It’s Important to Be Honest About Substance Use with Your Doctors: Here’s Why

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We often tell “little white lies” to our healthcare providers in terms of our diet, exercise, taking our medications as prescribed, and the amount of alcohol (and if we consume any drugs) we drink. We may say that we eat healthy, but in reality, we have a soft spot for fried food and drive-thru restaurants. We may say we consume two drinks per week when we consume five drinks per day. We may deny any drug use when we are struggling with substance abuse. Studies have shown that up to 80% of patients withhold information or lie to their physicians.

Why do patients lie to their doctors about substance abuse?

Studies have also shown that patients do not do this out of spite or maleficence but because they fear being judged or shamed and don’t want to be lectured by their physician if they do admit that they are not exactly the “perfect patient.” The physician-patient relationship is based on trust and honest communication. Although there are laws in place to protect patient-physician confidentiality, it is still very difficult to disclose that a patient is struggling with alcohol or drug use or with their mental health.  

It is also possible that some patients don’t think they have a problem, so they believe it is pointless to talk to their physicians about it. Some patients don’t want this information in their medical records, are not ready to talk about these issues, fear being reported by an authority or agency, or fear being mistreated by medical staff based on stigma. Most of these reasons are valid, and it is understandable to feel vulnerable when self-disclosing about substance abuse to a primary care provider. 

However, it is crucial to be completely honest with your doctor about how much you are drinking or if you are abusing any drugs. This will help you receive effective treatment and may save your life.

What happens if I don’t tell my doctor about my substance misuse?

For some of the reasons stated above, it is understandable why some people find it difficult to be honest about their substance use with their primary care provider. However, not being truthful about substance use can have significant implications and consequences on your health, ranging from mild to potentially fatal.  

For example, suppose the patient is dishonest with their physician about their substance misuse. This inaccurate initial assessment could lead to misdiagnosis and incorrect treatment (incorrect medications, wrong treatment plan). This can cause ineffective results or potentially dangerous outcomes, not to mention a waste of money and time. 

Here are a few examples of these consequences:

• Substance use history is directly related to your medical treatment. While this is something that people often do not want to disclose when they are admitted to the hospital, not disclosing substance use could create more health problems. For example, if you have been using cocaine and are having a heart attack, certain standard treatments might make it worse.

• Common mild to moderate symptoms of withdrawal from alcohol and benzodiazepines can feel like anxiety symptoms and can even lead to panic attacks. Sometimes, people obtain a mental health therapist or psychiatrist or inform their primary care provider of their symptoms without sharing information about their substance use.

  You can be accidentally treated for anxiety when, in fact, you are withdrawing from benzos or alcohol. Not disclosing one’s substance use history can lead an individual to endure potentially ineffective treatment. Withdrawal from alcohol or benzodiazepines can cause seizures, and these withdrawal symptoms can be potentially fatal if not medically treated.

• Specific drug interactions can be harmful. Some combinations make the medications stronger or weaker; some can even cancel each other out, making them ineffective.

• Suppose you are admitted to the hospital for an overdose. In that case, it is imperative that you share with your doctor exactly what substance you took so they can administer the proper medication to save your life. 

How to be honest with your doctor about drug use

While being honest with your doctor about your substance use may be difficult, the following can provide positive support for why you should be honest with your doctor.

Doctor-Patient Confidentiality: You don’t have to worry that disclosing your drug use to your doctor will get you in legal trouble. Per federal law, your doctor is bound by confidentiality and cannot release your information to a third party without your permission. Additionally, a prosecutor cannot call your doctor against you in a legal trial.

Your doctor is on your team: Your relationship with your doctor works best if you collaborate and work as a team for your treatment. To ease your anxieties about being honest about your health, you can think of your primary care provider as a scientist simply collecting data. They need honest answers from you in order to assess and treat the presenting concern accurately and effectively.

Your doctor is a resource: Your doctor may be able to provide objective feedback about the severity of your substance use and make referrals to specialists to determine the level of care that you need. Consider your doctor an important resource.

Your doctor has seen everything: Your doctor has spent many years or decades tending to a wide variety of needs for their patients. They have seen it all. While you may feel like your situation is too difficult or unique for a doctor, they have likely treated similar cases in the past. 

You may consider switching doctors: If you do not feel that you can be honest with your primary care provider, it may be time for a new doctor. You must feel comfortable and supported by your primary care provider. 

Blood work does not lie: Even if you do not disclose your substance use, your blood work and urine can indicate a high possibility of substance use.

Put your health first and seek help

Disclosing substance abuse to your health care providers is imperative to effectively tend to your health. Not being honest with your primary care provider can have serious implications and consequences. Find a compassionate and knowledgeable doctor that you can trust and be honest with about your substance use history. 

If you are struggling with drug or alcohol abuse, your doctor may recommend that you seek professional addiction treatment from AKUA Mind Body. This is meant with your best interest in mind so you can work towards living a healthy and fulfilling life.   

If you or a loved one has an addiction and are ready to find a rehab, contact a treatment provider at AKUA Mind Body today to discuss treatment options.