Seeing your Therapist as an Ally

Your therapist is trying to help you. This therapist may be your methadone doctor, psychiatrist, family doctor, counselor, psychotherapist,etc. In any case, they are trying to help you. In order to help you, they need all the information that you can give them. If you hold back some information, they may be missing some very important things that could affect your care. It is to your benefit to have full disclosure with your therapist.

In my addiction medicine practice, one area of dishonesty is cheating on urine drug screens (UDS). If you used street drugs, and are worried about losing carries, be reassured that you only lose one carry, and get it back the following week if your UDS is does not show street drugs. However, if you get caught cheating, you lose all your carries, and cannot get a new carry for one full month. If you cheat a second time, then you lose all carries and cannot get a new carry for three months. This would also seriously erode the trust between you and your doctor. It takes a long time to regain this trust.

It is much better just to be honest, lose the carry for one week, and move on. If you think about it, cheating on your UDS can seriously compromise your own recovery.

Being honest about what drugs you are using has other benefits. A major component of addiction is dishonesty to yourself. If you lie to your therapist, you can more easily lie to yourself. Not lying to your therapist will help you not lie to yourself.

Another benefit of honesty is showing your therapist your commitment to getting better. I have seen many patients come in and tell me “my UDS screen is faulty because it is showing that I did not use, but I did.” They know full well that they will lose a carry by telling me this, even though the UDS is negative. When I mention this, the reply I usually get is “I know, but I really want to get better.” This speaks volumes. You lose a carry for using drugs for your benefit alone. It is very important that you understand this.

Your therapist is your ally. Be honest, tell them all the street drugs that you use – even if they don’t ask you – and don’t hold back. Only then can your therapist fully help you. Your therapist wants to help you.

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