Does your doctor talk with you about your use of addiction substances?

MUDr. Bc. Jana Malinovská
May 8, 2021

Talk with your doctor about your drinking, smoking or drug use

How often does your doctor ask you how often and how much of alcohol do you drink, whether you use any drugs or whether you smoke and how many cigarretes a day? And if he asks you, does the discussion on this topic end with your answer or does the doctor provide you with feedback on your addictive substance use?

Whilst most doctors ask their patients on smoking and drinking, they often do not ask about use of other addictive substances. Sadly, a significant part of doctors do not realise that question on addictive substance use should never stand alone; the answer from a patient should be followed by brief feedback, either positive or negative. That means that the feedback can be in a form of approval that the patient does not smoke, does not use drugs and drinks only alcohol within low-risk range (followed by a reminder what are the low-risk amounts of alcohol). In case the patient indicates using addictive substances to the extend that is risk to the patient, then the doctor should provide the patient with professional feedback, advice and information so that the patient receives all the essential information to make an informed decision.

It is important to emphasise that a doctor is not someone who will judge you. On the contrary – a doctor should be a person who you trust and are not afraid to tell the truth to. We are only people and we are not always able to objectively assess our situation. With regards to the addictive substance use, we can think that we know what we are doing, and that we have everything under control. If we think we see our situation clearly, we should not be shy to discuss this with our doctor. Our doctor can confirm that this is right and we indeed have the situation under control. If we do not see our situation realistically, that the doctor can provide us with his professional opinion of an unbiased observer. This feedback can help us realise some things that we might not see ourselves otherwise.

A doctor is also someone who is aware of any treatment advances and developments and is able to advice on what to do next. In case of smoking cessation, a doctor can provide you with the lastest information on the addiction treatment options, including the pharmacological supportive therapy that can help you overcome the difficult period of withdrawal when you stop smoking.

Don’t be afraid to talk to your doctor freely about your use of addictive substances. Use the time with your doctor to find out about relevant information related to addictive substance use and addiction. Be informed about treatment options and ways how to reduce addictive substance use, either self-help or with help from a professional.

The final decision whether you will change your lifestyle or not is always up to you. To make the informed decision, it is best to have all the available information. Those can be easily obtained from your doctor.

As we found out there is only limited awareness about this among medical community, we decided to talk about this issue in a series of articles for a Czech medical journal “Vnitřní lékařství” that is aimed at general practitioners and internists. Our goal was to educate doctors not to forget to ask about addictive substance use. The articles can be found here (Czech article on how to ask patients about their drinking) and here (Czech article on how to ask patients on their illicit drug use).

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