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 might be taking opioids for chronic pain, using benzodiazepines for anxiety, or mixing prescriptions with alcohol. You know the risks, but saying it out loud feels like admitting you’ve failed. What if they think you’re just looking for drugs? What if they shut you down? You’re not alone. Nearly 7 out of 10 people with substance use disorder say they’ve been treated with disrespect or shame by healthcare providers. But here’s the truth: you have the right to ask for help without being labeled. And there’s a way to do it that actually works.

Start with the right words

The language you use changes everything. Saying “I’m an addict” or “I can’t stop using” puts the focus on your identity, not your health. That triggers stigma. Instead, use person-first language: “I have a substance use disorder.” That simple shift isn’t just politically correct-it’s backed by science. A 2022 Johns Hopkins study found that when patients used this language, doctors were 37% more likely to respond with empathy and offer real support.

Don’t say, “I’m scared I might overdose.” That sounds vague, emotional, and easy to dismiss. Say this instead: “I’d like to discuss overdose prevention strategies as part of my health plan.” That’s not a cry for help-it’s a medical request, like asking for a flu shot or a blood pressure check. And it works. A 2021 JAMA study showed patients who used this exact phrase were 62% more likely to get naloxone prescribed.

Prepare a simple medication timeline

Walk into your appointment with a one-page list. Not a confession. Just facts. Write down:

• Every prescription you take, including doses and how often
• Any over-the-counter meds or supplements (especially sleep aids or pain relievers)
• Alcohol use-how many drinks a week
• Any non-prescribed substances, even once a month

You don’t need to justify why you took them. Just list them. This takes 15 minutes. A 2021 study in the Journal of General Internal Medicine found that patients who did this were 53% more likely to have a productive conversation. Doctors aren’t judging your choices-they’re trying to see the full picture. A timeline removes guesswork. It turns emotion into data.

Ask for naloxone like you’d ask for an EpiPen

Naloxone isn’t a sign you’re using too much. It’s a safety tool-like a fire extinguisher in your home. Dr. Bobby Mukkamala from the American Medical Association says it best: “There’s no stigma for using an EpiPen or a defibrillator. Why should naloxone be any different?”

Say this: “I’d like to receive naloxone as a safety measure. Can you prescribe it today?”

That’s direct. It’s clinical. And it’s effective. Since the FDA approved a generic nasal naloxone in July 2023, the price has dropped from $130 to $25 per kit. Most insurance plans cover it now. If your doctor hesitates, ask: “Is this something you’d recommend for a patient with diabetes or heart disease?” The answer should be yes.

Anticipate the pushback-and how to handle it

Not every doctor is trained to handle this conversation well. A 2019 study found 43% of providers still hold negative attitudes toward people with opioid use disorder. You might hear things like:

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

If that happens, stay calm. You’re not arguing. You’re redirecting. Say: “I’m not here to be judged. I’m here because I care about staying alive. I’ve researched this. Naloxone saves lives. I’d like to have it as part of my care plan.”

If they still refuse, ask for a referral. Say: “Can you connect me with a provider who specializes in addiction medicine?” Most hospitals and federally funded clinics now have these specialists. You’re not asking for special treatment-you’re asking for standard care.

Use the same framework as for other chronic conditions

Substance use disorder isn’t a moral failure. It’s a medical condition-like diabetes or hypertension. The CDC’s 2023 update to its opioid prescribing guidelines says this clearly: “Assessment of overdose risk should be routine for all patients prescribed opioids, regardless of perceived risk.”

That means your doctor should be asking you these questions-not the other way around. But they often don’t. So you lead. Frame it like this: “As part of my comprehensive health plan, I’d like to talk about overdose prevention, just like we do for heart disease or asthma. What do you recommend?”

This approach aligns with the AMA’s 2023 policy, which requires all member physicians to complete annual stigma training. 78% have done it. That means most doctors now know how to respond. You’re not asking for something new. You’re asking for what they’re supposed to offer.

Know your support resources

You don’t have to do this alone. The Substance Abuse and Mental Health Services Administration (SAMHSA) runs a free, confidential helpline: 1-800-662-4357. In 2022, they answered nearly 300,000 calls-up 22% from the year before. They can help you prepare what to say, find local providers, and even connect you with peer coaches who’ve been through this.

Organizations like SMART Recovery host weekly online meetings focused on preparing for medical appointments. Over 1,200 people join each month. You can practice your script. Get feedback. Build confidence.

And if you’re worried about privacy: your medical records are protected by law. What you say stays confidential unless you’re in immediate danger.

What to do if your doctor still doesn’t get it

Sometimes, despite your best efforts, the conversation doesn’t go well. You feel dismissed. Shameful. Like you’ve been punished for trying to stay alive.

That’s not your fault. It’s a system failure.

You have options:

• Ask for a second opinion at a federally qualified health center (FQHC). 65% of these clinics now use standardized protocols for overdose prevention.
• Go to an urgent care center or ER. They’re required to offer naloxone to anyone at risk-and they don’t need a prior relationship with you.
• Buy naloxone over the counter at any pharmacy. In 48 states, you can walk in and ask for it without a prescription.

You don’t need permission to protect your life. You just need to know how to ask.

It’s not about being perfect-it’s about being alive

You don’t have to be “clean” to deserve safety. You don’t have to be “sick enough” to get help. You don’t have to earn the right to live.

This isn’t about guilt. It’s about preparedness. Just like you check your smoke detector every month, you can check in with your doctor about overdose risk. It’s not a failure. It’s responsibility.

The people who survive overdoses aren’t the ones who avoided talking about it. They’re the ones who found a way to say it-clearly, calmly, and without shame. You can be one of them.