these against your own rubric.
- 01State what competence in substance use practice requires concretely.
- 02Identify outdated treatment beliefs as an ethical rather than technical failure.
- 03Explain why substance use records carry heightened confidentiality protection.
- 04Work a collision between confidentiality and another duty.
Read the full question
Review every instruction before using the planning guidance that follows.
Turn the brief into deliverables
- 01The competence standard, with named evidence-based interventions.
- 02The confidentiality standard as it applies to substance use records.
- 03Why the protection is stricter than general health privacy.
- 04One worked conflict between confidentiality and another obligation.
- 05The role of informed consent about limits, set in advance.
- 06Citations to the code and standards.
The standards, then the conflicts they create
What the standards require
Set out competence and confidentiality as the code states them.
Competence in practice
Name evidence-based interventions and what knowing them means.
Where competence fails ethically
Identify outdated beliefs as an ethical problem.
Why confidentiality is stricter here
Explain the consequences that justify heightened protection.
A collision, worked
Take one conflict and reason to a decision.
Consent in advance
Say what you would tell the client before a conflict arises.
Where substance use confidentiality rules actually sit
Recommended databases
- National Association of Social Workers
- PubMed Central
- Federal substance use privacy rules
- Substance use treatment journals
Search sequence
- 1.Read the code sections on competence and confidentiality directly.
- 2.Look up the specific federal rules on substance use treatment records.
- 3.Search for current evidence on medication for opioid use disorder.
- 4.Find a documented case of a confidentiality conflict rather than inventing one.
Reference shortlist
These are authoritative starting points, not a ready-made bibliography. A qualified reviewer must confirm that each source fits the assignment and supports the claim beside which it is cited.
Nothing here is cleared for citation until you have read it.
- 01
Code of Ethics: English
National Association of Social Workers · 2021
The code itself — the source for both standards named in the prompt.
- 02
Minimum Necessary Requirement
Office for Civil Rights, U.S. Department of Health and Human Services · 2026
The general privacy baseline against which substance use protections are stricter.
- 03
The impact of substance use disorders on families and children: from theory to practice
Social Work in Public Health · 2013
How substance use disorders affect families, which is where most confidentiality conflicts arise.
- 04
Exploring a pilot alcohol and other drug (AOD) nurse practitioner mentoring program
Nursing Open · 2024
Building practitioner competence in alcohol and other drug practice.
- 05
Patient Rights and Ethics
StatPearls, NCBI Bookshelf, US National Library of Medicine · 2023
Patient rights and the principles underlying confidentiality obligations.
Review before submission
Common mistakes
- Discussing confidentiality generally without the substance-use-specific rules.
- Naming no evidence-based interventions, which is what the competence standard requires.
- Treating abstinence as the only legitimate treatment goal.
- Listing conflicts without working through how you would decide one.
Submission checklist
- Have you named specific evidence-based interventions?
- Is the heightened confidentiality protection explained rather than asserted?
- Does the post work one conflict to a decision?
- Is informed consent about limits addressed?
Use this guide to plan and review your own work. Follow your institution's rules and read our academic-integrity policy.

Written by
Aaron Bishop
MA, Education
assignment interpretation and research-methods coaching across disciplines
Aaron leads the EssayCrackers editorial desk. He works on how assignment briefs are read — what a rubric is actually asking for, and where students most often answer a different question than the one set.

Reviewed by
Dr. Nathan Cole
PhD, Rhetoric & Composition
Argumentation and thesis development
Nathan teaches first-year composition and directs a university writing center. He reviews EssayCrackers guides for argumentative soundness and citation accuracy.