It’s hard to say out loud that you’re afraid you might overdose. Maybe you’re on opioids for chronic pain. Maybe you’ve used alcohol or other substances to cope. Maybe you’re not sure if you’re at risk-but you feel uneasy, and you know you should talk to your doctor. But what if they judge you? What if they think you’re just looking for drugs? You’re not alone. Overdose risk is real, and so is the silence around it. Too many people avoid this conversation because they’ve been made to feel ashamed. But you don’t have to. There’s a way to talk about this that works-and it doesn’t require you to beg for help.

Why This Conversation Matters More Than You Think

Every day in the U.S., 78 people die from opioid overdoses. That’s not a statistic-it’s someone’s parent, sibling, friend, or neighbor. And the number one reason people don’t get help before it’s too late? Stigma. Not lack of access. Not cost. Not even ignorance. It’s the fear of being labeled as weak, reckless, or dishonest.

The good news? Doctors are trained to help. The CDC, AMA, and SAMHSA all agree: overdose prevention is part of routine care. Naloxone isn’t just for people who use heroin. It’s for anyone on long-term opioids, anyone mixing medications, anyone who’s ever felt like they might lose control. It’s like having an EpiPen for allergies. You don’t ask permission to carry one. You just do it.

What to Say (and What Not to Say)

The words you use change everything. Saying, “I’m scared I might overdose,” can trigger defensiveness. Saying, “I’d like to discuss overdose prevention as part of my safety plan,” changes the tone completely.

Here’s what works:

  • “I’m on opioids for pain, and I want to make sure I’m safe. Can we talk about overdose risk?”
  • “I’ve heard naloxone can reverse an overdose. Can I get a prescription, just in case?”
  • “I want to be proactive about my health. Can we go over my full medication list and make sure nothing’s dangerous together?”
Avoid these phrases:

  • “I think I have a problem.” (Too vague. Triggers assumptions.)
  • “I’m addicted.” (Labeling yourself invites judgment.)
  • “I’m worried I might use too much.” (Sounds like you’re asking for permission.)
Research from Johns Hopkins shows that using person-first language-like “person with a substance use disorder” instead of “addict”-makes providers 37% more likely to respond with compassion. You’re not asking for mercy. You’re asking for standard medical care.

Prepare Before You Walk In

Don’t wing it. Bring a written list. Not a confession. A record.

Write down:

  • All medications you take (including prescriptions, OTC painkillers, sleep aids)
  • Alcohol use (how many drinks, how often)
  • Any other substances-even if you think they’re “not a big deal”
  • Any times you’ve felt dizzy, passed out, or had trouble breathing after taking something
  • Any family history of substance use or overdose
This takes 15 minutes. But it makes your doctor’s job easier-and yours safer. A 2021 study in the Journal of General Internal Medicine found that patients who brought this kind of list were 53% more likely to have a productive conversation.

Trembling hands place naloxone beside pain meds and a coffee mug on a kitchen counter.

Ask for Naloxone-Like You’d Ask for a Flu Shot

Naloxone isn’t a reward for being “good.” It’s a safety tool. And it’s cheaper than ever. Since mid-2023, generic nasal naloxone costs about $25-down from $130. Many pharmacies carry it without a prescription. But your doctor can give you one, explain how to use it, and even train your family or friends.

Say this: “I’d like to receive naloxone as a standard safety measure, like we do with fire extinguishers or seatbelts.”

A 2021 JAMA study found patients who used this exact phrase were 62% more likely to get naloxone than those who said, “I’m worried I might overdose.” Why? Because you’re framing it as prevention-not punishment.

What If Your Doctor Reacts Badly?

Some providers still hold outdated views. A 2019 study found 43% of clinicians had negative attitudes toward patients with opioid use disorder. That’s changing-but not fast enough.

If your doctor says something like, “Are you using heroin?” or “You’re just looking for drugs,” here’s how to respond:

  • “I’m not here to get drugs. I’m here to stay alive.”
  • “I’ve read the CDC guidelines. They say all patients on opioids should be offered overdose education.”
  • “I’m concerned about being judged. That’s why I’m bringing this up now.”
You have the right to respectful care. If they dismiss you, ask for a referral. Say, “Can you recommend another provider who’s trained in addiction medicine?”

A group of people hold naloxone kits and safety plans together in a warmly lit community space.

Resources That Actually Help

You don’t have to do this alone.

  • SAMHSA National Helpline: 1-800-662-4357. Free, confidential, 24/7. They can help you prepare for your appointment.
  • Reverse Overdose Oregon: Their free toolkit has pre-written scripts tested with real patients.
  • SMART Recovery: Weekly online meetings to practice talking to doctors. Over 1,200 people join each month.
  • AMA’s Patient Guide: Available in 12 languages. It’s written for patients, not just doctors.

This Isn’t About Blame. It’s About Survival.

You’re not weak for needing help. You’re smart for asking for it. Overdose doesn’t care if you’re “deserving.” It doesn’t wait for you to hit rock bottom. It doesn’t ask if you’ve been “good.”

The medical system is changing. The CDC now says: Assess overdose risk for every patient on opioids, no matter who they are. That’s a policy shift. And it means you don’t have to prove you’re worthy of safety.

You deserve to live. You deserve to be heard. You deserve to have a plan.

Start with one sentence. Bring your list. Ask for naloxone. Say it like you mean it.

Your life isn’t a last resort. It’s a priority.

What if my doctor refuses to give me naloxone?

If your doctor refuses, ask why. If they say, “You don’t need it,” respond with: “The CDC recommends it for all patients on long-term opioids. Can you explain why you’re not offering it to me?” If they still say no, ask for a referral to a provider trained in addiction medicine. You can also get naloxone without a prescription at most pharmacies for under $25. You don’t need permission to protect your life.

Is it okay to mention alcohol or recreational drugs in this conversation?

Yes. Mixing alcohol or other drugs with opioids is one of the leading causes of overdose. Your doctor needs to know everything you’re using-even if you think it’s “not a big deal.” Hiding it puts you at greater risk. Doctors aren’t there to judge. They’re there to prevent death. The more honest you are, the better they can help.

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

In most cases, no. Doctors are not law enforcement. They can’t report you for drug use unless you’re a danger to yourself or others (like driving under the influence). Even then, their first step is usually to offer help, not punishment. The goal of modern medicine is treatment, not punishment. If you’re worried, you can say: “I’m sharing this so you can help me stay safe-not so I’ll get in trouble.”

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

You’re at higher risk if you: take opioids daily, use higher doses than prescribed, mix opioids with alcohol or benzodiazepines (like Xanax or Valium), have a history of overdose, use drugs alone, or have other health conditions like lung disease or liver problems. But risk isn’t just about what you use-it’s about context. Even someone on a low dose can overdose if they’re tired, sick, or haven’t used in a while. If you’re unsure, ask your doctor to assess your risk. You don’t need to be “addicted” to be at risk.

Can I get naloxone if I’m not on opioids?

Yes. Naloxone can reverse overdoses from any opioid, including heroin, fentanyl, or even prescription painkillers. You don’t need to be on opioids to benefit from having it. Many people carry it because they live with someone who is, or because they use other substances. If you’re around people who use opioids, or if you’ve ever been around someone who overdosed, having naloxone is a smart safety step.