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

It’s not easy to bring up overdose risk with your doctor-especially if you’re taking opioids for chronic pain, or if you’ve used substances in ways that don’t match what’s considered "normal." You might fear being labeled, dismissed, or even cut off from care. But here’s the truth: overdose risk isn’t a moral failure. It’s a medical condition, and talking about it is as normal as asking about blood pressure or cholesterol.

Why This Conversation Matters More Than You Think

Every day in the U.S., 78 people die from opioid overdoses. That’s not just statistics-it’s someone’s parent, sibling, friend, or neighbor. And most of those deaths are preventable. The CDC says naloxone, the life-saving medication that reverses opioid overdoses, can stop an overdose in minutes. Yet, only about 1 in 4 people who could benefit from it actually have access.

Why? Because stigma gets in the way. Many doctors still think people who use substances are "just looking for drugs" or "not trying hard enough." But research shows that when patients speak up using clear, factual language, doctors respond differently. In fact, a 2021 study in JAMA Internal Medicine found that patients who said, "I’d like to discuss overdose prevention strategies and receive naloxone as a safety measure," were 62% more likely to get it than those who just said, "I’m scared I might overdose."

What to Say-And What Not to Say

The words you use make a big difference. Saying "I’m an addict" or "I can’t control my use" can trigger defensiveness. Instead, use person-first language: "I have a substance use disorder," or "I’m managing a chronic condition that includes opioid use." Here’s what works:

• "I’m taking my prescription as directed, but I want to make sure I’m protected in case something goes wrong. Can we talk about naloxone?"
• "I’ve read that overdose risk can happen even when people follow their prescriptions. I’d like to have a safety plan, like we do for other chronic illnesses."
• "I’d like to discuss overdose prevention as part of my overall health care. Is naloxone something you recommend?"

Avoid these phrases:

• "I think I might overdose." (Too vague-it sounds emotional, not clinical.)
• "I’ve been using more than prescribed." (This can trigger guilt or shame, even if true.)
• "I’m worried people will judge me." (While valid, it puts the burden on the doctor to fix stigma, not the system.)

Prepare Before Your Appointment

Going in blind makes it harder. Take 15-20 minutes before your visit to write down:

• All medications you take-prescription, over-the-counter, supplements
• Any alcohol or recreational substances you use, even occasionally
• How much, how often, and when you use them
• Any past experiences where you felt unsafe, passed out, or had someone revive you

This isn’t about admitting guilt-it’s about giving your doctor the full picture. A 2021 study in the Journal of General Internal Medicine found that patients who brought this kind of "medication timeline" were 53% more likely to have a productive conversation.

Frame It Like Routine Care

Doctors treat diabetes with insulin, heart disease with aspirin, allergies with EpiPens. Why shouldn’t overdose prevention be part of the same model?

Dr. Bobby Mukkamala from the American Medical Association says naloxone should be thought of like a fire extinguisher: "You don’t wait until the house is burning to get one. You keep it handy."

Say it this way: "As part of my care plan for managing chronic pain, I’d like to include overdose prevention, just like we do with fall prevention or infection control. Can we add naloxone to my treatment plan?" This shifts the conversation from judgment to safety. It’s not about what you’ve done-it’s about what you’re doing to stay alive.

What If Your Doctor Reacts Poorly?

It happens. One patient on Reddit shared that when they mentioned naloxone, their doctor asked, "Are you using heroin?" They felt humiliated and didn’t return for eight months.

That’s not your fault. It’s a failure of the system. But here’s what you can do:

• Stay calm. Say: "I understand this might be uncomfortable, but I’m asking because I care about my health."
• Ask: "Is there a provider here who specializes in substance use care?" Many clinics now have addiction medicine specialists.
• Request a referral. You’re allowed to ask for a second opinion.
• Take notes. Write down exactly what was said. If you feel discriminated against, you can file a complaint with the clinic’s patient advocate.

The 2023 National Overdose Prevention Strategy requires all federally funded clinics to train staff in non-stigmatizing care. If your doctor hasn’t been trained, that’s a red flag-not yours.

What Is Naloxone, and How Do You Get It?

Naloxone (brand names: Narcan, Kloxxado) is a nasal spray that reverses opioid overdoses. It’s safe, non-addictive, and works even if you don’t know what drug caused the overdose.

Since July 2023, generic naloxone costs as little as $25 per kit-down from $130. In many states, you can walk into a pharmacy and get it without a prescription. Some pharmacies even give it out for free.

If your doctor won’t prescribe it, ask: "Can you write me a prescription for naloxone, or refer me to a pharmacy where I can get it directly?" Many states now allow pharmacists to dispense it under standing orders.

Support Is Out There-You Don’t Have to Do This Alone

You’re not the only one struggling with this. In 2022, the Substance Abuse and Mental Health Services Administration (SAMHSA) received nearly 300,000 calls to their free national helpline (1-800-662-HELP) from people preparing for medical appointments.

Organizations like SMART Recovery host weekly online meetings just for people getting ready to talk to doctors. They practice scripts, role-play tough conversations, and share what worked.

The CDC’s Stigma Reduction Toolkit and the American Medical Association’s patient guide (available in 12 languages) give you exact phrases to use. You don’t have to guess. You can bring printed copies to your appointment.

This Isn’t Just About You-It’s About Changing the System

Every time you speak up, you help break the cycle. When patients ask for naloxone, doctors start seeing it as standard care-not a sign of failure. When clinics see more requests, they train more staff. When more doctors get trained, stigma drops.

The 2025 rollout of the Substance Use Disorder Integrated Care Model will tie 15% of Medicare reimbursement to how well providers reduce stigma. That means change is coming-and your voice is part of making it happen.

What to Do Next

1. Write down your medication timeline-include everything, even if you think it’s "not important." 2. Pick one phrase from this article to use: "I’d like to discuss overdose prevention as part of my safety plan." 3. Call your pharmacy and ask if they carry naloxone. If they do, get one-no prescription needed in most places.

You don’t need permission to protect your life. You don’t need to be "perfect" to deserve care. You just need to speak up.