You're
a social smoker who only drinks on the weekend and you've never done drugs.
Riiiiiight
by Stephanie
Thurrott | April 30, 2019
When Denise Connell’s doctor asks her
about drinking alcohol, she replies in a way that might sound familiar: She’s
not entirely honest. She says that she drinks socially on weekends.
“I do drink socially
on weekends,” the Dedham, Mass., resident says. “But I also drink socially
during the week.”
Most weeknights,
she’ll have a glass of wine with dinner, and another in the evening. And on the
weekends, she might open a bottle of wine in the afternoon and finish it by the
end of the night.
Christina Raup of
North Smithfield, R.I., also downplays her alcohol use.
“I drink with the
express purpose of getting a buzz,” she says. “I can’t tell them that. I say I
have a couple of drinks once in a while.”
And as for her
history of drug use?
“I outright say no,”
she admits.
Why lie?
You might downplay or
lie about your habits because you don’t want to be embarrassed or feel judged.
In Connell’s case, she’s not just a patient. She worked as her doctor’s medical
secretary for six years.
“When
a doctor seems judgmental, they are inviting patients to lie.”
Donna
Casey physician
in Dallas
“I don’t want her to
think I’m an alcoholic,” she says. “I don’t want her to feel disappointed, or
say I’ve got to stop.”
It’s the same with
Raup, who also says she doesn’t want to feel like her doctor is judging
her.
It’s something
doctors need to watch for in themselves.
“When a doctor seems
judgmental, they are inviting patients to lie,” says Donna Casey, M.D., an
internal medicine physician on the medical staff at Texas Health Presbyterian
Hospital Dallas.
“I try to be open and
understanding and let people talk,” she says.
You might also be
leery about sharing information because you don’t want it showing up in your
medical record.
Sterling Ransone Jr.,
M.D., a spokesman for the American Academy of Family Physicians who practices
in Deltaville, Va., notes that security on medical records is very high. That
said, doctors may have some leeway about what they enter into the system.
“Depending on what it
is, it can be a matter of discretion,” he says.
You might not be
fooling anyone
Does your doctor know
you’re lying? Maybe.
“I usually can tell,”
says Ransone. “I’ve done this long enough that my BS meter is on.”
Here’s what doctors
watch for:
·
People
who aren’t making eye contact, or who change the cadence of their speech and
start adding fillers like “uh,” “yeah,” and “you know.”
·
The
smell of cigarettes, which smokers often don’t notice. A (nonsmoking) doctor is
likely to pick up the scent on clothing or hair right away.
·
Downplaying
alcohol use, which is so common that doctors are trained to increase the amount
they hear from patients—Casey says she was taught to quadruple the
number.
·
A
high heart rate, which can signal the use of amphetamines or Adderall, commonly
used for weight loss. “It’s a federal crime, but you can buy these drugs and
have them delivered to your house. You wouldn’t believe how many people do it,”
Casey says.
·
Urine
screens that show marijuana use. People often don’t admit to their doctors that
they use marijuana, especially in states where it isn’t legal,
“I’ve
done this long enough that my BS meter is on.”
Sterling
Ransone Jr. American Academy of
Family Physicians
Fibs and health risks
When doctors ask
about drinking, smoking, and drug use they aren’t just hoping to launch into a
lecture—they know that these habits are linked with health problems.
“I want to help you
live a long, quality life,” Casey says. Ransone agrees. “My goal from a
doctor’s standpoint is for you to be as healthy as you can be,” he says.
The health risks of alcohol,
smoking, and drug use are well known. Excessive drinking can lead to high blood
pressure, liver and kidney damage, and increased cancer risk.
Smoking cigarettes is
linked with high blood pressure, asthma, flu, bronchitis, COPD, and lung
cancer. Smoking marijuana can lead to bronchitis and lung damage. People with a
history of IV drug use are at higher risk for hepatitis C.
And mixing alcohol or
drugs with other medications can also cause problems. Combining alcohol or
marijuana use with drugs like Benadryl or some prescription medications for
urinary incontinence can trigger a high risk for falls. Drinking alcohol while
you’re taking antidepressants can increase your risk of blacking out.
Doctors might also be
concerned about your mental or emotional health. Are you drinking as a coping
mechanism? Have a few cigarettes before bed because you need a break? These
habits can fill a need.
“People don’t want to
tell me these things,” Casey says. “They are embarrassed.”
Coming clean
If you’ve been
fudging the facts with your doctor but overall you’re happy with your care, you
might want to fess up.
“I recommend
honesty,” Ransone says. “You can say something like, ‘Last time we talked, I
said I have one drink at night, but honestly, it’s probably two or three.’”
“Some
people are going to drink or smoke no matter what, even if it cuts their life
short. I appreciate their honesty.”
Donna
Casey physician
in Dallas
If people are honest,
she says, “I can help them get rid of the substance or manage their lifestyle
so they aren’t at increased risk.”
A good doctor will
work with you to help you stay as healthy as possible regardless of your
choices.
“Some people are
going to drink or smoke no matter what, even if it cuts their life short. I
appreciate their honesty,” Casey says.
In those cases, she
might recommend more frequent x-rays or liver enzyme tests to watch for signs
of trouble.
And if you don’t feel
comfortable being honest with your doctor, it might be time to make a
change.
“If you’re worried
about telling your doctor,” Ransone says. “I wonder if you should find a new doctor.”
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