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

It’s hard to bring up overdose risk with your doctor-not because you don’t care about your safety, but because you’re afraid of being judged. You’ve taken your meds as prescribed. You’re not using heroin. You’re not a ‘drug seeker.’ But you still worry. Maybe you’ve mixed painkillers with alcohol. Maybe you’ve missed doses and doubled up. Maybe you’ve seen someone overdose and now you’re scared it could happen to you. You want to ask for naloxone. You want to talk about your risks. But you don’t know how to say it without feeling like you’re confessing to something shameful.

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, neighbor, or friend. And most of those deaths are preventable. Naloxone, the medication that reverses opioid overdoses, works fast, is safe, and can be carried like an EpiPen. But only 1 in 5 people who could benefit from it actually have it. Why? Because too many patients don’t ask. And too many doctors don’t offer.

The problem isn’t just lack of awareness. It’s stigma. Even today, 43% of healthcare providers hold negative views about people who use substances. They might not say it out loud, but their tone, their silence, their rushed appointments tell you they think you’re to blame. That’s why you need a plan-not just to talk, but to be heard.

Start With Your Language-It Changes Everything

The words you use shape how your doctor hears you. Say you’re an “addict.” That label sticks. Say you’re a “person with a substance use disorder.” That’s clinical, accurate, and human. Research from Johns Hopkins shows that using person-first language increases the chance your doctor will respond with compassion by 37%.

Here’s what to avoid:

• “I’m addicted.”
• “I can’t stop.”
• “I’m a junkie.”

Here’s what to say instead:

• “I have a substance use disorder.”
• “I’m managing my pain with medication, and I want to make sure I’m safe.”
• “I’ve been thinking about overdose prevention because I care about my health.”

This isn’t about being politically correct. It’s about being understood. When you frame your use as a medical issue-not a moral failing-you shift the conversation from judgment to care.

Be Specific-Doctors Respond to Facts, Not Fear

Vague worries don’t get action. “I’m scared I might overdose” sounds emotional. “I take 40 mg of oxycodone daily, sometimes with alcohol, and I’ve had two near-misses in the last year” sounds like a medical concern.

Before your appointment, write down:

• All medications you take (including doses and how often)
• Any alcohol, benzodiazepines, or street drugs you use
• When and why you use them (e.g., “I take extra pills when I can’t sleep”)
• Any recent changes in your health or routine

This takes 15 minutes. But studies show it makes your conversation 53% more likely to lead to a helpful outcome. You’re not confessing-you’re sharing data. Just like you’d share your blood pressure or cholesterol numbers.

Ask for Naloxone Like You’d Ask for a Flu Shot

Naloxone isn’t a sign you’re failing. It’s a safety net. Dr. Sarah Wakeman from Massachusetts General Hospital says: “Think of it like a fire extinguisher. You don’t wait until your house is burning to get one.”

Say this:

“As part of my comprehensive care plan, I’d like to discuss overdose prevention strategies-including naloxone. I want to have it on hand, just like I have a glucagon kit for my diabetes.”

This works. A 2021 JAMA study found that patients who used this exact phrase were 62% more likely to get naloxone than those who said, “I’m worried I might overdose.”

And here’s the good news: since 2023, generic naloxone nasal spray costs just $25 per kit-down from $130. Most insurance covers it. If yours doesn’t, ask your pharmacy. Many offer it for free through public health programs.

Prepare for Pushback-And Know How to Respond

Not every doctor will respond well. Some will say things like:

• “Why would you need that? Are you using heroin?”
• “You’re just looking for drugs.”
• “You’re not a real patient.”

These are stigmatizing. They’re wrong. And you don’t have to accept them.

Here’s how to respond:

• If they assume you’re using street drugs: “I’m on a prescription. I’m not using heroin. But I’m still at risk because of how I take my meds.”
• If they minimize your risk: “The CDC says anyone taking opioids long-term should be offered naloxone. I’m not asking because I think I’ll overdose-I’m asking because I want to be prepared.”
• If they seem judgmental: “I’m concerned about being judged. That’s why I’m being direct. I need your help, not your assumptions.”

A 2022 survey found that 68% of people with substance use disorders have been shamed by healthcare providers. You’re not alone. And you deserve better.

Use the Right Tools-You’re Not Expected to Do This Alone

You don’t have to wing it. There are free, evidence-based resources made for people like you:

• SMART Recovery hosts weekly online meetings to help you prepare for doctor visits. Over 1,200 people join each month.
• SAMHSA’s National Helpline (1-800-662-4357) offers free, confidential coaching. In 2022 alone, they handled nearly 300,000 calls.
• The CDC’s Stigma Reduction Toolkit has printable talking points you can bring to your appointment.
• Reverse Overdose Oregon’s Media Toolkit offers scripts tested with real patients-no guesswork.

You can even print out the CDC’s guideline: “Assessment of overdose risk should be routine for all patients prescribed opioids.” Hand it to your doctor. Say, “This is what the CDC says. Can we talk about this?”

It’s Not Just About You-It’s About Changing the System

The system is slowly changing. Since 2021, the X-waiver for prescribing buprenorphine is gone. Over a million doctors can now treat opioid use disorder. The FDA approved cheaper naloxone. The CDC now says: everyone on opioids should be screened for overdose risk-not just those “at high risk.”

But progress depends on patients speaking up. Every time you ask for naloxone without shame, you normalize it. Every time you correct a doctor’s language, you help them learn. Every time you bring your facts, your timeline, your calm voice-you make it easier for the next person.

This isn’t about being perfect. It’s about being brave enough to say: “I care about my life, and I need help keeping it.”

What If Your Doctor Still Won’t Help?

If your doctor refuses, dismisses you, or makes you feel worse-you have options.

• Ask for a referral to a provider trained in addiction medicine. Many clinics now specialize in this.
• Go to a federally qualified health center (FQHC). 65% of them have stigma-reduction protocols built in.
• Call SAMHSA’s helpline. They can connect you to a provider who understands.
• Consider telehealth. Some online clinics offer naloxone prescriptions without judgment.

You don’t have to stay with a doctor who doesn’t see you as a person. Your health matters too much for that.

Final Thought: You’re Not Asking for Permission to Live

You’re not asking for permission to take your meds. You’re not asking for permission to be scared. You’re not asking for permission to want to survive.

You’re asking for the same thing every diabetic, every asthmatic, every person with heart disease asks for: a plan to stay safe.

Naloxone isn’t a reward for being “good.” It’s a tool. Like a seatbelt. Like a smoke detector. You don’t need to earn it. You just need to ask for it.

And you deserve to be heard.