Patients' Perspectives on the Development of Prescription Opioid Use Disorder in Patients with Chronic Non-Cancer Pain

Lisa E M Davies; Ellen S Koster; Katinka F M Damen; Harmen Beurmanjer; Arnt F A Schellekens; Marcel L Bouvy

doi:10.1159/000529926

Patients' Perspectives on the Development of Prescription Opioid Use Disorder in Patients with Chronic Non-Cancer Pain

Lisa E M Davies, Ellen S Koster, Katinka F M Damen, Harmen Beurmanjer, Arnt F A Schellekens, Marcel L Bouvy

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

INTRODUCTION: In the past decade, prescription opioid use increased exponentially and concomitantly opioid use disorders (OUD) are becoming more common. Several risk factors for developing OUD have been identified, but little 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 focussed on experiences with long-term opioid use, knowledge and attitudes regarding opioids, and access to opioids. A directed content analysis was conducted on the transcribed interviews using NVivo.

RESULTS: Participants showed 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.

CONCLUSION: Patients' experiences illustrate that the first stage of the development of prescription OUD differs from the development of other substance addictions. Negative reinforcement might play a more prominent role in the early phase of prescription opioid use. Patients expressed a lack of guidance, both at the start of use and long-term use, easy access to new prescriptions and a lack of monitoring as main drivers of the development. Poorly controlled pain and subjective stress fuelled continuous opioid use.

Original language	English
Pages (from-to)	141-149
Number of pages	9
Journal	European Addiction Research
Volume	29
Issue number	2
Early online date	14 Apr 2023
DOIs	https://doi.org/10.1159/000529926
Publication status	Published - 1 Jun 2023

Bibliographical note

Funding Information:
This work is part of the research project Tackling and Preventing the Opioid Epidemic (TAPTOE). This research received funding from the Dutch Research Council (NWO) in the framework of the NWA-ORC Call (NWA.1160.18.300).

Funding Information:
One researcher (L.D.) conducted the initial categorisation of the codes. The generated concept categories and themes, supported by quotes, were evaluated regularly with members of the research team to ensure consistency of interpretation. NVivo, version 12 was used for data management and analysis. The findings were supported by illustrating quotes and reported according to the Consolidated Criteria for Reporting Qualitative Research (COREQ) [].

Publisher Copyright:
© 2023 The Author(s). Published by S. Karger AG, Basel. This article is licensed under the Creative Commons Attribution 4.0 International License (CC BY). Usage, derivative works and distribution are permitted provided that proper credit is given to the author and the original publisher.

Keywords

Abuse of prescription drugs
Opiate addiction
Opioid dependency
Opioid use disorder
Prescription opioid dependency
Qualitative research

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1159/000529926Licence: CC BY

000529926Final published version, 370 KBLicence: CC BY

Cite this

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title = "Patients' Perspectives on the Development of Prescription Opioid Use Disorder in Patients with Chronic Non-Cancer Pain",

abstract = "INTRODUCTION: In the past decade, prescription opioid use increased exponentially and concomitantly opioid use disorders (OUD) are becoming more common. Several risk factors for developing OUD have been identified, but little 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 focussed on experiences with long-term opioid use, knowledge and attitudes regarding opioids, and access to opioids. A directed content analysis was conducted on the transcribed interviews using NVivo.RESULTS: Participants showed 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.CONCLUSION: Patients' experiences illustrate that the first stage of the development of prescription OUD differs from the development of other substance addictions. Negative reinforcement might play a more prominent role in the early phase of prescription opioid use. Patients expressed a lack of guidance, both at the start of use and long-term use, easy access to new prescriptions and a lack of monitoring as main drivers of the development. Poorly controlled pain and subjective stress fuelled continuous opioid use.",

keywords = "Abuse of prescription drugs, Opiate addiction, Opioid dependency, Opioid use disorder, Prescription opioid dependency, Qualitative research",

author = "Davies, {Lisa E M} and Koster, {Ellen S} and Damen, {Katinka F M} and Harmen Beurmanjer and Schellekens, {Arnt F A} and Bouvy, {Marcel L}",

note = "Funding Information: This work is part of the research project Tackling and Preventing the Opioid Epidemic (TAPTOE). This research received funding from the Dutch Research Council (NWO) in the framework of the NWA-ORC Call (NWA.1160.18.300). Funding Information: One researcher (L.D.) conducted the initial categorisation of the codes. The generated concept categories and themes, supported by quotes, were evaluated regularly with members of the research team to ensure consistency of interpretation. NVivo, version 12 was used for data management and analysis. The findings were supported by illustrating quotes and reported according to the Consolidated Criteria for Reporting Qualitative Research (COREQ) []. Publisher Copyright: {\textcopyright} 2023 The Author(s). Published by S. Karger AG, Basel. This article is licensed under the Creative Commons Attribution 4.0 International License (CC BY). Usage, derivative works and distribution are permitted provided that proper credit is given to the author and the original publisher.",

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AU - Koster, Ellen S

AU - Damen, Katinka F M

AU - Beurmanjer, Harmen

AU - Schellekens, Arnt F A

AU - Bouvy, Marcel L

N1 - Funding Information: This work is part of the research project Tackling and Preventing the Opioid Epidemic (TAPTOE). This research received funding from the Dutch Research Council (NWO) in the framework of the NWA-ORC Call (NWA.1160.18.300). Funding Information: One researcher (L.D.) conducted the initial categorisation of the codes. The generated concept categories and themes, supported by quotes, were evaluated regularly with members of the research team to ensure consistency of interpretation. NVivo, version 12 was used for data management and analysis. The findings were supported by illustrating quotes and reported according to the Consolidated Criteria for Reporting Qualitative Research (COREQ) []. Publisher Copyright: © 2023 The Author(s). Published by S. Karger AG, Basel. This article is licensed under the Creative Commons Attribution 4.0 International License (CC BY). Usage, derivative works and distribution are permitted provided that proper credit is given to the author and the original publisher.

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N2 - INTRODUCTION: In the past decade, prescription opioid use increased exponentially and concomitantly opioid use disorders (OUD) are becoming more common. Several risk factors for developing OUD have been identified, but little 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 focussed on experiences with long-term opioid use, knowledge and attitudes regarding opioids, and access to opioids. A directed content analysis was conducted on the transcribed interviews using NVivo.RESULTS: Participants showed 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.CONCLUSION: Patients' experiences illustrate that the first stage of the development of prescription OUD differs from the development of other substance addictions. Negative reinforcement might play a more prominent role in the early phase of prescription opioid use. Patients expressed a lack of guidance, both at the start of use and long-term use, easy access to new prescriptions and a lack of monitoring as main drivers of the development. Poorly controlled pain and subjective stress fuelled continuous opioid use.

AB - INTRODUCTION: In the past decade, prescription opioid use increased exponentially and concomitantly opioid use disorders (OUD) are becoming more common. Several risk factors for developing OUD have been identified, but little 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 focussed on experiences with long-term opioid use, knowledge and attitudes regarding opioids, and access to opioids. A directed content analysis was conducted on the transcribed interviews using NVivo.RESULTS: Participants showed 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.CONCLUSION: Patients' experiences illustrate that the first stage of the development of prescription OUD differs from the development of other substance addictions. Negative reinforcement might play a more prominent role in the early phase of prescription opioid use. Patients expressed a lack of guidance, both at the start of use and long-term use, easy access to new prescriptions and a lack of monitoring as main drivers of the development. Poorly controlled pain and subjective stress fuelled continuous opioid use.

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KW - Opiate addiction

KW - Opioid dependency

KW - Opioid use disorder

KW - Prescription opioid dependency

KW - Qualitative research

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DO - 10.1159/000529926

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C2 - 37062280

SN - 1022-6877

VL - 29

SP - 141

EP - 149

JO - European Addiction Research

JF - European Addiction Research

IS - 2

ER -

Patients' Perspectives on the Development of Prescription Opioid Use Disorder in Patients with Chronic Non-Cancer Pain

Abstract

Bibliographical note

Keywords

UN SDGs

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