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 might instead look at you like you’ve done something wrong. You’re not alone. Millions of people take prescription pain meds, use substances to cope, or are just trying to stay safe while managing chronic conditions. And yet, too many avoid this conversation because they fear being labeled, shamed, or dismissed. The truth? You have the right to talk about overdose risk like you would any other health concern-no shame, no judgment. Here’s how to do it.

Start with the right words

Language matters. Not just because it’s politically correct, but because the words you use change how your doctor hears you. If you say, “I’m afraid I might overdose,” your doctor might think you’re in crisis. If you say, “I’d like to talk about overdose prevention as part of my care plan,” you’re framing it as routine, not dramatic. Research shows this shift increases the chance your doctor will respond with support-not suspicion.

Use person-first language. Say “person with a substance use disorder,” not “addict.” Say “I use opioids for pain,” not “I’m hooked on pills.” Studies from Johns Hopkins show that when patients use respectful, clinical language, providers are 37% more likely to respond with compassion. It’s not about sounding perfect-it’s about sounding like someone who’s managing a health condition, not a moral failing.

Be specific. Don’t guess.

Vague statements like “I’m worried” or “I think I might be at risk” leave room for assumptions. Your doctor doesn’t know your history unless you tell them. Bring a simple list:

• What medications you take (name, dose, how often)
• Any other substances you use (alcohol, cannabis, benzodiazepines, etc.)
• When you’ve felt dizzy, passed out, or had trouble breathing after taking meds
• If you’ve ever used someone else’s prescription

This isn’t about confessing. It’s about giving facts. A 2021 study in the Journal of General Internal Medicine found that patients who brought a written medication timeline were 53% more likely to have a productive conversation. You don’t need to be perfect. Just honest. And prepared.

Ask for naloxone like you’d ask for an EpiPen

Naloxone saves lives. It reverses opioid overdoses in minutes. And it’s not just for people who use heroin. It’s for anyone taking opioids long-term-whether it’s oxycodone, hydrocodone, or fentanyl patches. Yet, only 1 in 4 people prescribed opioids ever get naloxone.

Here’s the script that works: “I’d like to discuss overdose prevention strategies and receive naloxone as a safety measure.” That exact phrase, used in a 2021 JAMA Internal Medicine study, increased naloxone prescriptions by 62%. Why? Because it frames naloxone as a standard safety tool-not a sign of failure.

Think of it like having a fire extinguisher in your kitchen. You don’t need to burn down your house to justify keeping one. Same here. Dr. Bobby Mukkamala from the American Medical Association says it best: “Naloxone is like an EpiPen for allergies. No one judges you for carrying one.”

Anticipate the pushback-and stay calm

Not every doctor will respond well. Some still believe people with substance use disorders are “just looking for drugs.” One Reddit user shared that when they mentioned naloxone, their doctor asked, “Are you using heroin?” They felt so shamed they didn’t return for eight months.

If your doctor reacts negatively, don’t take it personally. Their bias isn’t your fault. But you have options:

• “I understand this might be uncomfortable, but I’m asking because I care about staying alive.”
• “I’ve read the CDC guidelines. They recommend discussing overdose risk with every patient on opioids.”
• “Can you refer me to someone who specializes in this? I want to make sure I’m getting the right care.”

The NACCHO Healthcare Provider Stigma Measures Toolkit shows that 43% of providers still hold negative attitudes toward people with opioid use disorder. That’s not you. That’s their training-or lack of it. You’re not wrong for asking. They’re wrong for making you feel like you are.

Use the CDC’s toolkit. It’s free.

The Centers for Disease Control and Prevention has a free, downloadable patient guide called “Talking to Your Doctor About Overdose Risk.” It includes:

• Sample scripts
• How to document your medication use
• Questions to ask about alternatives to opioids
• Where to get naloxone for free or low cost

You can print it out and bring it to your appointment. Or just read it on your phone. It’s designed to help you speak with confidence. In 2023, the CDC updated its clinical guidelines to say: “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.

Know your rights

Since 2021, the X-waiver requirement for prescribing buprenorphine (a medication for opioid use disorder) has been eliminated. That means more doctors can now help you. And since 2023, the FDA approved a generic nasal naloxone that costs as little as $25-down from $130.

If your doctor refuses naloxone, ask why. If they say, “You don’t need it,” respond: “The CDC says everyone on opioids should have access to it. Can you help me get it?” If they still say no, ask for a referral to a pain clinic, addiction specialist, or community health center. Federally qualified health centers (FQHCs) have been required since 2020 to offer overdose prevention services as part of standard care.

It’s okay to walk away

If your doctor makes you feel judged, disrespected, or unsafe-leave. You don’t owe them your loyalty if they’re not treating you like a human being. There are thousands of providers who understand this isn’t about morality. It’s about medicine.

Find a new one. Use SAMHSA’s National Helpline (1-800-662-4357). They’ll connect you with providers who specialize in non-stigmatizing care. Or search for clinics that advertise “harm reduction” or “patient-centered opioid management.” These places don’t assume the worst. They assume you want to live.

What if you’re not on opioids?

You don’t need to be taking prescription painkillers to be at risk. Mixing alcohol with benzodiazepines? Using street drugs? Taking more than prescribed? Living alone? Having a history of overdose? These are all risk factors. The same tools apply. Ask for naloxone. Bring your list. Use clear language. You’re not overreacting. You’re being smart.

Support is out there

You don’t have to do this alone. SMART Recovery holds weekly online meetings specifically for preparing for medical appointments. Reverse Overdose Oregon offers free, tested scripts in multiple languages. The American Medical Association’s patient guide is available in 12 languages. And SAMHSA’s helpline took nearly 300,000 calls in 2022-up 22% from the year before. People are reaching out. And they’re getting help.

Overdose isn’t inevitable

You’re not doomed because you use substances. You’re not weak because you’re scared. You’re not a burden because you want to live. Overdose is preventable. And the first step isn’t quitting. It’s talking.

The goal isn’t to convince your doctor you’re “worthy” of care. It’s to remind them that you’re a patient. And like every other patient, you deserve safety, respect, and the tools to stay alive.