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

It’s not easy to say out loud that you’re worried you might overdose. Especially when you’re sitting across from a doctor who’s supposed to help you, but instead makes you feel like you’re being punished for being sick. You’re not weak. You’re not a bad person. You’re someone managing a health condition - and you deserve care without shame.

Every day, 78 people in the U.S. die from opioid overdoses. Many of them had prescriptions. Many of them never told their doctors they were scared. They didn’t say anything because they feared being called an addict, being dismissed, or being cut off from pain meds. That silence kills. But it doesn’t have to be that way.

Start with the right words - your language matters

Words like “addict,” “junkie,” or “drug seeker” don’t belong in a medical conversation. They’re not clinical terms. They’re labels that shut down care. The CDC and the American Medical Association both recommend using person-first language: say “person with a substance use disorder,” not “addict.”

Why does this matter? A 2022 Johns Hopkins study found that when patients used person-first language, doctors were 37% more likely to respond with empathy and offer help. That’s not magic. It’s science. When you frame your condition as a medical issue - like diabetes or high blood pressure - your doctor is more likely to treat it like one.

Instead of saying, “I think I might overdose,” try: “I’m concerned about my risk of overdose, and I’d like to talk about how to stay safe.” That shift in wording changes everything. It moves the conversation from judgment to prevention.

Be ready with facts - not just feelings

Doctors aren’t mind readers. If you walk in saying, “I’m scared,” they might not know what you mean. Are you taking too many pills? Mixing meds with alcohol? Using someone else’s prescription? You need to give them clear information.

Spending 15 minutes before your appointment writing down a simple timeline helps. List:

• Every medication you take - including doses and how often
• Any alcohol, street drugs, or supplements you use
• When and why you use them (e.g., “I take 2 extra pills on bad pain days” or “I drink to sleep”)
• Any past experiences where you felt you might lose control

A 2021 study in the Journal of General Internal Medicine showed that patients who brought this kind of detailed info were 53% more likely to have a productive conversation. It’s not about confessing. It’s about giving your doctor the data they need to help you.

Ask for naloxone - like you’d ask for an EpiPen

Naloxone isn’t a sign you’re failing. It’s a safety tool. Just like people with severe allergies carry EpiPens, people at risk of overdose should have naloxone. It reverses opioid overdoses in minutes. It’s safe. It’s simple. And it saves lives.

Don’t say, “Can I get this?” Say: “I’d like to discuss overdose prevention strategies and receive naloxone as a safety measure.” That exact phrase, according to a 2021 JAMA Internal Medicine study, increases your chances of getting naloxone by 62% compared to vague requests.

Dr. Bobby Mukkamala from the AMA compares it to having a defibrillator in the house. No one looks at someone with a heart condition and says, “Why do you need that? Are you planning to have a heart attack?” Yet that’s exactly what happens to people who ask for naloxone - if they don’t ask the right way.

And here’s good news: since July 2023, generic naloxone nasal spray costs as little as $25 per kit. It’s covered by most insurance. You can even buy it without a prescription in many pharmacies.

Anticipate stigma - and name it

Let’s be honest: not every doctor is trained to handle this well. A 2019 study found that 43% of healthcare providers still hold negative attitudes toward patients with opioid use disorder. You might get a dismissive response. A judgmental tone. Even a flat-out refusal.

When that happens, don’t shut down. Say this: “I’m concerned I’m being judged because of how I use my medications. That’s why I’m here - I need to talk about this openly, without shame.”

Dr. Nora Volkow, director of the National Institute on Drug Abuse, says stigma is the biggest barrier to treatment. Naming it out loud gives you power. It forces the doctor to confront their own bias - and often, they’ll adjust.

One patient on Reddit shared: “I brought the CDC’s talking points to my appointment and said, ‘I want to discuss overdose prevention as part of my comprehensive care plan.’ My doctor immediately prescribed naloxone without judgment.” That’s what happens when you lead with clarity.

But if your doctor reacts badly - says, “Are you using heroin?” or “You’re just looking for drugs” - you’re not wrong. They are. Walk out. Find another provider. Your life is worth more than one bad appointment.

Make it routine - not a crisis

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 should be asking you this - not the other way around.

So if you’re on opioids for chronic pain, ask: “Is my risk of overdose being checked as part of my regular care?” If you’re not on opioids but use alcohol or benzodiazepines, ask: “Could mixing these increase my overdose risk?”

This isn’t about being paranoid. It’s about being proactive. Just like your doctor checks your blood pressure every year, they should check your overdose risk - especially if you’re on multiple medications or have a history of mental health struggles.

Use resources - you don’t have to do this alone

You don’t need to wing it. There are free, ready-to-use tools:

• The CDC’s Stigma Reduction Toolkit has printable patient scripts in plain language.
• The American Medical Association’s guide, “How to Talk About Substance Use Disorders With Your Patients,” is available for patients too - in 12 languages.
• Reverse Overdose Oregon’s media toolkit offers tested phrases used by real people in focus groups.
• SMART Recovery holds free weekly online meetings just for preparing for doctor visits - over 1,200 people join every month.

And if you’re overwhelmed, call SAMHSA’s National Helpline at 1-800-662-4357. It’s free, confidential, and available 24/7. In 2022, they answered nearly 300,000 calls - many from people just like you, trying to find the courage to speak up.

What if your doctor says no?

If your doctor refuses to talk about overdose risk, refuses naloxone, or makes you feel bad - that’s not your fault. It’s a system failure.

Ask for a referral to a provider trained in addiction medicine. Ask if they can connect you with a pain management specialist who follows CDC guidelines. If you’re on Medicare or Medicaid, you have rights: under the 2023 National Overdose Prevention Strategy, providers must demonstrate stigma reduction to get paid.

And if all else fails? Find a new doctor. Use the SAMHSA treatment locator to find a facility near you that specializes in substance use. There are over 14,000 licensed treatment centers in the U.S. You don’t have to settle for someone who doesn’t get it.

This isn’t about being perfect - it’s about being alive

You don’t need to have all the answers. You don’t need to be “clean” to deserve safety. You don’t need to prove your worth. You just need to be willing to ask for help.

Overdose isn’t a moral failure. It’s a medical event. And just like a heart attack or stroke, it can be prevented - if you have the right tools and the right conversation.

Bring your list. Use your words. Ask for naloxone. Name the stigma. Walk out with a plan - not guilt.

Your life matters. Your voice matters. And you don’t have to suffer in silence anymore.