Talking to your doctor about dependence, addiction and treatment
You and your doctor have shared responsibility for your health, so it’s important to have a good relationship with them. If you can, try to see the same doctor. This allows your doctor to understand your health needs better and saves you having to explain the same things every time you see them. It’s also easier to build a trusting relationship if you see the same doctor. Having a regular doctor makes it easier to ask questions and helps them treat your healthcare needs.
Having a regular doctor also means you won’t be given prescriptions from multiple doctors. This reduces the chance of your medications mixing in a harmful way.
Talking to your doctor can be difficult or intimidating – especially when it comes to dependence and addiction. You might feel unsure about questioning their advice, or you may be worried that your doctor will see you as an ‘addict’ or might treat you differently.
Even if it’s hard, having open and honest conversations with your doctor is important. It means they can do their job more effectively and you’ll receive better healthcare.
Some doctors may react negatively if you talk to them or question them about dependence and addiction. If this happens, or if you don’t like or trust your doctor, find one you like and feel comfortable talking to. A local alcohol and drug service will know of doctors who specialise in treating dependence and addiction.
Before you visit a doctor, you should think about what you want from them. Write down what you want to say and what you want to ask.
If you don’t understand what the doctor is saying, tell them, and ask them to be clearer. Keep asking questions until you understand what they are saying.
There are doctors who specialise in seeing patients who use opioids or other drugs. Alcohol and drug services, harm reduction services or needle exchange services can connect you to these doctors. They may be easier to talk to about your concerns with the medications you’re taking.
Below are some examples of how you can talk to your doctor to make sure you understand the medications you’re taking.
Doctor: “You’re suffering from xxxxxxxxxxxx. You’ll need to take this medicine.”
Patient: “How will that medicine affect me?”
Doctor: “Here is a prescription for xxxxxxxxxxx.”
Patient: “I haven’t heard of this medicine before. Can you tell me about it?”
Doctor: “I’ve got a new prescription for you.”
Patient: “How will that medicine make me feel? Could it cause me any problems?”
Other questions that you can ask your doctor:
- Does this medication contain an opioid?
- Does this medication have any side effects or other risks? If so, what can I do about these?
- Is this the lowest dose possible?
- How long will I be on this medication for?
- Is this the best treatment for me?
- Are there other options for treatment?
- Can we develop a pain management plan?
- Should I see a pain management specialist?
If you’re currently taking other prescription medications, you should ask:
- I am currently taking [name of medicine]. Is it safe to take the medication you are prescribing with this?
If you or your family has a history of drug dependence or addiction, you should ask:
- I have/My family has a history of drug dependence. Should I take this medication?
Once you have started taking a medication, you should continue to see your doctor for regular follow-ups. At these follow-ups, you can ask:
- Do you think I still need to take this medication?
- When can I stop taking this medication?
- Will I need to taper off this medication?
- Are there medicines that don’t contain opioids I could switch to?
If you’re worried that you may be developing a dependence or if you have the urge to take more than directed, you should say:
- I am worried about this medication. I would like to reduce the amount I take or stop taking it. How should I do this?
- Are there any other treatments that may be more suitable?
- I’m worried I am becoming dependent on this medication. What treatments or strategies are available to help me?
If you’re currently using other drugs that have not been prescribed for you, it’s important to tell your doctor. This may affect how they choose to treat your pain.
Remember: quality healthcare is your right, regardless of whether you take drugs recreationally.
If your doctor prescribes you opioids, you can expect them to:
- Give you a prescription for the lowest effective dose for the shortest possible period of time
- Avoid or delay prescribing you opioids for chronic pain
- Work with you to set realistic treatment goals so you can achieve your best-possible health outcomes
- Schedule regular check-ups while you’re taking opioids
- Assist you with ‘tapering’ (reducing) your opioid use – when you no longer need opioids – to avoid unpleasant side effects.
In some countries, a doctor may ask you to sign an opioid therapy agreement before they prescribe you opioids for the longer-term.