Eight in Ten People in a New Study Had Recently Used Alone. Their Reasons Deserve a Better Answer Than 'Don't.'

You know why people use alone, even if nobody has ever asked you. You lock the door because no one is watching you there. Nobody is asking for some. Nobody is going to take it, or take advantage of how far gone you are. For a lot of people, alone is the safest-feeling room in a dangerous life.

Using alone is not a failure of judgment. It is a rational answer to an unsafe world, and overdose prevention that ignores that will keep losing.

A study published this month in Substance Use & Misuse by Kristin Schneider, Susan Sherman, and colleagues asked 493 people who use drugs about it directly. Eighty-one percent had recently used alone. When asked why, the most common answers were comfort, safety, and not having to share, per the Partnership to End Addiction’s research summary. The researchers also found who was most likely to use alone: people who used cocaine (about three and a half times as likely as people who never used alone, in statistical terms), people who had experienced physical violence (roughly twice as likely), and people without stable housing.

Read that list as a psychologist would. Violence teaches people that other people are the danger. Being unhoused means no private space at all, so a locked bathroom becomes the only privacy you get. None of that is irrational. The problem is that the same isolation that protects you from people also takes away the one person who could hand you naloxone.

That is why the shame-based message, “never use alone,” so often bounces off. It asks people to give up the thing that feels safe without offering anything that feels safer. Better tools meet people where the study says they are. The Never Use Alone hotline at 800-484-3731 stays on the line while you use and sends help to your location if you stop responding; it does not require you to let anyone into the room. Fentanyl test strips and naloxone within reach are still yours too.

For providers and outreach teams, the move this week is to change one intake question. Instead of “Do you ever use alone?”, which invites a lie, try “When you use alone, what makes that feel safer?” Then build the plan around the answer: a hotline number saved in their phone, naloxone left somewhere obvious, a check-in text with someone they trust. Our lived experience desk and stimulants hub have more.

Nobody locks a door because they want to die. They lock it because, out there, being seen has cost them too much.