Experiences and perspectives of patients visiting Dutch emergency departments on opioid (mis)use: a qualitative interview study
7 affiliations
- 1Emergency Medicine, Leiden Universitair Medisch Centrum, Leiden, Zuid-Holland, Netherlands
- 2Rode Kruis Ziekenhuis, Beverwijk, Netherlands
- 3Pharmacology and Toxicology, Radboud university medical center, Nijmegen, Gelderland, Netherlands
- 4Psychiatry, Radboudumc, Nijmegen, Netherlands
- 5Nijmegen Institute for Science Practitioners in Addiction (NISPA), Nijmegen, Netherlands
- 6Department of Emergency Medicine, Haaglanden Medical Center, The Hague, Netherlands
- 7MediD Consultancy Group, Stichting Centre for Human Drug Research, Leiden, Netherlands
Abstract
Background and importance: The increase in opioid prescribing and opioid-related harm is a public health concern in many Western countries. Physicians in the emergency department (ED) frequently prescribe opioids for acute pain and play a role in the acute management of opioid-related harm. Yet, patient perspectives on the role of the ED in opioid management remain largely unexplored.
Objective: This study aimed to explore how patients discharged from Dutch EDs with a new opioid prescription perceive ED opioid prescribing, the information and guidance they receive and the potential for opioid-related harm to inform safer opioid management in the ED.
Design: A qualitative interview study using semi-structured interviews.
Settings and participants: The study was conducted at two EDs in the Netherlands: Leiden University Medical Center (academic hospital) and Haaglanden Medical Center (teaching hospital). Adult patients (≥18 years) discharged from the ED with a new opioid prescription were recruited through purposive sampling. Patients (n=35) were interviewed either by telephone after discharge (n=28) or in person at the ED directly after discharge (n=7).
Outcome measures and analysis: Thematic analysis was performed to develop key themes reflecting patients' experiences and perspectives towards opioid use and potential misuse, in relation to an ED visit.
Results: Three themes were developed from 35 interviews, encompassing: (1) Opioid prescribing practices at the ED; where patients described variable prescribing behaviours, limited information and lack of structured follow-up, (2) Navigating pain and dilemmas in opioid use; reflecting how acute pain drove opioid use despite concerns about side effects and stigma, (3) The perceived risk of opioid addiction after an ED visit; where patients acknowledged risks but often considered themselves protected by resilience, self-regulation and social support.
Conclusion: These findings show that while ED patients trust physicians’ prescribing, insufficient communication and aftercare leave them uncertain about safe opioid use and tapering. Implementing standardised, patient-centred discharge instructions and follow-up could strengthen safe opioid-prescribing practices at the ED, support patients in managing acute pain and may help to reduce the risk of long-term opioid-related harm.
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BibTeX
@article{bahadoer2026experiences,
title = {{Experiences and perspectives of patients visiting Dutch emergency departments on opioid (mis)use: a qualitative interview study}},
author = {Viren Bahadoer and Charlotte Ten Pas and Cornelis Kramers and Hannah Ellerbroek and Merel Van Loon and Albert Dahan and Arnt Schellekens and Nicole Kraaijvanger},
journal = {BMJ Open},
year = {2026},
month = nov,
doi = {10.1136/bmjopen-2026-122049},
url = {https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2026-122049},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Experiences and perspectives of patients visiting Dutch emergency departments on opioid (mis)use: a qualitative interview study
AU - Viren Bahadoer
AU - Charlotte Ten Pas
AU - Cornelis Kramers
AU - Hannah Ellerbroek
AU - Merel Van Loon
AU - Albert Dahan
AU - Arnt Schellekens
AU - Nicole Kraaijvanger
PY - 2026
DA - 2026/11/02
JO - BMJ Open
DO - 10.1136/bmjopen-2026-122049
UR - https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2026-122049
AB - Background and importance: The increase in opioid prescribing and opioid-related harm is a public health concern in many Western countries. Physicians in the emergency department (ED) frequently prescribe opioids for acute pain and play a role in the acute management of opioid-related harm. Yet, patient perspectives on the role of the ED in opioid management remain largely unexplored. Objective: This study aimed to explore how patients discharged from Dutch EDs with a new opioid prescription perceive ED opioid prescribing, the information and guidance they receive and the potential for opioid-related harm to inform safer opioid management in the ED. Design: A qualitative interview study using semi-structured interviews. Settings and participants: The study was conducted at two EDs in the Netherlands: Leiden University Medical Center (academic hospital) and Haaglanden Medical Center (teaching hospital). Adult patients (≥18 years) discharged from the ED with a new opioid prescription were recruited through purposive sampling. Patients (n=35) were interviewed either by telephone after discharge (n=28) or in person at the ED directly after discharge (n=7). Outcome measures and analysis: Thematic analysis was performed to develop key themes reflecting patients' experiences and perspectives towards opioid use and potential misuse, in relation to an ED visit. Results: Three themes were developed from 35 interviews, encompassing: (1) Opioid prescribing practices at the ED; where patients described variable prescribing behaviours, limited information and lack of structured follow-up, (2) Navigating pain and dilemmas in opioid use; reflecting how acute pain drove opioid use despite concerns about side effects and stigma, (3) The perceived risk of opioid addiction after an ED visit; where patients acknowledged risks but often considered themselves protected by resilience, self-regulation and social support. Conclusion: These findings show that while ED patients trust physicians’ prescribing, insufficient communication and aftercare leave them uncertain about safe opioid use and tapering. Implementing standardised, patient-centred discharge instructions and follow-up could strengthen safe opioid-prescribing practices at the ED, support patients in managing acute pain and may help to reduce the risk of long-term opioid-related harm.
SN - 2044-6055
SN - 2044-6055
ER -