Even if your primary care physician doesn’t ask you directly about alcohol use, how many drinks you consume in a typical week is generally listed as a question on most pre-visit patient questionnaires. Depending on your level of openness and your weekly alcohol consumption, it might be tempting to fudge the answer a bit. But should you? Does it even matter?
According to Dr. Amber Tully, a primary care physician at Ohio’s Cleveland Clinic, you are “doing yourself a disservice” if you lie to your doc about your drinking habits ― and not because they exist to scold you about your alcohol consumption.
“We’re here to help you, not judge you, and it’s a team effort,” she said. “I think patients assume we’ll think less of them if they’re fully honest, but that’s not true at all.”
Modern Medicine Can Reveal The Truth
Your doctor might even know you’re lying about alcohol consumption anyway ― or at least highly suspect it, depending on your lab results.
“I would never assume a patient is lying. I hope they don’t, and I don’t think a patient who drinks more than a drink a day would claim to not drink at all,” Tully said. “But there might be indicators anyway. For instance, triglycerides might be high in someone who drinks a lot, or I could see certain elevated enzymes if I’m testing liver function. High blood pressure in someone with no other risk factors might clue me into excessive drinking.”
Doctors want to know your drinking habits, because they play into your overall health and well-being ― both mental and physical.
“Alcohol abuse has been associated with seizures, motor vehicle accidents, injuries, and violence ― but there’s a difference between alcohol use and alcohol abuse,” explained Dr. Todd Sontag, a family medicine specialist with Orlando Health Physician Associates.
“Someone that drinks his favorite drink a couple of times a week is handled different than someone that drinks a 12-pack of beer every night after work,” Sontag continued. “Someone that feels like they need a drink first thing in the morning, every morning, is medically treated differently than someone that meets their friends for happy hour after work on an occasional Thursday.”
Fibbing Hurts Your Health
Your doctor actually needs information about substance use, especially alcohol, for several reasons. “The focus of family medicine is to take a thorough history of a patient, so your doctor can best practice preventative medicine,” Sontag said. “It is imperative to identify risk factors in a patient that can be harmful to their health. Alcohol use may raise the risks of issues, including cancers and liver disease.”
“It is imperative to identify risk factors in a patient that can be harmful to their health. Alcohol use may raise the risks of issues, like including cancers and liver disease.”
You might also be experiencing other more common issues, of which alcohol can be a contributing factor, Tully said. “If someone is drinking excessively, it may be a reason for high blood pressure, high cholesterol or even migraines, dehydration or poor sleep,” she explained.
The poor sleep, caused by alcohol consumption, could even be contributing to your migraines, but it would be a lot harder for your doc to determine without the full picture. Your alcohol consumption could play a role in your weight, too.
“It could be as simple as someone struggling to lose weight, but they aren’t fully aware of the calories they’re taking in,” Tully said. “Most alcoholic beverages have at least 100 calories a drink. It’s the little things. Your doctor is there to pick up on them.”
Another issue is that alcohol can negatively interact with a lot of medications. “It could be as simple as an antifungal medication, which you shouldn’t drink on at all,” Tully said. “Medications for anxiety or sleeping meds, a patient may become more drowsy. There are even some pain meds or antibiotics where you shouldn’t drink,” or you might experience nausea, sleepiness or dizziness, she added.
Basically, you know that alcohol can make you feel poorly if you drink too much of it in a single sitting. But it also might make you feel even worse when your system is already compromised, or could exacerbate a problem you might not even know exists.
“Patients need to understand that they can trust their physician, and anything they say to them is in complete confidentiality.”
Bottom line? Doctors ask about drinking because the answers might actually be important; let your physician find you the right kind of medical care by being honest about how much alcohol you consume. And if you’re not totally OK discussing it verbally, just jot it down on the questionnaire. “The questionnaire is there to make the patient feel more comfortable sharing about substances,” Tully said.
And if you feel like you can’t be fully honest with your doctor, then don’t forget there might be a larger problem with your medical care.
“It’s extremely important to have a great rapport with your patients,” Sontag said. “So if you don’t feel like you can be 100 percent honest with your doctor, then that doctor is not the right one for you. Patients need to understand that they can trust their physician, and anything they say to them is in complete confidentiality.”
So, don’t fear ’fessing up about alcohol, substances and all your medical history. It’s in your best interest to do so ― and it’ll never leave the appointment room.