Patient Experiences of Access, Stigma, and Trust and Preferences for Non-Opioid Drug Delivery Systems in Chronic Pain Management.
- 1Department of Pharmaceutical Sciences, College of Clinical Pharmacy, King Faisal University, Al-Ahsa 36362, Saudi Arabia.
- 2Gerontological Nursing Department, Faculty of Nursing, Cairo University, Cairo 11562, Egypt.
- 3Department of Family and Community Medicine, College of Medicine, King Faisal University, Al-Ahsa 31982, Saudi Arabia.
Abstract
Background/Objectives: Chronic pain is common in Saudi Arabia, where opioid analgesics are prescribed and dispensed within a tightly regulated, electronically monitored controlled-substance framework. Qualitative evidence on how patients experience restrictive access comes almost entirely from high-consumption countries; to our knowledge, no study has examined these experiences among Saudi adults with chronic non-cancer pain or linked them to how patients appraise non-opioid alternatives. This study explored opioid access, stigma and therapeutic trust among adults with chronic non-cancer pain in Al-Ahsa and examined the anticipated acceptability of non-opioid drug-delivery systems. Methods: A qualitative interview study was conducted across seven public and private health settings in Al-Ahsa (May-June 2026). Thirty adults with chronic non-cancer pain were purposively sampled for maximum variation; 12 clinicians were also interviewed to contextualise the service conditions patients described, with patient accounts remaining the analytic focus. Sample adequacy was judged using information power, i.e., the capacity of a specific sample and focused dialogue to address a narrow aim. Data were analysed using reflexive thematic analysis and reported according to COREQ. Results: Four themes were constructed: navigating a restricted access pathway ("A door with many locks"); enacted and anticipated stigma ("As if I came to steal"); institutional distrust alongside trust in individual clinicians ("The person, not the system"); and conditional, anticipated acceptability of topical and transdermal non-opioid formats ("Something I can put on my skin"). Conclusions: Participants described restrictive opioid pathways in terms of access burden, stigma and disrupted trust. Their stated openness to non-opioid formats was hypothetical and conditional on affordability, reliable supply, credible efficacy, devotional compatibility and endorsement by a trusted clinician. Less stigmatising dispensing, explained dose reduction and a nurse-led continuity role are proposed as strategies requiring prospective evaluation.
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BibTeX
@article{almuqbil2026patient,
title = {{Patient Experiences of Access, Stigma, and Trust and Preferences for Non-Opioid Drug Delivery Systems in Chronic Pain Management.}},
author = {Rashed M Almuqbil and Mostafa Shaban and Sayed Ibrahim Ali},
journal = {Healthcare (Basel, Switzerland)},
year = {2026},
month = oct,
doi = {10.3390/healthcare14203379},
url = {https://europepmc.org/article/MED/42940424},
note = {CC BY},
}
RIS
TY - JOUR
TI - Patient Experiences of Access, Stigma, and Trust and Preferences for Non-Opioid Drug Delivery Systems in Chronic Pain Management.
AU - Rashed M Almuqbil
AU - Mostafa Shaban
AU - Sayed Ibrahim Ali
PY - 2026
DA - 2026/10/10
JO - Healthcare (Basel, Switzerland)
DO - 10.3390/healthcare14203379
UR - https://europepmc.org/article/MED/42940424
AB - Background/Objectives: Chronic pain is common in Saudi Arabia, where opioid analgesics are prescribed and dispensed within a tightly regulated, electronically monitored controlled-substance framework. Qualitative evidence on how patients experience restrictive access comes almost entirely from high-consumption countries; to our knowledge, no study has examined these experiences among Saudi adults with chronic non-cancer pain or linked them to how patients appraise non-opioid alternatives. This study explored opioid access, stigma and therapeutic trust among adults with chronic non-cancer pain in Al-Ahsa and examined the anticipated acceptability of non-opioid drug-delivery systems. Methods: A qualitative interview study was conducted across seven public and private health settings in Al-Ahsa (May-June 2026). Thirty adults with chronic non-cancer pain were purposively sampled for maximum variation; 12 clinicians were also interviewed to contextualise the service conditions patients described, with patient accounts remaining the analytic focus. Sample adequacy was judged using information power, i.e., the capacity of a specific sample and focused dialogue to address a narrow aim. Data were analysed using reflexive thematic analysis and reported according to COREQ. Results: Four themes were constructed: navigating a restricted access pathway ("A door with many locks"); enacted and anticipated stigma ("As if I came to steal"); institutional distrust alongside trust in individual clinicians ("The person, not the system"); and conditional, anticipated acceptability of topical and transdermal non-opioid formats ("Something I can put on my skin"). Conclusions: Participants described restrictive opioid pathways in terms of access burden, stigma and disrupted trust. Their stated openness to non-opioid formats was hypothetical and conditional on affordability, reliable supply, credible efficacy, devotional compatibility and endorsement by a trusted clinician. Less stigmatising dispensing, explained dose reduction and a nurse-led continuity role are proposed as strategies requiring prospective evaluation.
SN - 2227-9032
ER -