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Patients’ perspective on the development of a prescription opioid use disorder

  • At: PPR 2022 (2022)
  • Type: Poster
  • By: DAVIES, Lisa (Utrecht University)
  • Co-author(s): Lisa Davies, Phd, Utrecht University, Netherlands
    Ellen Koster
    Katinka Damen
    Harmen Beurmanjer
    Arnt Schellekens
    Marcel Bouvy

  • Abstract:

    Background: In the past decade prescription opioid use increased exponentially and concomitantly opioid use disorders (OUD) are becoming more common. Several risk factors for developing an OUD have been identified, but less is known regarding the patients’ perspective on developing a prescription OUD.
    Methods: We recruited 25 adults undergoing treatment for prescription OUD. In-depth, semi-structured interviews focussing on experiences with long term opioid use, knowledge and attitudes regarding opioids, and access to opioids were conducted. A directed content analysis was used to identify themes/codes in the transcribed interviews using Nvivo.
    Results: Participants mentioned that the development of an OUD is affected by various factors which could be grouped into three themes: 1) experiences driving initiation, 2) experiences driving continuation, and 3) experiences with prescription OUD. Besides the need for pain management the dynamics of patient-provider communication, care coordination, provider vigilance, and environmental support all contributed to the way patients used their opioids.
    Conclusions: Patients experiences illustrate that development of prescription OUD generally follows the lines of other substance addictions, though negative reinforcement might play a more prominent role in the early phase of prescription opioid use. Poorly controlled pain and experiencing subjective stress were considered major risk factors for developing an opioid use disorder. It seems critical that prescribing clinicians set realistic expectations for pain management and discuss the risks of long term opioid use at the start of treatment. Subsequently, the need for continued treatment and the risk of the development of OUD should be regularly evaluated.

Last update 4 October 2019

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