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May 2026
Talking About Concerning Texas PMP Results
Note: This article provides general information to support reflection and continued learning about integrating PMP checks and results review into practice.
When a patient’s controlled substance prescription history or recent use raises concerns, it can be challenging to start the conversation, especially when you have limited time with each patient. Still, building trust through effective communication is key to providing high-quality care and improving health outcomes.
Identify Patient Risk Factors
When reviewing Texas Prescription Monitoring Program (PMP) results, look for signs that may indicate potential misuse or increased overdose risk, including:
Overlapping prescriptions (such as early fills, risk-additive combinations and therapeutic duplications).
Multiple prescribers, pharmacies or both.
High dosages (≥50 MME per day doubles the overdose risk, compared to <20 MME per day, according to the CDC).
Keep in mind that concerning data should lead to a discussion and not a decision. Talking with your patient, asking open-ended questions and working together to determine the most appropriate treatment options could save their life.
Evidence-Based Communication Tips
These conversations can be challenging, but the words you use can affect the care your patient receives.
Use person-first, non-stigmatizing language. Place the person before the condition to respect their dignity and avoid reducing them to a single trait. For example, say “person with a substance use disorder” instead of “addict,” or “misuse” or “use other than prescribed” instead of “abuse.”
Demonstrate active listening. Show active listening through eye contact, follow-up questions and reflective statements.
Apply motivational interviewing techniques. Ask open-ended questions like, “How does that sound to you?” to encourage reflection, participation and trust.
Focus on positive, supportive language. Instead of “I don’t know what’s wrong,” say “Sometimes we struggle to know exactly what causes this problem, but I’ll do my best to help you.”
Visit TxPMP.org/Training for free continuing education trainings and evidence-based guidelines to help you navigate challenging conversations and communicate effectively with your patients.
Connect to Next Steps
If the discussion confirms a risk for misuse or an opioid use disorder, consider some of these risk-reduction measures and referrals
Offer naloxone to reduce overdose risk.
Connect the patient to local care using FindTreatment.gov or Texas Outreach, Screening, Assessment and Referral substance use services.
Schedule a follow-up appointment to continue the conversation and monitor progress.
Arrange a warm handoff when possible, so patients aren’t left navigating the system on their own.
Every conversation is an opportunity to build trust with patients and support their long-term health. For more strategies and real-world talking points to help you approach sensitive topics, visit TxPMP.org/Resources to download the Prescriber Toolkit.