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Presence Explore - March 2025

How Can the Real Talk Technique Help Speech-Language Pathologists Have Conversations About Opioid Use?

Susan Holmes-Walker, PhD, RN

May 15, 2026

Question

How can the Real Talk technique help speech-language pathologists have conversations about opioid use?

Answer

As healthcare professionals, we often need to have crucial conversations with our patients. When it has been determined that opioid exposure is one of the reasons a patient has developed issues with speech, language, or communication, it may be time to have a direct conversation with that patient. The ability to have real, transparent conversations and use proper communication skills so that patients and clients feel comfortable sharing is very important.

Real Talk is a strategy connecting people through meaningful conversations to reduce and prevent substance misuse. It is a valuable resource for healthcare professionals and focuses on improving communication skills and fostering open and honest conversations about opioid use and its implications. A lot of times it is not what we say, but how we say it.

Real Talk training involves workshops covering topics such as the science of addiction, the recovery process, and the impact of stigma. We know that there is implicit bias and stereotyping for patients who may misuse opioids, and so the level of comfort they have with sharing their specific challenges with healthcare providers may be limited. The training involves role-playing scenarios that allow participants to practice effective communication strategies, resource sharing to provide information about local recovery programs and support services, and community building to connect participants with a network of recovery allies.

To be an ally, it takes specific skills. Listening without judgment means that allies provide a safe space for individuals to share their experiences without fear of criticism. Using inclusive language means understanding the power of words and striving to use language that uplifts rather than alienates. We do not call people drug abusers; we call them people who misuse drugs. Advocating for resources means working to ensure that individuals in recovery have access to the tools and support they need. Educating themselves and others means that allies continually learn about recovery and share their knowledge to promote a culture of empathy.

Using Real Talk techniques, or whatever strategies you have learned over time to communicate with your patients, can guide honest, transparent communication with patients and community members. Being very open, building rapport, and having patients feel that they are not being stereotyped or looked down upon is a very important skill to have and utilize.

This Ask the Expert is an edited excerpt from the course, Opioids and Impact on Speech Development: What You Need to Know, presented by Susan Holmes-Walker, PhD, RN.


susan holmes walker

Susan Holmes-Walker, PhD, RN

Susan Holmes-Walker, PhD, RN, owner and founder of the Sulan Group LLC, a continuing education provider, is a registered nurse licensed in Michigan and Florida. Dr. Holmes-Walker has a diverse background in healthcare, including roles in non-opioid pain management, risk and safety, case management, continuous quality improvement, and the medical device industry, working in opioid use disorder. She is currently a Research Nurse Care Manager at Portland Health & Science University, participating in a research study aimed at improving pain management for Veterans in rural communities with high-impact chronic pain. She is committed to improving patient care in our global society, has documented success working within healthcare teams, and is committed to professional and personal growth through lifelong continuing education. Her mission is to share lessons learned from her professional career to provide continuing education for licensed health care professionals on improving the assessment and management of pain.


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