Can you tell your psychiatrist about drug use?

You have the expectation that you can talk about anything in therapy and that your therapist will not tell anyone what you have said. You are wondering if this applies to illicit substances because these substances may be a part of the problems you are experiencing. You are concerned about admitting these issues to a therapist, but in most cases, what you tell your therapist will remain confidential.


Confidentiality in the Therapist’s Office.

In most states, you have the privilege of being able to tell your psychiatrist anything, and the medical professional would be required to keep it confidential. In other words, your therapist cannot repeat anything that you say during therapy in any environment outside of therapy, but there may be exceptions to this rule.

Times When Confidentiality May not Apply.

If you live in California, a psychiatrist may violate the confidentiality agreement in the following circumstances:

  • Sometimes, a therapist needs to consult with other therapists to ensure that he or she is practicing the profession in the correct manner. In the event that your therapist has a question about a legal matter, he would be required to protect your identity. He would give the other person only the amount of information that is required to provide an adequate answer to the question.
  • After a therapist receives an order from the court to testify, he would be required to answer any questions truthfully under oath.
  • In the event that you wanted another medical professional or a family member to know information about you, you would need to give your therapist permission to speak with these people first.
  • If law enforcement authorities suspect someone of abusing a disabled person, an elder or a child, the therapist would be required to disclose information about a client.
  • In the event that you are deemed to be a danger to yourself or others, a therapist may not honor your confidentiality agreement for the purpose of keeping people safe.

Disclosing Drug Use during Therapy.

You may be concerned about seeing a therapist if you are using illicit substances, and this may be the reason that you are not currently getting treatment for your substance and mental health issues. If you are experiencing a mental health disorder, it is imperative that you obtain professional help for that issue. It is also important for your therapist to know that you are ingesting substances because your mental health disorder needs to be treated with your substance use disorder. You are not likely to recover from either condition if they aren’t treated at the same time.

If you are afraid of obtaining treatment for either or both issues, you can rest assured that it is highly unlikely that your therapist will report your substance use to the police. First, the laws of confidentiality discussed above require your therapist to keep this information confidential. Second, the Health Information Portability and Information Act or HIPAA requires medical professionals to keep all mental or physical information from being viewed by anyone without permission to see such information.

Some people are allowed to see this information, and they include anyone involved in your care, such as your insurance company, your doctors and pharmacists. Some states will give this information to law enforcement agencies in the event that they are investigating a crime.

Will Your Therapist Ever Have Reason to Disclose Your Substance Use?

Yes, this can occur because some laws require therapists to report substance use under certain circumstances. For example, a teacher may need to be reported for substance use because of her proximity to children. In most cases, your therapist will be required to report your substance use to authorities if you do any of the following:

  • You inform your therapist that you committed a crime.
  • You tell your therapist that someone else is currently endangering your life.
  • You let your therapist know that you were involved in substance use when children were present.
  • You tell your therapist that you are going to hurt yourself or another person.

When you seek help from a therapist for substance use, your therapist wouldn’t necessarily need to report the substance use. Therefore, if you see a therapist for the first time today, you don’t have to worry that the therapist will contact the police right after you leave the office. A professional is there to help you conquer your dependence on substances and would rather help you do that than report you.

Telling Your Therapist about Your Substance Use.

If you are thinking about informing your therapist that you have been using illicit substances, you must consider a few things before you do so. Your therapist must know about any substance use because your therapist cannot create the most effective treatment plan if he or she doesn’t know that substances are an issue. Leaving this information out of your conversations denies your therapist the ability to accurately assess your current situation.

Generally, if there are things that you are leaving out of your therapy sessions, the therapy that you receive cannot be as effective as it needs to be. It may be that you are not telling your therapist about your substance use because you would rather focus on other issues, but this approach rarely works. Your substance use is an important part of your life, and if your therapist is unaware of it, he or she cannot incorporate it into your therapy for the purpose of developing the most efficient therapy possible.

You May Believe that Other Issues Are More Important than Your Substance Use.

You may have sought a therapist because of issues that are not related to your substance use. That may be the reason that you continue to resist telling your therapist about the substance use. You believe that substance use will be the focus of therapy after you disclose it. Besides that, you may know that you have problems in other areas and that you are not particularly unhappy about your substance use. If you tell a therapist that you are using substances, you don’t want the therapist to try to convince you to stop.

If you are seeing a therapist outside of a treatment center, the therapist you choose will be aware that the choice to stop using a substance is entirely up to you. However, your substance use may be impacting your other issues, so you may need to accept help for your substance use disorder so that you can get adequate treatment for your other issues as well.

What If My Therapist Doesn’t Understand My Substance Use?

It’s possible that a therapist outside of a treatment center would not understand substance use issues. If you are unwilling to enter a treatment center, you may not need to discuss your substance use so that you can avoid problems with your therapist.

Even so, it is a good idea for you to tell your therapist that there are things that you do not wish to discuss in therapy, and let the therapist know why you feel that way. If the therapist has expressed negative feelings about substance use, you must let this person know that you are taking substances, but it’s not necessary to state exactly which substances you are using. You can just say in general terms that you are hesitant to mention certain things because you are afraid of the therapist’s reaction.

These discussions must be approached carefully because you are taking the risk of hurting your therapist’s feelings. That’s because it may seem to your therapist that he isn’t doing his job correctly. You may really like your therapist, so you may wish to avoid offending him at all costs. If this situation comes up, you must remember that you are in the therapist’s office because you are asking for help. Your therapist will agree that your health is the main purpose of your therapy sessions.

Your therapist is there to help you. This person doesn’t want to become an investigator for the police department and isn’t ever looking forward to the times when he or she will need to break confidentiality. If you are unsure of whether or not something you could say would need to be reported to someone, discuss this with your therapist. You and your therapist will talk about the benefits and the disadvantages of disclosing any sensitive information.

The best thing would be for you to enter into a treatment program at Mid Hudson Addiction Recovery. You may have a mental health disorder that requires treatment, and you can obtain this treatment at Mid Hudson Addiction Recovery. Treating substance use disorders and mental health disorders at the same time is the best way to have a full recovery from both. If you are only experiencing a substance use disorder, you must be able to discuss this issue with your therapist so that you can receive the help you need to become free of substances. Stop being afraid that you will be found out and contact us to get help for substance use today.


  • Can you tell your psychiatrist about drug use?
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