A qualitative study to know about the experience of patients with chronic pain who use opioids

The research report entitled Living with opioids: a qualitative study with patients with chronic non-cancer pain, has been accepted for its publication in the prestigious and international Health Expectations journal.

This work, started in 2018, takes part of Helena de Sola’s doctoral thesis, a member of the Observatory of Pain, and it was made in collaboration with researchers of the University of the Basque Country and the University of Umea (Sweden), where she did her pre-doctoral stay.

Opioids are one of the most prescribed treatments for chronic pain. However, its long-term use (> 3 months) has been surrounded by controversy. With the idea of knowing more about this issue in our environment, we decided to carry out this study. 

To achieve our goal, we used a qualitative methodology, from the constructivist paradigm, using semi-structured interviews that we made at the Pain Unit of Puerta del Mar University Hospital (Cádiz).

Our population target were men and women older than 18 years old, with chronic low back pain, (pain during more than 3 months and at least 4 days per week according to the established definition by the rules of the International Association for the Study of Pain) with a prescribed long-term treatment (more than 3 months).

15 semi-structured interviews were conducted and analysed in their qualitative contents, according to Graneheim and Lundman description and categories and discussed topics were developed in a biomedicalization framework.  

As principal results, we must underline the topic Living with opioids: dependence and autonomy while we are looking for relief”, that includes three categories: “The long way to opioids due to the invisibility of pain; Opioids: from a blind date to a long-term relationship and What opioids can not fix

The results emphasise how the long and difficult way to find effective treatments was a fundamental part to face pain in the interviewees, involving long-term relationships with the health system. 

Additionally, this research shows benefits and disadvantages of opioids, and the difficulties to maintain autonomy and to make decisions, sometimes with few information received from multiple professionals poorly coordinated with each other.

Among the principle conclusions of the study, we stand out how the experience of the participants were strongly influenced by the invisibility of the pain, what causes a long-term relationship with the healthcare system and different types of stigmatization.

The participants cancel out the limited information received from healthcare professionals browsing on the internet or asking other patients. However, they showed limited knowledge about side effects and long-term consequences of the treatment.

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