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Mar 2026
Why Patients Seek Opioids: How to Support Safer Prescribing
Note: This article provides general information to support reflection and continued learning about integrating PMP checks and results review into practice.
As a clinician, you may come across a patient’s Texas Prescription Monitoring Program (PMP) history that raises concerns. Rather than assuming misuse, it’s worth asking: Why is this patient seeking opioids? The reasons are often more complex than they appear.
Understanding your patient’s full story can help you make safer prescribing decisions, and the Texas PMP is a powerful place to start.
Pain Is Still a Primary Driver
According to the U.S. Centers for Disease Control and Prevention (CDC), an estimated 24% of U.S. adults experience chronic pain. For many, it’s not just about relief; it’s about regaining a sense of normalcy in their daily lives. If you see a concerning pattern in the Texas PMP, it may signal that a patient’s pain isn’t being well managed. Consider interventional pain management, nonopioid medication options, physical therapy and integrative approaches as ways to support your patient’s care.
Mental Health and Past Trauma Are Key Factors
Any mental health diagnosis or trauma increases the risk of opioid use. According to a study on prescription opioid misuse, people with higher rates of adverse childhood experiences are more likely to be prescribed opioids and may be at greater risk of developing opioid use disorder. Use a patient’s PMP history as a starting point for a conversation about the possibility of current or past trauma and emotional well-being. Having these discussions may uncover needs that require treatment other than opioids.
Life Stressors Influence Use
Chronic stress — whether from social or financial challenges such as job loss, housing instability, caregiving demands or work burnout — can affect how patients manage pain. Any of these stressors can lead patients to self-medicate with opioids or other substances. If Texas PMP data reveals a concerning pattern, consider asking about underlying stressors that your patient may not have disclosed.
Using the Texas PMP to Support, Not Just Screen
The Texas PMP is more than a monitoring tool. When a patient’s prescription history raises questions, it’s an opportunity to pause, ask open-ended questions and better understand the factors influencing their treatment. Explore the Texas PMP Prescriber Toolkit for communication guidelines and talking points to support productive conversations with patients about their Texas PMP data and the safe alleviation of pain.
When appropriate, reassess their care plan or connect them to local services like Texas Outreach, Screening, Assessment and Referral substance use services or FindTreatment.gov. For patients at higher risk, consider co-prescribing naloxone as recommended by the CDC.
