Honesty: To Be or Not To Be

Last week while evaluating an alcoholic as to whether or not she should continue PHP(Partial Hospitalization) treatment or move on to IOP(Intensive Outpatient)treatment my decision was based on one simple element; honesty. My feeling was that if the patient could not be honest about her alcohol and drug use 3 weeks into her treatment then she was not ready to graduate to less intensive therapy. If an addict cannot be honest with themselves first and then their therapist and their family (not necessarily in that order)then they cannot move effectively from abuse to recovery. Honesty is perhaps the most important element to effective treatment and at the same times perhaps the biggest obstacle.

Addicts have spent the entirety of their substance abusing lives being dishonest to anyone who will listen. the only truth they know is that they can never tell the truth. they spend all their time hiding their illness from everyone they know and love. Not necessarily because they don't want to get better but because it spares them from conflict and pain.

Perhaps the biggest challenge that addicts face when it comes to honesty is their employer. Families and friends are easy. They are more forgiving and more loving and more nurturing. Employers, however, are rarely any of those things. you can't entirely blame them. They have a business to protect. But when we preach so strongly that every addict must be honest at all times the question presents itself that how much honesty is an employer entitled to and how much t=can they handle. Employers will often associate substance abuse with a character flaw and make personal judgments about the employee's character that are often unfair and unfounded. Every addict deserves at least one chance to go into treatment and get it right without the fear of losing their job. Employers need to be educated about substance abuse and dual diagnosis so that they can be supportive in an addicts efforts to get clean and sober. That is rarely the case and it needs to change.