Understanding Opioid Use from Retrospective Accounts of Young Adults in Recovery: Motives, Experiences, and Implications for Prevention.

Opioid use disorder is a public health problem with disastrous effects for young people and their families. Opioid use shares risk factors with other substances; there may be additional unique motives and experiences associated with opioid use with potential implications for improving prevention. The present study used surveys and interviews to elicit retrospective accounts of 30 young adults (19 female) in recovery from opioid use disorder to examine (1) self-reported motives for opioid use, and (2) experiences and factors that participants associate with opioid use as compared to other substances. Motives reported for past opioid use on surveys were enhancement (i.e., fun or excitement) and coping (i.e., to forget worries or cheer up when in a bad mood), followed by conformity and social motives. Through analysis of interview data, we found that: experiences of opioid use differed from experiences associated with other substances, with effects described in terms of escape and numbing (theme 1); and the ability (early in use) to remain/appear functional (theme 2). Participants reported perceptions of lower risk of harm compared to other substances (theme 3). For some, access was the main factor reported to contribute to opioid use (theme 4). Evidence-based prevention approaches focused on environmental strategies (such as prescription regulation policies) and individual strategies (such as coping skills and prevention education) are relevant for opioid use prevention. Additional supplemental approaches are needed to focus on misperceptions among young people that prescription medications confer lower risk than other substances.