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MikeLitoris
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Registered: 07/16/20
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Disclosing Psilocybin Use to Psychiatrist
#27031667 - 11/10/20 01:40 PM (3 years, 2 months ago) |
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I’ve found myself at a point where I feel I should inform my psychiatrist that I’ve stopped taking Prestiq (Effexor) and have been using mushrooms to treat my depression.
She is a provider thru the VA health system and I also work in Health care as a licensed professional. Is she bound to patient confidentiality or is she obligated to report me to the medical board?
In my opinion (and now my experience), psilocybin treatment has shown to be highly effective. The research that has been done also supports this. As a veteran, this treatment should be made available to the millions of veterans, like myself, suffering from PTSD and Treatment Resistant Depression. I’ve been on numerous antidepressants, Several types of psychotherapy (talk and DBT) and had 10 electroshock treatments (ECTs). I took part in a ketamine study thru the VA but was in the control group and only received 1 dose of Ketamine (vs 6). Nothing has worked the way psilocybin has worked for me. NOTHING. I think the VA should conduct their own psilocybin research and make the treatments available ASAP.
Again, I feel that I need to disclose this information to her but I need to know the risk I’m facing for full disclosure.
Thanks for listening.
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Kmacmo
The aborted pin


Registered: 08/14/19
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Re: Disclosing Psilocybin Use to Psychiatrist [Re: MikeLitoris] 1
#27031790 - 11/10/20 02:49 PM (3 years, 2 months ago) |
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Glad to see the switch worked, and wish for continued improvement for you. Mental health professionals can only break the confidentiality if they feel you are a danger to yourself or others. I guess somone who knows nothing about psilocybin might see it as dangerous for you, hopefully your psychiatrist knows a little about it and might even support your efforts.
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MikeLitoris
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Re: Disclosing Psilocybin Use to Psychiatrist [Re: Kmacmo]
#27032406 - 11/10/20 10:19 PM (3 years, 2 months ago) |
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Thank you
-------------------- Weapons not food, not homes, not shoes Not need, just feed the war cannibal animal I walk tha corner to tha rubble that used to be a library Line up to tha mind cemetery now What we don't know keeps tha contracts alive an movin' They don't gotta burn tha books they just remove 'em While arms warehouses fill as quick as tha cells Rally round tha family, pockets full of shells
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PBJ710
Strangler


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Re: Disclosing Psilocybin Use to Psychiatrist [Re: MikeLitoris]
#27032530 - 11/10/20 11:52 PM (3 years, 2 months ago) |
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Have you asked her about her feelings on Psilocbin use/therapy vs. pharmaceuticals? Maybe that can tell you which way to go with your conversation.
Best wishes on getting off the pharmaceuticals.
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MikeLitoris
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Registered: 07/16/20
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Re: Disclosing Psilocybin Use to Psychiatrist [Re: PBJ710]
#27034070 - 11/11/20 07:29 PM (3 years, 2 months ago) |
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Quote:
PBJ710 said: Have you asked her about her feelings on Psilocbin use/therapy vs. pharmaceuticals? Maybe that can tell you which way to go with your conversation.
Best wishes on getting off the pharmaceuticals.
She’s intrigued by the research but understands that psilocybin is still an illegal substance. I asked if the VA was doing any research with psilocybin and she couldn’t find any studies. I did suggest that the VA has a significant population that could benefit from such research.
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PBJ710
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Re: Disclosing Psilocybin Use to Psychiatrist [Re: MikeLitoris]
#27034289 - 11/11/20 10:23 PM (3 years, 2 months ago) |
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That makes it sound like she is at least open to the idea of it, but likely can't advocate it due to legal reasons. I would at least share with her how your previous use has helped or hurt things and open that door. Let it be a tool for her to help you without her telling you to do it I would be prepared to discuss it in a clinical manner though as she will likely want to know dosages/timings/other info. relevant to your usage and how it's working for you.
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pslyke
fantasmagoric



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Re: Disclosing Psilocybin Use to Psychiatrist [Re: MikeLitoris]
#27034735 - 11/12/20 08:01 AM (3 years, 2 months ago) |
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Great to hear that you are feeling better. Be careful (it sounds like you are) with mixing psilocybin with other psychiatric drugs that modulate serotonin receptor signaling.
What's the upside for you in disclosing? Seems to me there is a potential downside, albeit very unlikely, but no upside. Unfortunately it's not like she is going to commend you on your research capabilities and write you a prescription for psilocybin. You are perhaps 10 years too early for that to be happening. Protect yourself until you are absolutely certain there is good reason to share.
-------------------- "What appears impenetrable to us does exist, manifesting itself in the deepest wisdom and the most radiant beauty" Einstein "The conservatives of 70 years ago would be outraged at what has come to pass. It embodies everything they took up arms for to defeat"Asante
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nothanksman

Registered: 09/25/20
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Re: Disclosing Psilocybin Use to Psychiatrist [Re: pslyke] 1
#27034932 - 11/12/20 09:59 AM (3 years, 2 months ago) |
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Quote:
pslyke said: What's the upside for you in disclosing? Seems to me there is a potential downside, albeit very unlikely, but no upside.
I disagree. The more your psychiatrist or other mental health professional knows and the more honest you are with them, the better they can help you, especially when it concerns what medications or other substances you are or are not taking.
Like someone else said, HIPAA prevents a psychiatrist from disclosing confidential information about a patient unless they are a danger to themselves or others, so I would say there is no downside, only up.
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pslyke
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Re: Disclosing Psilocybin Use to Psychiatrist [Re: nothanksman]
#27034959 - 11/12/20 10:13 AM (3 years, 2 months ago) |
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Quote:
nothanksman said:
Quote:
pslyke said: What's the upside for you in disclosing? Seems to me there is a potential downside, albeit very unlikely, but no upside.
I disagree. The more your psychiatrist or other mental health professional knows and the more honest you are with them, the better they can help you, especially when it concerns what medications or other substances you are or are not taking.
Like someone else said, HIPAA prevents a psychiatrist from disclosing confidential information about a patient unless they are a danger to themselves or others, so I would say there is no downside, only up.
A danger to themselves need not be anything more than 'my patient is using a dangerous, illicit substance' potentially in dangerous combination with other psychiatric medications. Furthermore, 'my patient is in possession of illegal substances'. I would say at the very least, the patient should contemplate the length/quality of the patient:doctor relationship and the state in which they are receiving treatment from the standpoint of permissiveness for psilocybin.
And for the record-- I completely agree that having open, honest dialogue with your psychiatrist is vital to receiving the most effective therapy-- accept where you put them in a position where they feel they can do no less than fire you as a patient or report your indiscretions to law enforcement to protect themselves.
-------------------- "What appears impenetrable to us does exist, manifesting itself in the deepest wisdom and the most radiant beauty" Einstein "The conservatives of 70 years ago would be outraged at what has come to pass. It embodies everything they took up arms for to defeat"Asante
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nothanksman

Registered: 09/25/20
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Re: Disclosing Psilocybin Use to Psychiatrist [Re: pslyke] 2
#27035058 - 11/12/20 11:25 AM (3 years, 2 months ago) |
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Quote:
pslyke said: A danger to themselves need not be anything more than 'my patient is using a dangerous, illicit substance' potentially in dangerous combination with other psychiatric medications. Furthermore, 'my patient is in possession of illegal substances'.
Under what circumstances may a HIPAA covered entity disclose PHI to law enforcement? A HIPAA covered entity may disclose PHI to law enforcement with the individual’s signed HIPAA authorization. A HIPAA covered entity also may disclose PHI to law enforcement without the individual’s signed HIPAA authorization in certain incidents, including: • To report PHI to a law enforcement official reasonably able to prevent or lessen a serious and imminent threat to the health or safety of an individual or the public. • To report PHI that the covered entity in good faith believes to be evidence of a crime that occurred on the premises of the covered entity. • To alert law enforcement to the death of the individual, when there is a suspicion that death resulted from criminal conduct. • When responding to an off-site medical emergency, as necessary to alert law enforcement to criminal activity. • To report PHI to law enforcement when required by law to do so (such as reporting gunshots or stab wounds). • To comply with a court order or court-ordered warrant, a subpoena or summons issued by a judicial officer, or an administrative request from a law enforcement official (the administrative request must include a written statement that the information requested is relevant and material, specific and limited in scope, and de-identified information cannot be used). • To respond to a request for PHI for purposes of identifying or locating a suspect, fugitive, material witness or missing person, but the information must be limited to basic demographic and health information about the person. • To respond to a request for PHI about an adult victim of a crime when the victim agrees (or in limited circumstances if the individual is unable to agree). Child abuse or neglect may be reported, without a parent’s agreement, to any law enforcement official authorized by law to receive such reports
Unless the patient indicates that they are planning suicide by overdose, drug use is not disclosable to law enforcement. I work in mental health with a specialization in substance abuse. We would never contact the police and say 'my patient is using a dangerous, illicit substance' or 'my patient is in possession of illegal substances'. That is illegal.
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pslyke
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Re: Disclosing Psilocybin Use to Psychiatrist [Re: nothanksman]
#27035225 - 11/12/20 12:53 PM (3 years, 2 months ago) |
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Very helpful and thankyou for providing the relevant information. While I suspected that most psych Drs wouldn't report, it is nice to see that this is the case plainly written.
-------------------- "What appears impenetrable to us does exist, manifesting itself in the deepest wisdom and the most radiant beauty" Einstein "The conservatives of 70 years ago would be outraged at what has come to pass. It embodies everything they took up arms for to defeat"Asante
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nothanksman

Registered: 09/25/20
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Re: Disclosing Psilocybin Use to Psychiatrist [Re: pslyke] 1
#27035289 - 11/12/20 01:34 PM (3 years, 2 months ago) |
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No problem. I don't mean to be that guy who has to be right on the internet, but I don't want anyone to ever feel like they can't be honest with their doctor or therapist. It makes treatment much easier when they have all relevant information, and stopping prescribed anti-depressants to take psilocybin is definitely relevant.
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Jokeshopbeard
Humble Student

Registered: 11/30/11
Posts: 26,088
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Re: Disclosing Psilocybin Use to Psychiatrist [Re: nothanksman]
#27035347 - 11/12/20 02:17 PM (3 years, 2 months ago) |
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Quote:
MikeLitoris said: She’s intrigued by the research
I think between this, and this:
Quote:
nothanksman said: I work in mental health with a specialization in substance abuse. We would never contact the police and say 'my patient is using a dangerous, illicit substance'
You're pretty safe OP. Especially when you've got much to gain by opening up on this.
Bottom line is you need to be comfortable. If you feel she's good, then you could open with the fact that you wanted to, but have been worried about it; that should prompt her to share her feelings on the matter so you can feel her out further (and be hopefully further reassured).
When it comes down to it, I doubt most Psychiatrists want to report you to LEO unless they absolutely can't avoid it.
-------------------- Let it be seen that you are nothing. And in knowing that you are nothing... there is nothing to lose, there is nothing to gain. What can happen to you? Something can happen to the body, but it will either heal or it won't. What's the big deal? Let life knock you to bits. Let life take you apart. Let life destroy you. It will only destroy what you are not. --Jac O'keeffe
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Itzpapalotl
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Re: Disclosing Psilocybin Use to Psychiatrist [Re: Jokeshopbeard] 1
#27036206 - 11/13/20 12:41 AM (3 years, 2 months ago) |
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Maybe one day I would feel okay with disclosure in your situation. I don't think I would admit to doing anything illegal to someone who can potentially inform your licencing board.
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skOsH
Functionally dysfunctional



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Re: Disclosing Psilocybin Use to Psychiatrist [Re: Itzpapalotl]
#27036318 - 11/13/20 03:19 AM (3 years, 2 months ago) |
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I've done it before. I told them it got rid of my depression for a year as well as my PTSD and they were in awe.
I don't know if I would let them know how much you're doing, just that it actually helps.
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MikeLitoris
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Loc: Minnesota
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Re: Disclosing Psilocybin Use to Psychiatrist [Re: pslyke]
#27037417 - 11/13/20 05:07 PM (3 years, 2 months ago) |
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Quote:
pslyke said: Great to hear that you are feeling better. Be careful (it sounds like you are) with mixing psilocybin with other psychiatric drugs that modulate serotonin receptor signaling.
What's the upside for you in disclosing? Seems to me there is a potential downside, albeit very unlikely, but no upside. Unfortunately it's not like she is going to commend you on your research capabilities and write you a prescription for psilocybin. You are perhaps 10 years too early for that to be happening. Protect yourself until you are absolutely certain there is good reason to share.
I weaned myself off of effexor (Pestiq) and have not taken the medication for over a month. I'm aware of serotonin syndrome and the dangers of mixing the two substances. My biggest concern during the transition was the transition itself.
Thanks for the input
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MikeLitoris
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Re: Disclosing Psilocybin Use to Psychiatrist [Re: MikeLitoris]
#27037437 - 11/13/20 05:15 PM (3 years, 2 months ago) |
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Thanks for all the input. My next appointment is in 3 months and I have time to think about this issue. She is going to notice that I've stopped filling my prescription and this will certainly prompt a discussion.
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Nikon Addict
Another Earthling



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Re: Disclosing Psilocybin Use to Psychiatrist [Re: MikeLitoris]
#27040522 - 11/15/20 12:50 PM (3 years, 2 months ago) |
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This subject is dear to my heart
First off I want to congratulate you for having the courage to trust the research, especially if you didn't have experience with psychedelics beforehand... Physically psychedelics are harmless unlike psyche meds... You have found relief which is all that's important...
There's a popular PhD clinical psychologist on YouTube... His channel name is Dr Todd Grande... He actually said that legally he could not report a client to the police if the client admitted he or she murdered someone... Of course nothing could prevent the doctor or therapist from reporting the individual anonymously...
HIPPA Laws are restrictive too... The thing is only doctors or individuals you permit to have access to your medical records have access... Under certain circumstances court orders can override HIPPA confidentiality... That said, there should be no way for your employer to find out... I would ask my psychiatrist if what I share during an office visit can be passed onto anyone other then a health care provider... Just to be sure...
Way to go man...
-------------------- personal note: "It’s fair to say I’m stepping out on a limb, but I am on the edge and that’s where it happens.”
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