"Do you or have you smoked marijuana?"—it's a casual question that can come up during patient intake, but when it comes to talking about cannabis use with therapists, many patients are hesitant to answer. Though it seems obviously beneficial to be honest with a medical professional, patients are still pressured by the stigma the plant carries and states' inconsistent stances on its legality.
Remember when you were (incorrectly) taught that weed was a gateway drug that would lead to harder ones like cocaine or crystal meth? Even today, the Drug Enforcement Agency classifies marijuana as a Schedule-I drug with the likes of heroin, LSD, and ecstasy—even though these comparisons have been refuted. These scare tactics are compounded by the fact that recreational legalization is a fairly new concept, so you can imagine why industry professionals in psychology may still be skeptical.
Read more: Why People Smoke Weed to Treat Depression
Last month, the Georgia state House expanded medical cannabis coverage to include the treatment of HIV, AIDS, Alzheimer's disease, autism, autoimmune disease, Tourette's syndrome, and more—but recreational use is still illegal in the state. Atlanta-based psychotherapist Tori Rodriguez, who has also been reporting on cannabis for publications like Psychotherapy Network and Psychiatry Advisor for the past seven years, noticed her colleagues made generalized and misinformed statements about marijuana. She tells Broadly that's when she decided to focus on debunking myths about the increasingly popular yet misunderstood plant. And while she doesn't expect every client to disclose their marijuana use, she recommends discussing it with your therapist in order to paint a "complete picture"—especially if it's relevant to your mental health history, like if you have a family history of substance abuse.
After all, confidentiality is included in the APA's code of ethics; psychologists have a duty to protect a patient's private information, including what's discussed behind closed doors. The only exceptions therapists must abide by are: If you pose a danger to yourself or others, or if they suspect that a child is being abused. That means a therapist would be legally required to report you if you were using cannabis with or selling to a minor. And if a patient is under 18 years of age, a therapist can disclose their weed use to their parents or guardians. Additionally, if you're distributing or have the intent to distribute marijuana, your therapist may feel required to report you under the "harm to others" clause. Oftentimes, patients are required to sign a disclosure form regarding these exceptions, which vary slightly by state.
If you feel comfortable with your therapist's disclosure agreement but still don't know how best to mention your weed use, Rodriguez suggests inviting an open dialogue.
"Since it can tough for a client to know what might be relevant in the big-picture scheme of things, it can be helpful to simply put it out there [by stating] 'I just want you to know this so you have the complete picture,'" Rodriguez explains. "Therapists aren't supposed to police client's' behavior—that's not what we're there for, and it can be counterproductive to therapy."
Indeed, if your therapist tries to police your behavior, it's likely their reaction is rooted in condition bias. "If you feel judged by your therapist because of your weed use or for any other reason, talk to him or her about it," Rodriguez says. "People tend to balk at or ignore that suggestion, but it really is a great opportunity to clarify your perception of the situation and to let the therapist know how they're coming off."
Ultimately, if your therapist isn't receptive to a conversation about cannabis, Rodriguez suggests looking for a new one—and even recommends discussing your weed use during your first meeting to gauge how comfortable you feel with them. After all, she notes, isn't that the point of therapy? "See if this is really a safe place for you where you don't have to hide certain parts of yourself like you do elsewhere."