Should you tell your doctor about your drug use?

Uh oh. You took a marijuana edible Friday night—just a tiny one—and now it’s Tuesday, and you’re sitting in your doctor’s office and she’s just asked you about your drug use.

Do you tell her?

Is it even that big of a deal?

As a family medicine physician, I can tell you those answers: Yes, and maybe.

The fact is, I can treat you better if I know what you’re putting into your body. You aren’t going to shock me—you’d be surprised by how many people use drugs—and you won’t upset me. You won’t get in trouble. But I do need to know.

Here are some questions you may have felt too embarrassed or worried to ask about drug use and your doctor, and some answers that I hope put your mind at ease.

Should you disclose your illegal drug use to your doctor?

Absolutely. It’s important for your doctor to know all of your medical history, including any prescription or recreational drugs. Some illicit drugs can interact with medications. Depending on the drug, they can also have negative effects like causing high blood pressure, insomnia, depressed mood, persistent nausea, heart attacks or irregular heart rhythms. If your doctor doesn’t know everything you’re taking, then they won’t be able to treat you as well.

What if it’s just, say, a single edible over the weekend or drugs you did years ago?

It’s always better to disclose too much than too little to your doctor. Even if you used drugs a long time ago in high school or college, it’s still a good idea to let your doctor know. They might want to do extra blood tests depending on what drug you use. Even small infrequent drug use can have serious effects on your body.

What if you’re taking someone else’s prescription medication?

Your doctor should know everything you take. Even if it’s ibuprofen or over the counter cough syrup, we need to know. We don’t advise taking someone else’s prescriptions. Something that’s safe in one person might be dangerous in another, depending on their medical history. However, it’s good for your doctor to know if you took someone else’s medication because if it worked for you and is a safe option, your doctor might prescribe it for you.

If you do tell your doctor, can you get in legal trouble? Is your doctor allowed to report you to the authorities?

No. Your doctor isn’t legally allowed to report drug use to the police. The only situations in which doctors can break confidentially is if there’s concern about someone seriously harming themselves or others. Our main focus is on your health and how to partner with you to improve your health. We really have no interest in getting anyone in trouble.

Could drug disclosures affect your health insurance?

Not that I’ve seen. Insurances do have access to that information, including a summary of every condition your doctor treats you for. But I haven’t had patients have any issues with insurance because of drug use. Drug use is more common that we realize.

Will your doctor judge you for your drug use? Could it affect how they treat you or whether they prescribe other medication?

It shouldn’t affect the way your doctor views you. Lying or not disclosing important information will. It typically doesn’t affect how we’d prescribe medications. However, if I have someone who tells me that they used to be addicted to Percocet in the past, then I will try to use alternative non-opiate medications to treat their pain because I don’t want to contribute to them falling into that addiction again.

Rachael McGuirk is a family medicine physician at The Ohio State University Wexner Medical Center and an assistant professor in the Ohio State College of Medicine.