Can I tell my doctor I smoke weed?

September 4, 2007 8:41 PM

Are there any potential downsides to telling one's doctor that he uses marijuana?

I'm thinking about it getting in my records and being used against me for insurance purposes or possibly getting out. How confidential is this sort of thing?

posted by anonymous to health & fitness (22 comments total)

You are fairly well protected by HIPAA. What is discussed between you & your doctor is confidential.
posted by Argyle at 8:49 PM on September 4, 2007

IANAD or lawyer, but I do know the extent of doctor- patient confidentiality laws varies from state to state. A followup might be helpful.
posted by StrikeTheViol at 8:55 PM on September 4, 2007

How well do you know/like your doctor? You might want to discuss it with him, but rephrase it with, I don't want this leaving this room or being written down in my chart.

Also, ever had any desire to work for the govt? The chances of them getting that particular part of your file in a background check isn't that great, but still if it's even a remote possibility, I wouldn't do it. But then again I'm a little paranoid about these types of things.
posted by whoaali at 8:57 PM on September 4, 2007

Ever since I read about this guy I've refrained from answering doctors' questions about drugs, drinking, smoking, or anything else which could conceivably be compromising. But, like whoaali, I'm paranoid.
posted by enn at 9:06 PM on September 4, 2007 [1 favorite]

I'm Canadian and I'm not worried to tell most people that I smoke weed. But then again, a fourth of us smoke marijuana.

If it's relevant to the "disease/issue" then by all means let him/her know.
posted by PowerCat at 9:07 PM on September 4, 2007 [1 favorite]

I'm currently in an insurance claim suit for a car accident. I had to release all my records. I don't smoke pot, but I was still shocked to learn that I could ever be in a position where I had to *voluntarily* reveal my medical records.
posted by acoutu at 9:18 PM on September 4, 2007

Why are you even considering it? Has your doctor asked?
posted by Poolio at 9:45 PM on September 4, 2007

Ever since I read about this guy I've refrained from answering doctors' questions about drugs, drinking, smoking, or anything else which could conceivably be compromising. But, like whoaali, I'm paranoid.

You're not being candid with your doctors because of one "News of the Weird" type story from three years ago? Seriously?
posted by jayder at 9:46 PM on September 4, 2007

You're not being candid with your doctors because of one "News of the Weird" type story from three years ago? Seriously?

Pennsylvania's transportation agency receives about 40,000 medical reports and revokes 5,000 to 6,000 licenses a year but does not keep any statistics on its reasons for doing so, Nissley said.

I'm not sure what makes this a "'News of the Weird' type [sic]" story in your eyes. I have a number of reasons for failing to be candid, the balance of which are not directly relevant to the question and which I consequently omitted, but all of which lead me to believe this story is unusual only in having made the news.

Let's take any continuation of your derail to email, shall we?
posted by enn at 9:56 PM on September 4, 2007 [1 favorite]

Depending on the prescribing doctor, I've heard that illegal drug use in your charts might make it harder to get prescriptions for medications with a potential for abuse, like vicodin or adderall... even if you really need them.
posted by glibhamdreck at 10:00 PM on September 4, 2007 [1 favorite]

A large part of HIPPA is detailing when the providers can/have to release medical information. I would never advise on what you should or should not say to your doctor because circumstances vary, but there are any number of circumstances under which what is in your charts can be released to the authorities and sometimes insurance companies.
I, personally, would not have that type of info in my charts if I could avoid it. Now, if there is a legitimate medical reason to confide in your doc immediate medical necessity trumps fear of future legal concerns.
posted by edgeways at 10:09 PM on September 4, 2007

"I've heard that illegal drug use in your charts might make it harder to get prescriptions for medications with a potential for abuse."

Even looking "disreputable" has that effect; if you think you need Vicodin be sure to be shave and wear a suit and tie to the doctor's office.

I can see that the doctor knowing you "abuse" one "substance" or another might affect their medical and/or prescription decisions, e.g., it makes sense not to prescribe something liver-damaging or brain-addling to someone you know is an alcoholic, and it's good to be able to come clean about such things to your doctor so s/he can keep them in mind. Requiring that doctors snitch on people would be counterproductive in that sense; if I were making rules I'd penalize doctors that blabbed. But then IANADOL, and I've been told many times that what makes swense to me is weird, so...
posted by davy at 10:37 PM on September 4, 2007 [1 favorite]

I tell my dentist.
posted by klangklangston at 10:57 PM on September 4, 2007 [2 favorites]

unless marijuana use is somehow relevant to the condition for which you seek treatment, don't tell him!
posted by bruce at 11:44 PM on September 4, 2007 [1 favorite]

unless marijuana use is somehow relevant to the condition for which you seek treatment, don't tell him!

Catch-22. If you're not a doctor, how are you supposed to know whether or not it's relevant?
posted by 0xFCAF at 4:01 AM on September 5, 2007

As a doctor, I'd recommend that you don't need to worry too much about this. Even if the Hivemind all advised you to disclose freely, it's not like you're going to go straight to your doctor and blurt out your entire history of recreational drug use. As and when you get a) a chest infection b) mental health issues c) hypertension d) some other stuff I can't think of now, your doctor may or may not choose to ask you about recreational drug use. i.e. "unless marijuana use is somehow relevant to the condition for which you seek treatment" your doctor won't ask, and doesn't need to know. You can let your doctor take responsibility for this. As and when they do need to know, you need to discuss confidentiality issues with them first, relevant to your local laws and insurance provider, so that you feel safe being honest with them.
posted by roofus at 4:24 AM on September 5, 2007

roofus, as a doctor, would you say most doctors would be willing to honor a patient's request that information about his/her recreational drug use not be included in medical records that might later be released to police, lawyers or insurance companies? Is that something that doctors are willing to do, in your experience?
posted by mediareport at 4:30 AM on September 5, 2007

roofus: In my experience as a patient, and being graded on mock/moot interviews, they make us go into drug use details for the new patient interview. It was actually pretty funny observing a classmate of mine giving a patient in the hospital a we're-just-practicing-here interview and having no idea what drugs she was talking about. I could easily believe that many doctors don't go into it right away, since your patient is just going to lie to you anyway.

That said, I lie to my doctor just like I lie to anyone else in a position of authority who asks about drug use. If I had roofus's three I would probably tell. Also if I had random weight gain, pain issues, or social problems which might be related to my drug of choice.
posted by a robot made out of meat at 4:59 AM on September 5, 2007

What is discussed between you & your doctor is confidential.

Don't believe the hype. All manner of people get to see your records. HIPAA just means that you have to sign a permission for them which you do all the time for insurance etc. Frequently this means your employer gets to see them. I would keep this to yourself.
posted by caddis at 5:57 AM on September 5, 2007 [1 favorite]

I ask all my patients about smoking history, use of alcohol, and other drugs, as I generally prefer not to assume anything about my patients based on their appearance or social status. (What, newly rich dot-commers going through alcohol withdrawal? That's impossible! Not when they're having a bottle of wine every night with dinner.)
posted by gramcracker at 6:38 AM on September 5, 2007

acoutu nailed what I would be most worried about.

If you are involved in future litigation, your past medical records will be turned over and you could be questioned/deposed about the contents.
posted by Sheppagus at 10:42 AM on September 5, 2007

When you apply for life insurance, you will sign a waiver saying that it is ok for your doctor to send your records to the insurance company. So HIPPA is irrelevant when you waive that right.
posted by about_time at 11:10 AM on September 5, 2007