How to Talk to Your Doctor About Overdose Risk Without Being Judged

It’s hard to bring up overdose risk with your doctor-even if you’re taking prescribed pain medication, have a history of substance use, or just want to be safe. You might worry they’ll judge you, assume you’re using drugs illegally, or think you’re exaggerating. But here’s the truth: overdose risk isn’t about being weak or irresponsible. It’s a medical reality for millions, and your doctor is supposed to help you manage it-not shame you.

Why This Conversation Matters More Than You Think

Every day in the U.S., 78 people die from opioid overdoses. That’s not just a statistic-it’s someone’s parent, sibling, friend, or neighbor. And many of those deaths could be prevented if people had access to naloxone and felt safe talking about their risks. Yet, a 2022 survey found that 68% of people with substance use disorder have been met with stigmatizing language from healthcare providers. Phrases like “You’re just looking for drugs” or “Why would you need that?” shut down conversations before they even start.

The good news? You don’t have to wait for your doctor to bring it up. You can lead the conversation-and there’s a proven way to do it that works.

Use Person-First Language

Words matter. Calling someone an “addict” or “junkie” is not just hurtful-it’s medically outdated. Research from Johns Hopkins shows that using person-first language like “person with a substance use disorder” increases the chance of getting compassionate care by 37%. Your doctor may not say it out loud, but they’re more likely to listen if you frame your experience as a health condition, not a moral failure.

Instead of saying:

• “I’m addicted to painkillers.”

Say:

• “I have a substance use disorder, and I’m managing it with my prescribed medication.”

This isn’t about being politically correct. It’s about shifting the conversation from blame to treatment. And it works.

Prepare Specific Facts Before Your Appointment

Doctors respond to data, not emotions. If you walk in saying, “I’m scared I might overdose,” they might not know how to respond. But if you say, “I’ve been taking 40 mg of oxycodone daily for six months, and I’ve started using alcohol on weekends to help me sleep,” that’s actionable information.

Take 15-20 minutes before your appointment to write down:

• All medications you take (including dosages and how often)
• Any alcohol, marijuana, benzodiazepines, or other substances you use
• Any times you’ve felt dizzy, passed out, or had trouble breathing after taking meds
• Any recent changes in your routine, stress levels, or sleep

A 2021 study in the Journal of General Internal Medicine found that patients who brought this kind of detailed timeline were 53% more likely to have a productive conversation about overdose prevention.

Ask for Naloxone Like You’d Ask for an EpiPen

Naloxone is a life-saving medication that reverses opioid overdoses. It’s safe, easy to use, and doesn’t cause euphoria. Yet, only 1 in 4 people at risk for overdose ever get it prescribed.

Here’s the script that works:

“I’d like to discuss overdose prevention strategies as part of my safety plan. Can you prescribe me naloxone? I want to have it on hand, just like I would for an EpiPen if I had severe allergies.”

This framing-comparing it to a common, non-stigmatized safety tool-is backed by a 2021 JAMA Internal Medicine study. Patients who used this exact phrase were 62% more likely to receive naloxone than those who said, “I’m worried I might overdose.”

And now, thanks to FDA approval of a generic nasal naloxone in July 2023, the cost has dropped from $130 to $25 per kit. It’s affordable. It’s accessible. And it’s not a sign of failure-it’s a sign of responsibility.

Anticipate Stigma-And Name It

Not every doctor will respond well. Some still hold outdated beliefs. A 2019 study found that 43% of healthcare providers have negative attitudes toward patients with opioid use disorder. That’s not your fault. But you can prepare for it.

If your doctor says something like, “Why would you need that?” or “Are you using heroin?”, don’t shut down. Try this:

“I’m concerned that stigma might be getting in the way of us having a real conversation. I’m not asking for this because I’m using illegally-I’m asking because I want to stay safe, and I’ve read that this is standard care for people on long-term opioids.”

Dr. Nora Volkow, Director of the National Institute on Drug Abuse, says: “Stigma is the single greatest barrier to people seeking treatment.” Naming it out loud takes power away from it.

Frame It as Routine Care

The CDC updated its guidelines in August 2023 to say this: “Assessment of overdose risk should be routine for all patients prescribed opioids, regardless of perceived risk.” That means your doctor is supposed to ask this question-not you.

So you can say:

“As part of my comprehensive health plan, I’d like to discuss overdose prevention strategies, including naloxone, just as we discuss blood pressure checks or flu shots for other chronic conditions.”

This shifts the conversation from “Are you at risk?” to “How do we keep you safe?” It’s the same way you’d talk about diabetes, heart disease, or asthma. Substance use disorder belongs in that same category.

What If Your Doctor Refuses?

You’re not powerless. If your doctor says no to naloxone or shuts down the conversation:

• Ask for a referral to a provider who specializes in addiction medicine.
• Visit a pharmacy-they can dispense naloxone without a prescription in 47 states.
• Call SAMHSA’s National Helpline at 1-800-662-4357. They’ll help you find resources and even practice what to say before your next appointment.

And remember: you’re not asking for permission to be safe. You’re asking for support to stay alive.

Real Stories, Real Results

One Reddit user, u/PainManagementJourney, shared: “I brought the CDC’s patient talking points to my appointment and said, ‘I want to discuss overdose prevention strategies as part of my comprehensive care plan.’ My doctor immediately prescribed naloxone without judgment.”

Another, u/OpioidPatient, said: “When I mentioned I’d researched naloxone, my doctor asked, ‘Are you using heroin?’ I felt shamed and didn’t return for eight months.”

The difference? One person used clear, factual, non-shaming language. The other didn’t.

Where to Get Help

You don’t have to do this alone:

• SAMHSA National Helpline: 1-800-662-4357 (free, confidential, 24/7)
• Reverse Overdose Oregon: Free, tested patient talking points in multiple languages
• SMART Recovery: Weekly online meetings to practice medical conversations
• Pharmacies: Naloxone is available over the counter in most states

It’s Not About Blame-It’s About Survival

Overdose isn’t a failure. It’s a medical emergency. And just like you wouldn’t feel guilty for carrying an inhaler if you had asthma, you shouldn’t feel guilty for carrying naloxone if you’re on opioids or using substances.

The system isn’t perfect. Some doctors still don’t get it. Insurance still blocks care. Rural areas still lack providers.

But you have more power than you think. You can use the right words. You can bring the facts. You can ask for help without apology.

Your life matters. Your safety matters. And you deserve care without shame.