How to Discuss Overdose Risk with Your Doctor Without Stigma

Talking to your doctor about overdose risk shouldn’t feel like confessing a crime. Yet for many people using opioids, benzodiazepines, or other high-risk medications - even when prescribed - the fear of being judged stops them from asking for life-saving help. You’re not alone. In 2022, over 70,000 people in the U.S. died from drug overdoses. Many of those deaths could have been prevented if the person had access to naloxone and felt safe enough to ask for it.

Why This Conversation Matters

Overdose isn’t just about illegal drugs. It happens to people taking prescription painkillers exactly as directed. The CDC now says overdose risk should be discussed with every patient prescribed opioids, no matter their background. That’s because risk isn’t about who you are - it’s about what you’re taking, how much, and what else you’re using. Mixing opioids with alcohol or sleep meds? That’s a red flag. Taking more than prescribed? That’s a warning sign. Even if you’ve never used street drugs, you can still be at risk.

But here’s the problem: 68% of people with substance use disorder say they’ve been treated with shame or disrespect by healthcare providers. Phrases like “You’re just looking for drugs” or “Why would you need that?” aren’t just hurtful - they push people away from care. And when you avoid the doctor, you lose access to naloxone, which can reverse an opioid overdose in minutes.

What to Say - And How to Say It

The key isn’t to apologize. It’s to speak like you’re discussing blood pressure or cholesterol. Use clear, factual language. Here’s what works:

• “I’d like to discuss overdose prevention as part of my health plan.”
• “I’m taking [medication name] at [dose] and sometimes [context, e.g., ‘I have trouble sleeping’ or ‘I’ve been under a lot of stress’]. I want to make sure I’m safe.”
• “Can I get a prescription for naloxone? I see it like an EpiPen - it’s a safety tool.”
• “I’m concerned about being judged. I need to talk openly so I can stay safe.”

These phrases aren’t magic. They’re backed by data. A 2021 study in JAMA Internal Medicine found patients who used direct, calm language like these were 62% more likely to get naloxone than those who said vague things like “I’m scared I might overdose.”

And don’t let the word “addict” slip in - not from you, not from them. Use “person with a substance use disorder.” That’s not political correctness. It’s science. A 2022 Johns Hopkins study showed that using person-first language made doctors 37% more likely to respond with empathy.

Prepare Before You Go

Walking in unprepared is like showing up to a car repair without knowing your model. Bring a short list:

• All medications you take - including prescriptions, OTC painkillers, sleep aids, and anxiety meds.
• How much and how often you take each one.
• Any alcohol or recreational substances you use - even if you think it’s “not a big deal.”
• Any past overdoses, near-misses, or times you felt you couldn’t breathe after taking something.

This takes 15 to 20 minutes. Write it down. Print it. Bring it with you. Studies show patients who do this are 53% more likely to have a productive conversation. Your doctor doesn’t need to guess. Give them the facts.

What to Do If Your Doctor Reacts Poorly

Not every provider is trained. In rural areas, only 28% of primary care doctors are certified to prescribe buprenorphine. Some still believe addiction is a moral failure. If your doctor says something like, “Are you using heroin?” or “You’re just looking for drugs,” here’s what to do:

• Stay calm. Say, “I understand you’re concerned. I’m not here to get drugs. I’m here to stay alive.”
• Ask for a referral. “Can you recommend another provider who specializes in safe pain management?”
• Know your rights. Under the 21st Century Cures Act, providers receiving federal funding are required to complete stigma training. You can ask if they’ve done it.
• Leave if you feel unsafe. Your health is more important than loyalty to one provider.

One patient on Reddit shared: “I brought the CDC’s talking points to my appointment. My doctor said, ‘You’re right - let’s get you naloxone.’” Another said: “I got shut down. I didn’t go back for eight months. I almost didn’t make it.”

Naloxone Is Not a Reward - It’s a Right

Naloxone isn’t for “drug users.” It’s for anyone who might accidentally overdose. It’s not addictive. It doesn’t get you high. It doesn’t encourage drug use. It saves lives. In 2023, the FDA approved the first generic nasal naloxone - now it costs under $25 instead of $130. Many pharmacies give it out for free. You don’t need a prescription in 47 states. You can walk in and ask: “I’d like to pick up naloxone for overdose prevention.”

Think of it like a fire extinguisher. You don’t wait until your house is on fire to buy one. You keep it handy. Same with naloxone.

Who Else Can Help?

You don’t have to do this alone.

• SAMHSA National Helpline (1-800-662-4357): Free, confidential, available 24/7. They’ll help you prep for your appointment.
• SMART Recovery: Online meetings specifically for preparing for medical visits. Over 1,200 people join monthly.
• Reverse Overdose Oregon: Offers free, tested scripts for patients. Available online.
• AMA’s Patient Guide: Repurposed from their physician guide. Available in 12 languages.

These aren’t just resources. They’re lifelines. In 2022, the helpline answered nearly 300,000 calls - up 22% from the year before. People are asking for help. And help is there.

The Bigger Picture

Stigma isn’t just about words. It’s about systems. Insurance still denies treatment 41% of the time. In some states, there’s one treatment center per 100,000 people. But change is happening. The 2023 National Overdose Prevention Strategy aims to train half a million providers in non-stigmatizing care by 2025. Medicare will soon tie 15% of payments to how well doctors reduce stigma. That’s real progress.

But none of it matters if you don’t speak up.

You’re not weak for needing help. You’re smart for preparing. You’re brave for asking. And you deserve care - not judgment.