For many reasons, it may be difficult to discuss substance abuse and addiction openly with your doctor. However, your doctor's office is perhaps one of the most important places for you to be completely honest.

Why Lie?

You may find that you have one or more of the following reasons for blatantly lying, distorting the truth or omitting important details.

  • Shame: Although attitudes are changing for the better, addiction still carries an unfortunate stigma among some Americans. Many people have internalized the idea that addiction is morally or ethically wrong, rather than a complicated medical condition influenced by numerous genetic and environmental factors.
  • Pride: Some people may worry that their physician will judge them if they tell the truth about their addiction. Keep in mind that although your doctor has more training in this specific area than you do, he or she is still human and may have a friend or family member who has struggled with addiction; or might even be a recovering addict themselves. Your doctor's first responsibility is to you and your health.
  • Legal Problems: Abusing alcohol is not illegal, but abusing cocaine, heroin and a number of other drugs clearly is. Addicts and well-intentioned family and friends may weigh quality medical care (i.e., being candid with a doctor) against the possibility of a damaged reputation, legal problems and even possible jail time, depending on the substance. However, it is a violation of the federal Health Insurance Portability and Accessibility Act (HIPAA) for anyone with access to your health information to share it without your permission.

Privacy Policies

Certain parties are exempt (insurance companies may be granted access to records to determine if treatment is justified, in order to warrant their payment), but doctors, therapists and others privy to this confidential information cannot simply call police and say, “I want to report a crime" unless certain conditions are met.

For example, if the doctor has reason to believe you will hurt or kill yourself or another person, they may put you on a hold and the information may be submitted to a court system. If the addict is engaged in or the victim of child abuse, the doctor may be required by law to report it. If you are concerned about how your honesty in a health care context can affect you in other areas, you should consult an attorney about the specifics of your situation and the laws of your state.

Why Being Honest Will Benefit You More

Doctors try to obtain a complete picture of who you are when they take your medical history. Because symptoms and conditions are connected with each other and with your environment, omitting facts about your life will change the doctor's understanding of your physical health.

Most drugs of abuse are associated with short- and long-term health consequences that your doctor may be able to predict, monitor and warn you about. Additionally, if you actually are addicted to a substance or behavior, your doctor can help you address the root of the problem, which is always more complicated than a simple lack of willpower. Most addicts turn to substances to cope with other problems, and a doctor's job is to help the addict stop physical and psychological dependence by directing the person to healthy alternatives.

If you have been keeping the truth from your doctors, it may be time to evaluate why. Schedule an appointment, tell them what's really going on and get on the path to recovery.