Magee-Womens Research Institute, Pittsburgh, Pennsylvania, USA.
University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, USA.
Subst Abus. 2021;42(4):865-872. doi: 10.1080/08897077.2021.1878084. Epub 2021 Feb 22.
The impacts of opioid use disorder and opioid-involved overdose are known, but less is known about the contexts in which people first misuse opioids, and the motivations for continued misuse. In-depth interviews with 26 individuals in Allegheny County, Pennsylvania with current or past histories of opioid misuse were conducted. Narratives were analyzed to understand the circumstances and influences contributing to initial and continued misuse of opioids. Participants described social and familial contexts that normalized or accepted opioid misuse-this often included their own use of other illicit substances prior to initiating opioids. Participants also described initial use of opioids as related to efforts to cope with physical pain. They also described recognizing and then seeking psychological/emotional benefits from opioids. All three of these themes often overlapped and intersected in these stories of starting opioid misuse. Opioid misuse stemmed from complex interacting influences involving coping with physical and psychological pain, perception that opioids are needed to feel "normal", and acceptance or normalization of opioid use. This suggests a multi-pronged approach to both prevention and treatment are needed.
阿利根尼县（宾夕法尼亚州）有 26 名当前或过去有过滥用阿片类药物史的个人接受了深入访谈。对这些参与者的叙述进行了分析，以了解导致初始和持续滥用阿片类药物的情况和影响。参与者描述了使阿片类药物滥用正常化或被接受的社会和家庭环境——这通常包括他们在开始使用阿片类药物之前自己使用其他非法物质。参与者还描述了最初使用阿片类药物是为了努力应对身体疼痛。他们还描述了认识到并随后从阿片类药物中寻求心理/情绪上的好处。在这些开始滥用阿片类药物的故事中，这三个主题经常重叠和交叉。阿片类药物滥用源于涉及应对身体和心理疼痛、认为需要阿片类药物才能感觉“正常”以及对阿片类药物使用的接受或正常化的复杂相互影响。这表明需要采取多管齐下的方法来预防和治疗。
