Philadelphia Veterans Affairs Medical Center, Philadelphia, PA 19104, USA.
Qual Health Res. 2013 Jul;23(7):963-75. doi: 10.1177/1049732313488837. Epub 2013 May 8.
Although studies on the initiation of substance abuse abound, the body of literature on prescription opioid abuse (POA) etiology is small. Little is known about why and how the onset of POA occurs, especially among high-risk populations. In this study we aimed to fill this important knowledge gap by exploring the POA initiation experiences of 90 prescription opioid abusers currently in treatment and their narrative accounts of the circumstances surrounding their POA onset. This research was conducted within a storyline framework, which operates on the premise that the path to drug abuse represents a biography or a process rather than a static condition. Audiotapes of in-depth interviews were transcribed, coded, and thematically analyzed. Analyses revealed the presence of four trajectories leading to POA. This study adds to the limited research on POA etiology by not only illuminating the psychosocial factors that contribute to POA onset, but also by situating initiation experiences within broader life processes. The study findings provide crucial insights to policymakers and interventionists in identifying who is at risk for POA, and more important, when and how to intervene most efficaciously.
虽然关于物质滥用的起始原因有很多研究，但关于处方类阿片滥用（POA）病因的文献却很少。对于为什么以及如何发生 POA 的发病，人们知之甚少，尤其是对于高危人群。在这项研究中，我们旨在通过探索 90 名目前正在接受治疗的处方类阿片滥用者的 POA 起始经历以及他们对 POA 发病情况的叙述性描述来填补这一重要的知识空白。本研究基于故事情节框架进行，该框架的前提是，滥用药物的途径代表了一种传记或过程，而不是一种静态的状态。深入访谈的录音带被转录、编码并进行主题分析。分析结果显示，导致 POA 的存在四种轨迹。本研究通过不仅阐明导致 POA 发病的社会心理因素，而且将起始经历置于更广泛的生活过程中，为 POA 病因学的有限研究做出了贡献。研究结果为政策制定者和干预者提供了重要的见解，以确定谁有 POA 的风险，更重要的是，何时以及如何最有效地进行干预。
