Addressing Prior Substance Abuse & Treatment as an Applicant

[gillyfish]

Good Evening SDN,

I am opening this thread with intention to hopefully obtain a number of opinions & create a place for open discussion/feedback regarding views of early substance abuse, addiction & treatment history in a pre-medical applicant.

Physicians, as privelidged providers are expected to embody a certain degree of astutness & moral integrity (and rightfully so). Their occupation, albeit inately intertwined with the sciences, is firmly grounded in altruistic beliefs & the selfless pursuit of making & maintaining (pending one's specialty) a positive impact on another's well-being. Part of successfully managing that responsibility, is largely impacted by one's choices, down to the most mundane/routine of tasks on a day to day basis. Be it maintanence of their physical health, through regular screening/prevention/management, diet, exercise & implementation of healthy lifestyle habits. Socially & psychologically, by maintaing strong networks & social structure with family, friends, colleagues, co-workers, etc. Even one's spirituality, as it applies. All pivotal parts of maintaining an optimal condition so that they can without impedement serve those in need while on-duty. Essentially, holding oneself accountable for their action(s) & leading a virtuous life.

I have on occasion seen posts in these & similar forums from hopeful pre-med/law/pharm students, discussing their prior involvement with substance abuse and/or addiction. Some individuals are even open enough to disclose their personal stories on these types of boards, all in view of recieving insighful feedback from other applicants/current students/adcoms etc. to be used throughout their application process. It seems whether or not an applicant should disclose this type of history has been a rather hot topic over the years. With many suggesting that even touching on these issues is almost a sure fire way of receiving a polite decline.

As the world around us (especially with regard to medicine) is constantly evolving & ever-changing, including societal "norms" & inclusive/exclusive standards, I was interested in getting some open dialouge, be it thoughts/suggestions from & for both applicants & those on the other side of the ivory tower.

By not being exhaustively honest about one's history, are they not potentially leaving out a significant portion of their life story & event(s) that thereafter molded them into the individual they stand as of present? I understand the risk any governing body is taking by putting their bid in for an individual with any substance history, be it for a seat in a professional program or a position thereafter for those who may unfortunately stumble across this problem later in life. The numbers don't lie. It's undoubtedly something to think twice (make it three times) about before extending an offer. But to advise those whom are in a position (having no legal ramifications or other significant misconduct that they must report) to not mention it AT ALL, seems questionably dishonest in itself. It seems willingly choosing not to disclose (which is apparently not "dishonest", per se) or acknowledge one's past in favor of increasing their chances of recieving an admission acceptance/landing a sought-after position, is more acceptable than opening a channel for dialogue & discussion of past faux pas. It's a rather interesting scenario, especially in regards to those virtuous character traits that have been called for to act as the foundation for producing sound clinicians over the years. Does the prior or latter applicant seem to embody a firm grasp of their transgressions & the backage it entails? Would one expect higher rates of relapse/complications among a population of "closet" recovering addicts versus those who have chosen to become openly accountable, and as by mere byproduct have thus established a firm social reinforcement & support system (a "safety net", if you will). This is something I am genuinely curious in hearing others opinions about. Especially, those who find themselves in a position to evaluate said candidates.

From a purely rehabilitation-based perspective & with respect to sustaining positive outcomes: including well-being/quality of life/societal contribution & any or all higher hierarchical pursuits thereafter, I am inclined to believe the answer is full disclose. For myself (*if applicable), I'd be hard-pressed to imagine doing otherwise. Then again, that could be my youthful naivety speaking.

Regardless of stance, any & all dialouge is very much welcomed.

Merci.

---

Members don't see this ad.

 

[NimbleNavigator]

Nice wall of text, bro.

Anyway, I know you're talking about drugs, but that's just a subset of the deeper issue of incarceration in my opinion. My personal view is that we need to stop viewing ex-convicts as subhuman. If they've done their time, then we as a society shouldn't add insult to injury by discriminating against them because of their past. Of course, some people say that you have to be cautious because there is still a high recidivism rate. In that case, I think that it's really not the ex-convict's fault. It's the government's responsibility to make sure that punishments actually work in bringing about positive change and reform. If we aren't able to do that, then in my opinion the death penalty would be better because that's essentially what you're giving them anyway when you shut them out of their livelihood (jobs).

(For the record, I do NOT agree that the death penalty is the way to go in most cases)

 

[ace_inhibitor111]

Nice wall of text, bro.

Anyway, I know you're talking about drugs, but that's just a subset of the deeper issue of incarceration in my opinion. My personal view is that we need to stop viewing ex-convicts as subhuman. If they've done their time, then we as a society shouldn't add insult to injury by discriminating against them because of their past. Of course, some people say that you have to be cautious because there is still a high recidivism rate. In that case, I think that it's really not the ex-convict's fault. It's the government's responsibility to make sure that punishments actually work in bringing about positive change and reform. If we aren't able to do that, then in my opinion the death penalty would be better because that's essentially what you're giving them anyway when you shut them out of their livelihood (jobs).

(For the record, I do NOT agree that the death penalty is the way to go in most cases)

I don't think this issue can just be grouped under the header of incarceration... I trust that many of the people applying to med school who used to be ex-drug addicts, dealers or whatever, never got in trouble with the law. Otherwise, there wouldn't be the question of whether to include it in the application-- your pretty much forced to lol.

That said, I still say mentioning past addictions is a risky idea for the same reason mentioning depression is a risky idea. Mental issues are seen as a negative by most medical schools, regardless of the strength and will power it might have taken to get out.

 

[7331poas]

My question is why does this need to even come up in medical school admissions? Are drugs such a big part of your life that it has shaped you as a person? If so that is a bigger problem.

 

[LizzyM]

Good Evening SDN,

I am opening this thread with intention to hopefully obtain a number of opinions & create a place for open discussion/feedback regarding views of early substance abuse, addiction & treatment history in a pre-medical applicant.

Physicians, as privelidged providers are expected to embody a certain degree of astutness & moral integrity (and rightfully so). Their occupation, albeit inately intertwined with the sciences, is firmly grounded in altruistic beliefs & the selfless pursuit of making & maintaining (pending one's specialty) a positive impact on another's well-being. Part of successfully managing that responsibility, is largely impacted by one's choices, down to the most mundane/routine of tasks on a day to day basis. Be it maintanence of their physical health, through regular screening/prevention/management, diet, exercise & implementation of healthy lifestyle habits. Socially & psychologically, by maintaing strong networks & social structure with family, friends, colleagues, co-workers, etc. Even one's spirituality, as it applies. All pivotal parts of maintaining an optimal condition so that they can without impedement serve those in need while on-duty. Essentially, holding oneself accountable for their action(s) & leading a virtuous life.

I have on occasion seen posts in these & similar forums from hopeful pre-med/law/pharm students, discussing their prior involvement with substance abuse and/or addiction. Some individuals are even open enough to disclose their personal stories on these types of boards, all in view of recieving insighful feedback from other applicants/current students/adcoms etc. to be used throughout their application process. It seems whether or not an applicant should disclose this type of history has been a rather hot topic over the years. With many suggesting that even touching on these issues is almost a sure fire way of receiving a polite decline.

As the world around us (especially with regard to medicine) is constantly evolving & ever-changing, including societal "norms" & inclusive/exclusive standards, I was interested in getting some open dialouge, be it thoughts/suggestions from & for both applicants & those on the other side of the ivory tower.

By not being exhaustively honest about one's history, are they not potentially leaving out a significant portion of their life story & event(s) that thereafter molded them into the individual they stand as of present? I understand the risk any governing body is taking by putting their bid in for an individual with any substance history, be it for a seat in a professional program or a position thereafter for those who may unfortunately stumble across this problem later in life. The numbers don't lie. It's undoubtedly something to think twice (make it three times) about before extending an offer. But to advise those whom are in a position (having no legal ramifications or other significant misconduct that they must report) to not mention it AT ALL, seems questionably dishonest in itself. It seems willingly choosing not to disclose (which is apparently not "dishonest", per se) or acknowledge one's past in favor of increasing their chances of recieving an admission acceptance/landing a sought-after position, is more acceptable than opening a channel for dialogue & discussion of past faux pas. It's a rather interesting scenario, especially in regards to those virtuous character traits that have been called for to act as the foundation for producing sound clinicians over the years. Does the prior or latter applicant seem to embody a firm grasp of their transgressions & the backage it entails? Would one expect higher rates of relapse/complications among a population of "closet" recovering addicts versus those who have chosen to become openly accountable, and as by mere byproduct have thus established a firm social reinforcement & support system (a "safety net", if you will). This is something I am genuinely curious in hearing others opinions about. Especially, those who find themselves in a position to evaluate said candidates.

From a purely rehabilitation-based perspective & with respect to sustaining positive outcomes: including well-being/quality of life/societal contribution & any or all higher hierarchical pursuits thereafter, I am inclined to believe the answer is full disclose. For myself (*if applicable), I'd be hard-pressed to imagine doing otherwise. Then again, that could be my youthful naivety speaking.

Regardless of stance, any & all dialouge is very much welcomed.

Merci.

What you seem to have overlooked in your essay is the legal responsibility a physician has as one licensed by the state to prescribe medications including narcotics. It is also important to acknowledge that for someone who has struggled with addiction, that access to prescription drugs can be a powerful source of temptation. Physicians are not exempt from the power of addictive drugs and the dangers of substance abuse among physicians is a required part of the curriculum in medical school and some (most? all?) residencies.

A criminal record that involved drugs would almost guarantee that an applicant would not be admitted to medical school given the high probability that the criminal record would preclude licensure and hospital privileges. No criminal record but "merely" a history of substance abuse, particularly narcotics or street drugs, would give an adcom pause given that the risks of a relapse would be serious and could end in tragedy for the student as well as for patients and others in society. Imagine the repercussions when something bad happens, "The school knew and yet they gave him access to those drugs! Now my sister is dead due to his negligence while he was impaired." Schools don't want that.

There are plenty of other careers out there. Medicine will circle the wagons and try to help a licensed physician who develops a problem with substance abuse (google "impaired physician") but taking in applicants known to have a troubled history is a tough sell to medical school administrators and adcoms.

 

[gillyfish]

Thank you all for your input. Apologies for the wall of text, I didn't quite realize how much rolled out there at the moment. For better perspective, I am specifically curious about a scenario in which an individual was NOT involved in any sort of legal complications, but is questioning as to whether to divulge such information during an application process. To the user asking about why this need be addressed in the first place, I would be curious to hear your opinion as to what timeline you believe is standard to assess whether something is still pertinent/relevant enough for an applicant to address. Within the past x12 months? How about x24? If an individual developed an unhealthy relationship with a narcotic (substance abuse) & realized the potential for full-fledged addiction prior to LE involvement & proceeded on their own accord to seek professional care, thereafter becoming involved in a thorough outpatient program (many include group-based meetings for patients 2-4x weekly), routine provider f/u's, toxicology screenings, attending NA sessions & counseling/behavioral therapy to address triggers & educate individuals on addiction (including development/implementation of healthy coping mechanisms & lifestyle changes for further prevention). To sweep this under the rug as something "in the past", is a notion I believe anyone knowledgeable in addiction, whether as a provider, former addict or family member/loved one to, would firmly disagree. Addiction is not something to be viewed as in the past or beaten, yet an ongoing, ever-present entity for the remainder of one's life. It has to be respected for it's potential to reoccur & have serious negative implications. In that case, is one in fact best off by completely steering-clear of any mention of the above? Rather muddy waters it seems...

 

[Goro]

Like it or not, with so many qualified applicants, it's a seller's market, and we can afford to turn away tons of just as qualified candidates who don't come with red flags or enough baggage that it scares us.

The common thought is "With so many qualified people who didn't do this, why take a risk on someone who did?"

Thank you all for your input. Apologies for the wall of text, I didn't quite realize how much rolled out there at the moment. For better perspective, I am specifically curious about a scenario in which an individual was NOT involved in any sort of legal complications, but is questioning as to whether to divulge such information during an application process. To the user asking about why this need be addressed in the first place, I would be curious to hear your opinion as to what timeline you believe is standard to assess whether something is still pertinent/relevant enough for an applicant to address. Within the past x12 months? How about x24? If an individual developed an unhealthy relationship with a narcotic (substance abuse) & realized the potential for full-fledged addiction prior to LE involvement & proceeded on their own accord to seek professional care, thereafter becoming involved in a thorough outpatient program (many include group-based meetings for patients 2-4x weekly), routine provider f/u's, toxicology screenings, attending NA sessions & counseling/behavioral therapy to address triggers & educate individuals on addiction (including development/implementation of healthy coping mechanisms & lifestyle changes for further prevention). To sweep this under the rug as something "in the past", is a notion I believe anyone knowledgeable in addiction, whether as a provider, former addict or family member/loved one to, would firmly disagree. Addiction is not something to be viewed as in the past or beaten, yet an ongoing, ever-present entity for the remainder of one's life. It has to be respected for it's potential to reoccur & have serious negative implications. In that case, is one in fact best off by completely steering-clear of any mention of the above? Rather muddy waters it seems...

 

[LizzyM]

Like it or not, with so many qualified applicants, it's a seller's market, and we can afford to turn away tons of just as qualified candidates who don't come with red flags or enough baggage that it scares us.

The common thought is "With so many qualified people who didn't do this, why take a risk on someone who did?"

I agree but it is not so much "who did this" as "who is at high risk for doing something in the future". It's all about risk avoidance.

 

[LizzyM]

I can't really figure out exactly what exactly you're asking here but I'll offer my experience as an applicant with a history of substance abuse. I had issues with substance abuse during undergrad and ended up having to take a semester off to attend treatment. I addressed these issues and my subsequent recovery in my personal statement and elsewhere in my application by focusing on the impact they had on my desire to become a physician. I also included a letter from my doctor attesting to my continued recovery as one of my LoRs. When discussing my recovery, I made an effort to focus on the impact recovery had on me as opposed to my actual substance abuse.

I struggled with deciding whether or not to disclose this on my application but ultimately decided to do so as it was a major part in my deciding to become a physician and gave me an opportunity to set myself apart. Also, it let me explain my weaker academic performance before I got sober and reinforce that my post-treatment grades reflected my true capabilities as well as giving me an opportunity to fight the stigma about those in recovery. I had been sober for about 2.5 years when I applied and ended up with multiple acceptances at US MD schools. I applied with a 3.4 cGPA and 3.2sGPA but did have a 39 MCAT and around a 3.8 in the two years of school after treatment which certainly helped.

At the end of the day, it is up to you as to whether or not to disclose your recovery in your application, and it certainly can and probably will be looked at as a negative by some schools. Based on conversations with adcoms at schools I was accepted to, being honest about my circumstances helped me in my application. Obviously, this is just my personal experience, and things could work out differently for you.

Was this alcohol with or without marijuana, and/or opiods or street drugs? I think that adcoms are less gunshy about booze and pot than about other drugs.

 

[osckey]

TL;DR

 

[Dr Tony T. Chopper]

I understand the risk any governing body is taking by putting their bid in for an individual with any substance history.......It seems willingly choosing not to disclose (which ........or acknowledge one's past in favor of increasing their chances of recieving an admission acceptance/landing a sought-after position, is more acceptable than opening a channel for dialogue & discussion of past faux pas.

From a purely rehabilitation-based perspective & with respect to sustaining positive outcomes: including well-being/quality of life/societal contribution & any or all higher hierarchical pursuits thereafter, I am inclined to believe the answer is full disclose. For myself (*if applicable), I'd be hard-pressed to imagine doing otherwise. Then again, that could be my youthful naivety speaking.

Merci.

Several things:

1. You are right that sifting through dodgy records to morally exonerate a questionable candidate when one could easily take a "clean slate" applicant instead is a fools errand with few exceptions.
2. You posit that non-disclosure equates to dishonesty. I contend that any type of strategic posturing or clever framing within the confines of established bylaw is not only defensible, but to your best interest.
3. The admissions committee is not a rehabilitation committee. Their modus operandi is to recruit candidates best suited to their school and its rigor. If that means taking a student that had multiple IAs but since redeemed themselves through action/academic record, then it will happen.

 

[gillyfish]

I agree but it is not so much "who did this" as "who is at high risk for doing something in the future". It's all about risk avoidance.

I appreciate your insight.

 

[gillyfish]

I can't really figure out exactly what exactly you're asking here but I'll offer my experience as an applicant with a history of substance abuse. I had issues with substance abuse during undergrad and ended up having to take a semester off to attend treatment. I addressed these issues and my subsequent recovery in my personal statement and elsewhere in my application by focusing on the impact they had on my desire to become a physician. I also included a letter from my doctor attesting to my continued recovery as one of my LoRs. When discussing my recovery, I made an effort to focus on the impact recovery had on me as opposed to my actual substance abuse.

I struggled with deciding whether or not to disclose this on my application but ultimately decided to do so as it was a major part in my deciding to become a physician and gave me an opportunity to set myself apart. Also, it let me explain my weaker academic performance before I got sober and reinforce that my post-treatment grades reflected my true capabilities as well as giving me an opportunity to fight the stigma about those in recovery. I had been sober for about 2.5 years when I applied and ended up with multiple acceptances at US MD schools. I applied with a 3.4 cGPA and 3.2sGPA but did have a 39 MCAT and around a 3.8 in the two years of school after treatment which certainly helped.

At the end of the day, it is up to you as to whether or not to disclose your recovery in your application, and it certainly can and probably will be looked at as a negative by some schools. Based on conversations with adcoms at schools I was accepted to, being honest about my circumstances helped me in my application. Obviously, this is just my personal experience, and things could work out differently for you.

Thank you for sharing. I am very aware of the stigma involved & still believe it holds merit for mention to some degree. I could live with the consequences. Positive or negative.

 

[Crayola227]

I know a former user of IV heroin that is a physician, I don't know if it came up during their application process but I believe it did

it's been said on this forum that as Americans we like "come from behind" stories (I think I may have just quoted @Goro there, um, sorta sounds wrong maybe), and the underdog, and people reinventing themselves in a positive way

if you have an otherwise excellent application, you could take the risk of rejection in revealing this, some have had success and some have been rejected, no one can give you numbers
I can see your point in feeling that it's somehow dishonest not to "reveal"
however, being a physician is a job
that means frequently you are choosing to project an image that gives your patients the most comfort
it is *frequently* NOT about "being yourself"

while I agree that there's an aspect to being a physician that is a calling, touches on the spiritual, blah blah blah, too many people have made it about what a special snowflake they are

I found that some of my peers came from the sort of culture, like family/socioeconomic, to be very comfortable in the role
I didn't

do you think I enjoy wearing slacks and a button up shirt and a starched white coat in my down time?
(believe it or not a lot of my peers dress in business casual as their default!)
my "real" self curses like a sailor, wears daisy dukes, tiny tanks, too much lipstick, and probably resembles a streetwalker more than a physician in their "downtime"
I was raised by people who would say "time to warsh our clothes in the crick" (translation: wash our clothes in the creek, and they weren't kidding!)
at work, I dress nothing like my actual self, and I take pains to clean up my language
work isn't the place for my "self expression"
my job is to try to express whatever will best serve my patients (sometimes that's the "crick" joke) and leave the rest at home (the lipstick)

many of us, myself especially, have what's known as "imposter" syndrome

in any case, *you* know all of your background and how that makes you who *you* are, what makes you special, specially qualified, what unique things you bring to medicine, and you can, and *should*, bring all of that to the table to help the patient
--however--
you can accomplish *all* of that, without them ever even knowing your name!

you don't have to, and probably shouldn't, always explain the source of your empathy to patients
I think every provider before and during med school, needs to read about psychology, about interpersonal boundaries, transferance/countertransferance, and really think about what governs what personal information you reveal to a patient (hint, it should *always* be about how it will help them, and not about how it will make you feel closer to them or that it will feel good to reveal, questioning your motive for self-disclosure itself takes insight, and you must always carefully consider what if any negative impact it might have on the therapeutic alliance, sometimes patients don't take what you say as you intend, so you need to be able to put yourself into different *types* of people's shoes)

so if all of what I said makes sense with regards to patients, why wouldn't some apply to your interaction with adcom? that's the whole point, you are essentially auditioning in front of them for the role of physician, so you should show them that you are a professional that understands boundaries and privacy, even if said privacy is your own!

yes, adcoms on some level want to look into your nooks and crannies for themselves to determine if you can be set loose in an authority position on people, they want to know you on a much deeper psychological level, so you definitely want to be yourself and let them get to know you, and they could certainly know personal things about you, but my question would be, how personal is appropriate? since your future job is presenting a professional image, and in general we are in the business of information & expectation management, then you should present a professional image. In doing so, it might not be dishonest or wrong not to discuss mental illness or drug addiction.

Look at it this way, do you think you have a right to some privacy? Maybe this isn't privacy that you care to have for yourself, but as we already said, part of being a physician is showing that you can mesh with others and their expectations
To my knowledge, there's not stigma to being a sexually active heterosexual in the confines of marriage, however we consider people's sex lives to be a private topic in most social spheres. You probably wouldn't talk to adcom about the great missionary style sex you had with your wife last night! And if somehow that sexual relationship was part of your decision to be a physician, still wouldn't you look for other less private reasons to discuss?

so I'm making an argument that similarly, can past substance use and mental illness, far from just being topics of stigma, be considered private topics?

was substance abuse, and overcoming it, is it *that* central to your identity?
is there no better way to communicate who you are, why medicine, and what you uniquely contribute to it?

I would, at the least, focus as much on cultivating everything positive about your self image *for yourself* that *does not* involve substance use or recovery, as you might on those topics

I feel like sometimes I see people "embrace" being an addict and recovery so much to the point that they over identify with it, and fail to put as much importance on who they are outside that part of their identity
that's part of recovery! learning to stop defining everything in terms of your drug of choice, especially yourself

sorry, I essentially blogged on this topic and came to what I think is at issue: given how "open" our culture has become, and how "open" with us we need/expect patients to be, that certainly some adcoms, being doctors, even bring that same type of patient interview style to the applicant interview
and that with the "Reality TV"/social media overshare culture applicants are acculturated to, plus a desire to stand out, any sense of propriety, decorum, privacy on the part of the applicant know seems to be thrown out the window

A lot of the very personal and potentially embarrassing challenges came up in my PS and interviews, but nothing I feel that contradicts a professional image I am expected to maintain. And for as much personal stuff came up, there was also plenty that stayed private.

Much as you respect patients' privacy, can you respect your own?
I could get into the psychology and anthropology of "secret sharing" and what that does. Indeed, too much self disclosure too soon can be a sign of pathology, in that some personality disorders use it to try to create a false sense of intimacy and manipulate, or, at best, some insecure types will do this, or that traumatized individuals do this to create a "trauma bond." Google these concepts they're at least useful to be aware of. I'm getting into some evolutionary behaviorism next. Given all of that, I've read some things that suggest that people with healthy boundaries may be naturally inclined to find too much self disclosure a sign to danger, and now you can see with what potentially good reason! The idea goes that people with a healthy respect for their boundaries and that of others don't expect too much too soon, and that it's healthy to lead with things like, "I'm a straight A student good at playing piano" and that other things, like "I hate the size of my nose and I used to inject heroin" will come later as trust is built. It's natural to try to to protect one's image, and we question when people don't if it seems they didn't to the extent that seems "normal."

All of this was me trying to explore the aspects of not sharing certain personal things with adcom that *didn't* have to do with stigma - unfair judgement.

If there's so many philosophical reasons not to self-disclose certain things that have nothing to do with stigma, however stigma remains on the list, do we ignore all the other reasons just so we can fly in the face of stigma? Maybe that *feels* more like we are not bowing to stigma. But is that how we win the battle?

I'm playing devil's advocate here a bit. I think there is too much stigma around mental illness and substance abuse in physicians, but I'm not sure that the best way to de-stigmatize them is during the admissions process.

They are common enough that without advertising them, physicians with those experiences will end up in medical school. From there, I think there is more they can do to address true stigma, without it necessarily needing to tread on the issue of privacy.

 

[Crayola227]

tldr:
being a physician is not about self expression, but what's best for patients
therefore, image management
perhaps keeping a history of mental illness and substance abuse to yourself isn't about dishonesty or stigma, but perhaps privacy
you deserve privacy too
isn't there more to who you are, why medicine, and what you bring to the table to to talk about?
none of this to say you can't or shouldn't bring it up, just exploring the issue

 

[gillyfish]

Interesting food for thought. Will definitely check out some of those topics. Thanks

 

[TimmyTurner]

tldr:
being a physician is not about self expression, but what's best for patients
therefore, image management
perhaps keeping a history of mental illness and substance abuse to yourself isn't about dishonesty or stigma, but perhaps privacy
you deserve privacy too
isn't there more to who you are, why medicine, and what you bring to the table to to talk about?
none of this to say you can't or shouldn't bring it up, just exploring the issue

Cosign this. Avoid revealing this fact of your past if at all possible. I had a story about my poor grades during that time that wasn't a completely fabricated lie, but also wasn't the total truth. There is very little to be gained from revealing your past and rebound, and much to be lost. Remember, you can't unsay things, and you can't control what people make of or do with information once it is revealed. I think of the famous scene from the end of 'Goodfellas' when they're debating whether or not to assasinate someone who could potentially testifty in court against them... while everyone agreed that the fella was 'solid as a rock, he won't flip'- all it took was one guy saying 'I agree but, way I see it- why take a chance?'. Same concept applies here.