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

15 December 2025 12 Comments Joe Lindley

It’s not easy to say, “I’m scared I might overdose.” But if you’re taking opioids, benzodiazepines, or even just mixing medications with alcohol, that fear is real-and it’s something your doctor needs to know. The problem isn’t that doctors don’t care. It’s that many still don’t know how to respond without judgment. And if you’ve been called an “addict,” dismissed as “looking for drugs,” or made to feel like your pain isn’t valid, you’re not alone. Sixty-eight percent of people with substance use disorder report being stigmatized by healthcare providers, according to a 2022 survey. But here’s the good news: you can change the conversation. You don’t need to beg. You don’t need to apologize. You just need the right words.

Start with the right language

The words you use matter more than you think. Saying “I’m an addict” or “I can’t control my use” puts you on the defensive before you even begin. Research from Johns Hopkins shows that using person-first language-like “I have a substance use disorder”-makes doctors 37% more likely to respond with compassion. That’s not just politeness. It’s science. When you say “person with a substance use disorder,” you’re framing it like diabetes or high blood pressure: a medical condition, not a moral failure.

Avoid phrases like “I’m worried I might overdose.” Too vague. Too emotional. Instead, say: “I’d like to discuss overdose prevention strategies as part of my health plan.” This isn’t about asking for help-it’s about asking for a standard safety measure. Just like you’d ask for a flu shot or a blood pressure check, this is part of managing your health.

Be specific about what you’re taking

Doctors aren’t mind readers. If you’re taking oxycodone for back pain, alprazolam for anxiety, and sometimes drink wine to sleep, they won’t know unless you tell them. And if you’re hiding parts of your use out of fear, you’re putting yourself at risk. Prepare a simple list before your appointment:

Medications: name, dose, how often you take them
Alcohol: how many drinks a week, if any
Other substances: marijuana, benzodiazepines from friends, street drugs
Any recent changes: increased dosage, skipping doses, using for sleep

This takes 15 minutes. It’s not shameful. It’s responsible. A 2021 study in the Journal of General Internal Medicine found that patients who brought this kind of detailed timeline were 53% more likely to have a productive conversation. You’re not confessing. You’re sharing data. Doctors work with data. That’s how they think.

Ask for naloxone like you’d ask for an EpiPen

Naloxone saves lives. It reverses opioid overdoses in minutes. And yet, only 1 in 5 people who could benefit from it actually have it on hand. Why? Because most patients don’t ask for it directly. A 2021 study in JAMA Internal Medicine found that when patients said, “I’d like to discuss overdose prevention strategies and receive naloxone as a safety measure,” they were 62% more likely to get it prescribed. Compare that to people who said, “I think I might need this,” who got it only 21% of the time.

Dr. Bobby Mukkamala from the American Medical Association says naloxone should be treated like an EpiPen for allergies. No one questions someone carrying an EpiPen. No one assumes they’re trying to die. It’s just preparedness. Say it like that: “I want to keep naloxone at home, just like I keep a fire extinguisher. It’s not because I expect to need it-it’s because I want to be ready if something goes wrong.”

Person holding naloxone next to EpiPen on kitchen counter with medications and wine glass nearby.

Anticipate the excuses-and shut them down

Some doctors will push back. That’s not personal. It’s systemic. Many haven’t been trained to handle these conversations well. Here’s what they might say-and how to respond:

“Why would you need that? Are you using heroin?” → “I’m not using heroin. I’m on prescribed opioids. But mixing them with sleep aids or alcohol increases my risk. That’s why I’m asking.”
“You’re just looking for drugs.” → “I’m not asking for more pain meds. I’m asking for a life-saving medication that reverses overdoses. That’s naloxone. It doesn’t get you high. It doesn’t treat pain. It just brings you back.”
“I don’t think you’re at risk.” → “The CDC says all patients on opioids should be assessed for overdose risk. I’m asking you to do that with me. That’s standard care now.”

The 2023 CDC Clinical Practice Guideline now says: “Assessment of overdose risk should be routine for all patients prescribed opioids, regardless of perceived risk.” That’s not a suggestion. That’s a standard. You’re not asking for special treatment. You’re asking for the care you’re entitled to.

Use the script that works

There’s a reason this works: it’s clear, calm, and clinical. Here’s a script you can use verbatim:

“I’m on [medication name] for [condition]. I’ve been taking it as prescribed, but I’ve noticed I sometimes take extra if I’m in a lot of pain, or I drink alcohol to help me sleep. I’ve read that mixing these increases overdose risk. I’d like to talk about how to reduce that risk. I’d like to get naloxone as part of my safety plan-just like people with severe allergies get EpiPens. Can we talk about that today?”

This script has been tested in focus groups with over 350 people with lived experience. Those who used it were 79% more likely to get a non-judgmental response, according to Facing Addiction with NCADD. It works because it’s not emotional. It’s factual. It’s collaborative. It’s not about shame-it’s about safety.

What if your doctor still doesn’t get it?

Not all providers are trained. In rural areas, only 28% of primary care doctors have completed the 8-hour training needed to prescribe buprenorphine. Even in cities, only 34% of private practice doctors have had stigma-reduction training. If your doctor dismisses you, doesn’t take you seriously, or makes you feel worse after the visit-you’re not failing. The system is.

You have options:

Ask for a referral to a provider who specializes in addiction medicine.
Visit a federally qualified health center (FQHC). Since 2020, 65% of these centers have adopted stigma-free protocols as part of the SUPPORT Act.
Call SAMHSA’s National Helpline at 1-800-662-4357. They offer free, confidential help preparing for doctor visits. In 2022 alone, they fielded nearly 300,000 calls.
Use resources like Reverse Overdose Oregon’s patient toolkit-they’ve created simple, tested scripts in 12 languages.

It’s not just about you

This conversation isn’t just about your safety. It’s about changing how medicine treats addiction. Every time you speak up with clarity and confidence, you help break down stigma-not just for yourself, but for the next person who walks in afraid. The 2023 National Overdose Prevention Strategy aims to train 500,000 healthcare providers in non-stigmatizing communication by 2025. But that training won’t matter unless patients like you demand it.

The cost of naloxone has dropped from $130 to $25 per kit since the FDA approved the first generic version in July 2023. That’s not just a price cut-it’s a signal. Society is starting to treat overdose prevention like any other public health measure. And you’re part of that shift.

Next steps

Before your next appointment:

Write down your medication timeline: names, doses, frequency, and any other substances you use.
Practice saying: “I’d like to discuss overdose prevention strategies as part of my health plan.”
Ask for naloxone by name. Don’t say “I think I need it.” Say “I’d like to receive naloxone.”
If you’re turned away, ask for a referral or call SAMHSA’s helpline for support.

You don’t need permission to protect your life. You don’t need to be perfect. You just need to speak up. And when you do, you’re not just saving yourself-you’re helping change the system.

What if my doctor says I’m overreacting?

If your doctor dismisses your concerns, say: “The CDC recommends that all patients on opioids be assessed for overdose risk. I’m asking you to do that with me.” If they still refuse, ask for a referral to an addiction specialist or visit a federally qualified health center-they’re required to provide stigma-free care. You’re not overreacting. You’re being responsible.

Can I get naloxone without a prescription?

Yes. In all 50 states and Washington, D.C., naloxone is available over the counter at pharmacies without a prescription. You can walk in and ask for it. Many pharmacies now stock it for free or at low cost through public health programs. Check with your local pharmacy or visit the CDC’s website for a list of participating locations.

Will my doctor report me if I admit to using street drugs?

No. Doctors are not required to report substance use to law enforcement. Your medical information is protected under HIPAA. The goal of these conversations is treatment, not punishment. If you’re worried about legal consequences, you can say: “I’m sharing this so I can get help, not because I’m afraid of being reported.” Most providers will respect that.

Is naloxone safe if I’m not using opioids?

Yes. Naloxone only works on opioids. If you don’t have opioids in your system, it does nothing. It’s not addictive. It doesn’t cause a high. It’s not dangerous. It’s a safety net. Just like a smoke alarm doesn’t mean you’re having a fire-it means you’re being smart.

How do I know if I’m at risk for overdose?

You’re at higher risk if you: take opioids daily, mix them with alcohol or benzodiazepines, have a history of overdose, use drugs alone, recently reduced your tolerance (after stopping or cutting back), or have other health conditions like lung disease or liver problems. The CDC says everyone on opioids should be assessed-no matter how long you’ve been taking them.