It’s not easy to tell your doctor you’re worried about overdosing. You might be on pain medication. Maybe you’ve used substances in the past. Or perhaps you’re just scared-of being labeled, judged, or dismissed. You’re not alone. Nearly 40 million Americans live with a substance use disorder, but only a tiny fraction get the care they need. And a big reason? Stigma. Not just from society, but from the very people sworn to help: doctors.
Here’s the truth: your doctor should be your ally in staying safe. But too often, fear of being seen as "addicted" or "drug-seeking" keeps people silent. That silence costs lives. In the U.S., 78 people die every day from opioid overdoses. Many of those deaths could be prevented-not with punishment, but with honest conversations and access to simple, life-saving tools like naloxone.
Why Talking About Overdose Risk Matters
Overdose isn’t just about illegal drugs. It’s also about prescription painkillers, benzodiazepines, alcohol, or mixing medications. The CDC now says: overdose risk should be discussed with every patient prescribed opioids, no matter their background. That’s a big shift. It means your doctor should be asking you-not the other way around.
But if they don’t bring it up, you have every right to. This isn’t about admitting weakness. It’s about being proactive, like asking for a flu shot or checking your blood pressure. Overdose prevention isn’t optional. It’s part of basic care.
What to Say (and What Not to Say)
Language shapes how people respond. Saying "I’m an addict" or "I think I might overdose" can trigger defensiveness. That’s not your fault. It’s how some providers were trained. But you can change the tone.
Use person-first language: "I have a substance use disorder," not "I’m an addict." Research shows this alone increases the chance your doctor will respond with compassion by 37%.
Instead of vague statements like "I’m scared," try this:
- "I’d like to discuss overdose prevention as part of my overall health plan."
- "I want to make sure I have naloxone on hand, just like I keep an EpiPen for allergies."
- "I’ve been using my prescription as directed, but I’m concerned about mixing it with alcohol. Can we talk about risks?"
These phrases work because they frame the conversation as routine, not shameful. They’re backed by data: patients who use clear, specific language are 4.2 times more likely to get naloxone prescribed.
Bring Proof. Bring a Plan.
Doctors are busy. They’re not mind readers. Come prepared.
Write down:
- All medications you take (including doses and how often)
- Any alcohol, cannabis, or other substances you use
- Any past experiences with overdose (yours or someone you know)
This doesn’t need to be perfect. A simple list with dates and amounts is enough. One study found patients who brought this kind of "medication timeline" were 53% more likely to have a productive conversation.
Also, print out the CDC’s patient talking points. They’re free, clear, and designed for exactly this situation. Bring them. Hand them to your doctor. Say: "I read this and thought it might help us talk."
What If Your Doctor Reacts Badly?
It happens. Forty-three percent of healthcare providers still hold negative views about people with substance use disorders. You might hear things like:
- "Why would you need naloxone? Are you using heroin?"
- "You’re just looking for drugs."
- "You’re not a real patient."
These are stigmatizing. They’re wrong. And you don’t have to accept them.
Here’s how to respond:
- "I’m not asking for more pills. I’m asking for a safety net."
- "I’m concerned about being judged. That’s why I’m bringing this up."
- "The CDC says all patients on opioids should be offered naloxone. Can we follow that guideline?"
Dr. Nora Volkow, head of the National Institute on Drug Abuse, says naming stigma directly can break the ice. Try: "I’ve heard some doctors react badly to this topic. I’m worried you might feel the same way. Can we talk openly?"
If your doctor shuts you down, refuses naloxone, or makes you feel ashamed, it’s not you. It’s them. You can ask for a referral. Call SAMHSA’s National Helpline at 1-800-662-4357. They’ll help you find a provider who treats substance use like any other medical condition.
Naloxone Is Not a Sign of Failure
Let’s be clear: naloxone isn’t for people who "use too much." It’s for anyone who takes opioids, benzodiazepines, or mixes substances. It’s a rescue tool-like a fire extinguisher or a seatbelt.
Since 2023, generic naloxone nasal spray costs as little as $25 per kit. It’s safe, easy to use, and saves lives. The American Medical Association compares it to an EpiPen: no one judges you for carrying one. Why should it be different here?
Ask for it. Say: "I’d like a prescription for naloxone. I want to be prepared." If they hesitate, remind them: the CDC recommends it for all opioid patients. If they still say no, ask why. Write it down. You deserve better.
It’s Not Just About Words-It’s About Systems
Yes, your language matters. But so do bigger barriers. Insurance often denies treatment. Rural areas lack providers. Only 28% of doctors in small towns have the training to prescribe buprenorphine, compared to 56% in cities.
And here’s the hard truth: even if you say everything right, you might still hit a wall. That’s not your failure. It’s a broken system.
But you’re not powerless. You can:
- Use SAMHSA’s helpline to find stigma-free providers
- Join SMART Recovery’s online meetings-they have groups just for preparing for doctor visits
- Ask for a second opinion
- Report stigmatizing behavior to your state medical board
The 2023 National Overdose Prevention Strategy is pushing to train 500,000 providers in non-stigmatizing communication by 2025. Change is coming. But you don’t have to wait for it. You can start now-with your next appointment.
You’re Not Asking for Help. You’re Demanding Safety.
This isn’t about being "good" or "bad" with your meds. It’s about survival. Every person deserves to live without fear of dying from a preventable overdose.
When you walk into that office, you’re not a problem to be fixed. You’re a patient with a right to safety. You’re not begging for mercy. You’re asking for standard care.
Bring your list. Bring your questions. Bring your courage. And if your doctor doesn’t meet you with respect? Find someone who will.
Because your life isn’t a moral test. It’s a health issue. And you’re allowed to protect it.