Youth Perceptions of and Experiences with Opioids for Pain Management: Intersecting Stigmas and Ambivalence

Objective:There is very little in-depth qualitative research regarding youth experiences with medical use of prescription opioids and this is concerning as some youth are shown to be at risk for future nonmedical opioid use, addiction, and overdose as a result of medical use of opioids in adolescence. We sought to understand and characterize youth experiences with prescription opioids, such that researchers and healthcare professionals can improve both opioid and pain-related treatment and intervention programs for young people.Methods:We recruited participants through postering and television advertisements from the Emergency, Orthopedics, Dental, and Oncology/Hematology departments at a local children's hospital. We performed 3 focus groups, 5 in-depth interviews and one youth summit (n = 11 youth) for a total of 25 youth who had experience with prescription opioids. The results were analyzed using a thematic analysis approach.Results:The participants were heterogeneous and were youth who had been prescribed opioids due to surgery for scoliosis, cancer, brain surgery, dialysis, and other acute injuries. Youth simultaneously emphasized the positive (eg, to improve physiological functioning and to cope with mental (emotional) struggles related to their conditions in some instances) and negative effects of opioids (eg, adverse side effects and concerns about whether opioid use was related to other psychological struggles). The experience of ambivalence coincided with youth experience of intersecting stigma(s) related to their physiological conditions and their use of opioids. Youth discussed several solutions for how to improve youth-provider interactions in the context of these experiences and perceptions.Conclusion:Youth encounter a dearth of nuanced information about opioids during illness experiences and recovery and the experience of opioid-related ambivalence may be compounded by the everyday struggles associated with their conditions including intersecting prejudicial attitudes and stigmatization. Consistent with an interdisciplinary approach to prescription opioid use and pain rehabilitation, service providers could consider engaging in nuanced, empathetic, and empowering discussions with youth and provide alternatives or adjuncts to opioids for pain management.