Lucey Evan, Dean Erica, Chapman Brittany P, Perugini Richard, Chai Peter, Goldfine Charlotte E, Carreiro Stephanie
Department of Emergency Medicine, Division of Medical Toxicology, UMass Chan Medical School, Worcester, MA, USA.
Tox(In)novation Lab, Worcester, MA, USA.
J Pain Res. 2025 Jun 14;18:2961-2972. doi: 10.2147/JPR.S518088. eCollection 2025.
Opioids are highly effective in treating acute pain but have various detrimental, non-therapeutic effects that may lead to the development of opioid use disorder (OUD) in certain individuals. This creates a complex landscape of opioid prescribing and use. The present manuscript uses a qualitative research lens to understand the patient experience during opioid therapy for acute pain, including perceptions, behaviors, and factors that drive both during the third wave of the opioid epidemic.
Patients receiving opioids for acute pain were recruited from the emergency department and general surgery clinic as part of a larger study to perform continuous physiologic monitoring during opioid use. Semi-structured interviews were conducted within 10 days of hospital discharge. Interviews were recorded, transcribed verbatim and subject to applied thematic analysis by two independent coders.
Of the 60 subjects that completed the parent study, 44 completed the semi-structured interviews (mean age 47 years, 50% female). Three main themes emerged from the interviews: the direct effects of opioid analgesia, internal factors and external factors that influenced therapy. Symptoms of opioid tolerance, withdrawal and dependence were described in a subset of participants, even with a relatively short duration of therapy. Participants expressed a desire for more education around opioid therapy, and more engagement with their plan of care.
Opioid therapy, even in short courses for acute pain, can be a complicated experience for patients to navigate. Prescribers should consider how patients' unique experiences and perspectives shape their responses when providing counseling to patients and monitoring of response to opioid therapy.
阿片类药物在治疗急性疼痛方面非常有效，但具有各种有害的非治疗性作用，在某些个体中可能导致阿片类药物使用障碍（OUD）的发生。这使得阿片类药物的处方和使用情况变得复杂。本手稿运用定性研究视角来了解急性疼痛患者在阿片类药物治疗期间的经历，包括认知、行为以及在阿片类药物流行第三波期间驱动这些因素的因素。
作为一项在使用阿片类药物期间进行持续生理监测的更大规模研究的一部分，从急诊科和普通外科诊所招募了接受阿片类药物治疗急性疼痛的患者。在出院后10天内进行了半结构化访谈。访谈进行了录音，逐字转录，并由两名独立编码员进行应用主题分析。
在完成母研究的60名受试者中，44名完成了半结构化访谈（平均年龄47岁，50%为女性）。访谈中出现了三个主要主题：阿片类镇痛的直接影响、影响治疗的内部因素和外部因素。即使治疗时间相对较短，一部分参与者也描述了阿片类药物耐受、戒断和依赖的症状。参与者表示希望获得更多关于阿片类药物治疗的教育，并更多地参与其护理计划。
阿片类药物治疗，即使是用于急性疼痛的短疗程治疗，对患者来说也可能是一段复杂的经历。开处方者在为患者提供咨询和监测阿片类药物治疗反应时，应考虑患者独特的经历和观点如何塑造他们的反应。
