First counseling appt tomorrow - advice?

[Speeder906]

My community college offers personal counseling (including substance abuse counseling) and today I scheduled my first apointment for tomorrow morning. I have struggled with substance abuse for quite some time (I am turning 21 next month). I've never been to counseling (outside of seeing my psychiatrist for 5 minute meetings every 4-6 months) so I don't really know what to expect. Hoping to get some idea from people here who have done counseling before. I also have a couple questions about couseling. Basically any advice or tips at all is very appreciated.

1.) Can a counselor contact my psychiatrist and tell her that I abuse my medicine?
 
2.) How reserved or open should I be for my first session?
 Is it safe to just come clean about ALL drug misuse experiece? Even about other pill abuse? Or even illegal substances like cocaine which I did a bit too...

Getting drug abuse couseling is obviously very new for me and I just want to kinda prepare myself as well as I can. I don't wanna say too much not knowing the next day my doc will stop my meds, put me in rehab, maybe even tell my parents since I am on their health insurace..

Thanks everyone

[quit-once]

I think you have to assume that your session will be entirely confidential.  The only times they are required to break confidentiality is in cases of sexual assault or other horrible crimes or if you threaten suicide.  But I would get all of that straight right from the start.  I suggest you be only as open as you are comfortable with during your first session.  Not all counselors are the same and some you will relate to better than others.  I am speaking from having experience with relationship counseling, and I have never discussed substance abuse with one.  If I were going for my first session, I would focus on the drug(s) I had a problem with and not the occasional recreational experience that I didn't feel had a negative impact on my life.    If you get too fucked up or use it too often that is certainly something to get some help with.  If you can't quit or take too much, that is something to get help for as well.  I have had good luck the few times I have needed a counselor, and when I felt like it had helped me sufficiently I discontinued the counseling relationship.  You should expect at least several weekly sessions for at least a couple of months to work through your substance abuse issues, although, like I said I am only going off my experience regarding relationship issues.