Many people suffer from substance use disorder (SUD), but few people want to talk about it. This is typically because of shame, guilt, and the fear of judgment from other people. Even those who want to seek help for their drug or alcohol addiction may hesitate to receive proper treatment because of the stigma surrounding rehab.
But ultimately, talking to someone about your personal issues may feel like a huge relief. A therapist may be able to help, especially when it comes to topics like illicit drug use. However, for those who are dealing with these issues, seeking help from a professional might not seem so straightforward.
Given the illegal nature of certain drugs, you might find yourself asking, “Can I even talk to my therapist about my drug use without facing serious consequences?” [1]
The short answer to this question is yes, you can. In fact, for many people, bringing up drug use in therapy is one of the most important steps toward understanding their habits and figuring out how it fits (or doesn’t fit) into their life.
Here we will cover everything you need to know about talking to your therapist about illicit drug use—what to expect, how it’s handled, and why it’s probably not as scary as it seems.
Why it’s Okay to Talk about Drug Use
The first thing you need to remember when it comes to speaking to your therapist about your substance use is that they are trained for this.
Therapists are trained professionals. They have spent years studying mental health, human behavior, and even addiction. If you’re using illicit substances, you’re not the first person to sit in front of them with that problem. You won’t be the last either.
Remember that substance abuse is common. According to the National Institute on Drug Abuse (NIDA), millions of people in the U.S. use illicit drugs every year, and many of those people seek therapy.
In fact, the National Survey on Drug Use and Health found that about 20% of people who visit a therapist report issues related to substance use at some point. So, therapists are used to hearing about it, and the best part is that they have the tools to help.
The Role of Confidentiality in Therapy
Confidentiality is one of the cornerstones of therapy. When you go into a session, your therapist is bound by ethical guidelines and state laws to protect your privacy. This means that everything you say in therapy is confidential, with very few exceptions. [1]
The American Psychological Association (APA) outlines strict rules about what can and cannot be shared outside of the therapy room. Generally speaking, your therapist cannot report your illicit drug use to anyone, including the police or your employer, unless it falls under certain exceptions, which we will cover shortly. [1]
This confidentiality exists so you can feel safe enough to share anything you need to, even something as potentially sensitive as drug use.
Why Talk About It at All?
Bringing up drug use in therapy can open the door to honest conversations about how it’s impacting your life—mentally, emotionally, physically, and even socially. Here are a few reasons it’s worth talking about:
- Support and Understanding: Therapists provide a safe, non-judgmental space where you can express your feelings and experiences related to addiction. They understand the complexities of addiction and can help you feel less alone. [2]
- Identification of Triggers: A therapist can help you identify the underlying triggers and patterns that contribute to your substance use. Understanding these can be vital in developing strategies to cope with them.
- Developing Coping Strategies: Speaking of coping, therapy can provide you with tools and techniques to manage cravings, cope with stress, and navigate situations that might lead to relapse.
- Exploring Underlying Issues: Substance abuse is often linked to underlying mental health issues such as anxiety, depression, or trauma. Addressing these issues can be important in the recovery process. [2]
- Setting Goals: A therapist can assist you in setting realistic and achievable goals for your recovery, providing motivation and accountability along the way.
- Building Healthy Relationships: Therapy can help you improve your interpersonal skills and build healthier relationships, which can be vital for a supportive recovery environment.
- Relapse Prevention: Therapists can work with you to create a relapse prevention plan, helping you anticipate challenges and strategize ways to overcome them. [2]
- Long-Term Recovery: Engaging in ongoing therapy can support your long-term recovery efforts, helping you maintain sobriety and adapt to life without substances. [2]
Being open about your experiences with drug abuse can be the step in the right direction so that you can begin your journey to long-term recovery.
Common Fears and Misconceptions
Even though therapists are supposed to be nonjudgmental and confidential, people often have specific concerns about bringing up illicit drug use. Let’s address a few of those common fears:
“My Therapist Will Judge Me”
Therapists are human, and humans have biases, but a professional therapist is trained to approach all topics—including drug use—with empathy and understanding. If you feel judged, it might not be the right therapist for you. Most therapists, though, will not react negatively to you discussing your drug use; instead, they’ll explore how they can help.
“My Therapist Will Call the Cops”
This is one of the biggest misconceptions. In almost all cases, a therapist cannot and will not call law enforcement about your drug use. Even if you admit to using illegal substances, the therapist’s job is not to act as a law enforcer; it’s to help you.
“My Therapist Will Drop Me as a Client”
It’s rare for a therapist to stop working with you solely because you admit to using drugs. If they do, it’s usually because they feel they’re not equipped to help with addiction or drug-related issues. In that case, they’ll often refer you to a specialist rather than simply abandoning your care.
“I’ll Be Reported to Someone Else”
There are specific cases where therapists are legally required to break confidentiality. These are usually related to safety concerns and not to personal behaviors like drug use. Here’s when a therapist is obligated to break confidentiality:
- Harm to self: If you express that you’re planning to harm yourself (e.g., suicidal ideation), a therapist may need to intervene.
- Harm to others: If you express intent to harm someone else, especially if you name a specific person, a therapist may need to take steps to protect that individual.
- Abuse: In cases of child abuse, elder abuse, or dependent adult abuse, therapists are mandatory reporters and are required by law to report these situations to authorities.
Notice that drug use alone is not on this list. You won’t be reported simply for admitting to taking drugs.
Harm Reduction vs. Abstinence
Not everyone who talks to a therapist about drug use wants to quit entirely, and that’s okay. In fact, some therapists take a harm reduction approach rather than pushing for total abstinence.
Harm Reduction
Harm reduction is a pragmatic approach to substance abuse that emphasizes minimizing the negative consequences associated with drug use rather than requiring complete cessation. This philosophy recognizes that while abstinence is a goal for some, it may not be realistic or achievable for everyone. [3]
Harm reduction strategies can include providing clean needles to reduce the risk of infectious diseases, offering supervised consumption sites to prevent overdose, and promoting safe use practices. By focusing on reducing harm, this approach seeks to improve the overall well-being of individuals, supporting them in making informed decisions about their substance use.
Harm reduction acknowledges the complexities of addiction and aims to create a non-judgmental environment where patients can access resources, education, and support tailored to their specific needs.
Abstinence
On the other hand, abstinence advocates for the complete cessation of substance use as the primary goal of treatment. This approach is often rooted in the belief that any level of substance use can lead to a relapse or worsening of addiction. [3]
Abstinence-based programs typically involve comprehensive treatment strategies, including counseling, support groups, and sometimes medication-assisted treatment (MAT). The goal is to help patients overcome their drug dependence.
This model can be empowering for many, as it promotes the idea of reclaiming control over one’s life without the influence of substances. However, abstinence can also be challenging, as it may not address the underlying issues of addiction for everyone. [3]
Critics argue that this approach can stigmatize those who continue to use substances, potentially alienating individuals who may benefit from a more gradual and supportive method, such as harm reduction.
What to Expect in Addiction Counseling
Therapy and counseling are only one aspect of a complete addiction treatment program. It works best when combined with other treatment approaches such as medical detox and behavioral therapy.
If your drug use is severe and you’re struggling to control it, you might benefit from specialized addiction counseling. This is a structured therapeutic process designed to help patients engage in open and honest discussions about their experiences, feelings, and motivations related to their addiction. [4]
Addiction counselors focus specifically on helping people manage substance use and develop coping strategies for recovery. They often employ various evidence-based techniques, such as cognitive-behavioral therapy (CBT), motivational interviewing, and relapse prevention strategies, to help clients identify triggers and develop coping mechanisms. [4]
It is very important for therapists to create a supportive and non-judgmental environment so that their clients are able to freely explore their thoughts and emotions.
Throughout the counseling journey, clients can also expect to set achievable goals, monitor their progress, and build a strong support network—all of which are crucial for long-term recovery. At the end of the day, therapists and counselors aim to empower individuals so that they can understand the underlying issues contributing to their addiction and equipping them with the tools necessary for a healthier, substance-free life. [4]
Talking to your therapist about your illicit drug use can feel intimidating, but it’s a crucial step toward understanding yourself and finding healthier coping strategies.
Remember, drug use is common, and many people navigate similar challenges. By bringing it up in therapy, you’re taking an important step toward personal growth and healing. Whether you seek harm reduction strategies or aspire to quit altogether, your therapist can guide you through the process.
If you or someone you love is struggling with drug addiction, look for a rehab near you today and learn more about the different treatment programs that are available. Don’t hesitate to seek help. You may find that it’s the key to unlocking deeper insights about yourself and ultimately leading a healthier, happier life. The road to recovery begins here.
Sources:
[1]: https://www.amahahealth.com/blog/can-i-talk-to-my-therapist-about-my-illicit-drug-use/
[3]: https://willingway.com/abstinence-harm-reduction/
[4]: https://www.webmd.com/mental-health/addiction/counseling-and-addiction-how-therapy-can-help
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— RehabNearMe (@RehabNear_Me) September 27, 2024
