Should you tell your doctor you use cannabis? How doctor-patient confidentiality works when it comes to weed


Cannabis users can face penalties outside of the court of law. They may pay more for life or auto insurance, face issues in the workplace, or deal with threats to their parental rights.

For these reasons, many people hesitate to disclose cannabis use to their doctors or therapists. But this hesitation is typically unwarranted. Patients who use cannabis are protected by doctor-patient confidentiality.

We broke down how and when to tell your doctor you use cannabis.

RELATED: Will CBD Make Me Fail a Drug Test?

What Is Doctor-Patient Confidentiality?

Doctor-patient confidentiality is a legal construct that protects patients’ privacy. It includes all medical staff and clinicians a patient interacts with, including therapists.

Clinical professionals may not disclose anything said in an appointment, nor anything written in a patient’s file without their express consent.

This means medical professionals will not—and, legally, cannot—report any patient’s unlawful activities to the police. This includes cannabis use.

Likewise, medical professionals will not report any marijuana in your system discovered during routine urine samples or blood tests.

RELATED: Why do I feel high on CBD? 4 Reasons and what to do about it

Legal Exceptions

There are some circumstances where a clinician may disclose patient health information (PHI) legally. For example, medical practices are often legally required to report gunshot wounds and other injuries caused by violence.

One of the most relevant exceptions is the exception regarding child abuse and neglect.

If a clinician suspects child abuse or neglect, they may legally disclose certain patient information. Specifically, they can disclose what a child patient said in an appointment. And, they can disclose signs of injury or malnutrition in a child patient.

However, clinicians cannot legally disclose a parent’s PHI when simply reporting suspected child abuse. Reporting a suspicion differs from filing a Child Protective Services (CPS) report.

Clinicians may only report a parent’s cannabis use (disclosed in confidence) if they believe a child’s life or well-being is currently threatened due to neglect or abuse.

Clinicians can also legally disclose confidential PHI under a court order. These orders are common when investigating cases of abuse, neglect, or violence.

Unfortunately, the risk of a CPS investigation often discourages disclosure in a medical setting. Most pregnant marijuana users do not disclose cannabis use to doctors, including OB-GYNs.

Benefits of Telling Your Doctor (or Therapist) About Your Cannabis Use

It’s important to weigh the limited legal risks against the benefits of disclosure. Cannabis users benefit from disclosure in a few ways. These include:

  • Improved diagnostic accuracy
  • Better evaluation of prescription drug interactions
  • More effective long-term treatment planning

Cannabis affects your endocannabinoid system. This system interfaces with cells throughout your body, altering how they communicate with one another.

By altering this communication, cannabis can change how medical treatments affect you.

RELATED: 3 Reasons why you should tell your doctor you’re using CBD (and why people don’t)

Drug Interactions, Diagnosis, and Treatment

Specifically, cannabis and other prescription medications can increase or decrease your body’s production of certain enzymes and neurochemicals.

This can radically change your body’s response to medication.

It’s important to be aware of “red flag” interactions.

When a clinician knows you use cannabis, they will refrain from prescribing treatments that cause toxic effects when used with weed. Or, they will help you plan to reduce your cannabis intake, so you can take prescriptions safely.

Cannabis can also cause physical and mental changes that mirror illness symptoms. When a clinician knows you’re using cannabis, they can factor that into their diagnostic assessment.

Finally, clinicians are likely aware of the effects of long-term cannabis use. If cannabis is important to your life, medical professionals can help you plan long-term treatment around continued cannabis use.

Weighing Other Risks

Under the Affordable Care Act, it is illegal for insurance companies to factor in your medical history when setting premiums.

That said, health insurers do not typically cover cannabis prescriptions.

And, it is legal for health insurance companies to charge smokers more. Health insurance companies have access to your medical records. So, your premiums may increase if your medical records indicate that you smoke marijuana or tobacco.

Disclosing to Doctors is (Usually) Wise

Ultimately, the benefits of disclosure outweigh the risks for most people. It is easier to get accurate, effective medical treatment if you are open about your cannabis use. And you can generally expect your medical team will not disclose your drug use.

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