Experiences of non-prescribed opioid use during opioid agonist therapy: an interpretative phenomenological analysis.
6 affiliations
- 1Institute of Health Policy, Management and Evaluation, University of Toronto, Health Sciences Building, 155 College St., Suite 425, Toronto, ON, M5T 3M6, Canada.
- 2Centre on Drug Policy Evaluation, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, 209 Victoria St., Toronto, ON, M5B 1T8, Canada.
- 3Division of Infectious Diseases & Global Public Health, Department of Medicine, University of California San Diego, 9500 Gilman Drive, Mail Code 0507, La Jolla, CA, 92093-0507, USA.
- 4Institute of Health Policy, Management and Evaluation, University of Toronto, Health Sciences Building, 155 College St., Suite 425, Toronto, ON, M5T 3M6, Canada. [email protected].
- 5Department of Family and Community Medicine, St. Michael's Hospital, Unity Health Toronto, 80 Bond St, Toronto, ON, M5B 1X2, Canada. [email protected].
- 6MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, 209 Victoria St, Toronto, ON, M5B 1T8, Canada. [email protected].
Abstract
Background
Although the goal of opioid agonist therapy is typically understood by clinicians to be the cessation of the use of non-prescribed opioids, many people taking opioid agonist therapy continue to use other opioids. The purpose of this study was to explore how people who use both prescribed opioid agonist therapy and non-prescribed opioids understand their use of both agents.Methods
An interpretative phenomenological analysis was conducted with ten participants recruited from harm reduction sites in Toronto who were concurrently using opioid agonist therapy and non-prescribed opioids. Semi-structured interviews were audio-recorded and transcribed verbatim. Data were analysed to explore participants' understanding of their use of both opioid agonist therapy and non-prescribed opioids.Results
Participants had unique reasons for the use of opioid agonist therapy and non-prescribed opioids; while opioid agonist therapy is free, relatively safe, and helps control opioid withdrawal symptoms, non-prescribed opioids satisfy opioid cravings, ease physical and emotional pain, and can be used with more autonomy. The participants' relationships with different opioids are complicated, and some struggle to reconcile their use with their goals.Conclusions
Participants shared that opioid agonist therapy and non-prescribed opioids fill complementary roles in their lives, each presenting their own benefits and challenges. Their experiences highlight opportunities for improving the provision of opioid agonist therapy in order to make it more effective and acceptable for people who use non-prescribed opioids, which is a crucial strategy in combatting mortality from the opioid toxicity crisis. Opioid agonist therapy can thus be situated within the harm reduction continuum as a practice that can be beneficial whether or not it results in abstinence, and clinicians should offer tailored regimens that take patient preferences and goals into account.
Related
- "Acceptance" as an Ongoing Negotiation: An Interpretative Phenomenological Analysis of the Experiences of Young Adults Living with HIV
- Kafkaesque systems: An interpretative phenomenological analysis of lived experiences of stateless migrants within the UK
- Comment from the winner of ‘My thesis in 180 seconds’ – ‘I’m happy, considering what I’ve been through’: An interpretative phenomenological analysis of quality of life after acute brain injury
- "I want to take the power back": An interpretative phenomenological analysis of self-management in coexisting physical and mental long-term conditions
- The Lived Experiences of Long-Term Users of Copper-T Intrauterine Devices: A phenomenological Qualitative Study among women at Kawempe National Referral Hospital in Uganda
BibTeX
@article{clarke2026experiences,
title = {{Experiences of non-prescribed opioid use during opioid agonist therapy: an interpretative phenomenological analysis.}},
author = {Sarah Clarke and Kelly Holloway and Daniel Werb and Nav Persaud},
journal = {Addiction science \& clinical practice},
year = {2026},
month = jul,
doi = {10.1186/s13722-026-00658-2},
url = {https://europepmc.org/article/MED/42897590},
note = {CC BY},
}
RIS
TY - JOUR
TI - Experiences of non-prescribed opioid use during opioid agonist therapy: an interpretative phenomenological analysis.
AU - Sarah Clarke
AU - Kelly Holloway
AU - Daniel Werb
AU - Nav Persaud
PY - 2026
DA - 2026/07/01
JO - Addiction science & clinical practice
DO - 10.1186/s13722-026-00658-2
UR - https://europepmc.org/article/MED/42897590
AB - Background Although the goal of opioid agonist therapy is typically understood by clinicians to be the cessation of the use of non-prescribed opioids, many people taking opioid agonist therapy continue to use other opioids. The purpose of this study was to explore how people who use both prescribed opioid agonist therapy and non-prescribed opioids understand their use of both agents.Methods An interpretative phenomenological analysis was conducted with ten participants recruited from harm reduction sites in Toronto who were concurrently using opioid agonist therapy and non-prescribed opioids. Semi-structured interviews were audio-recorded and transcribed verbatim. Data were analysed to explore participants' understanding of their use of both opioid agonist therapy and non-prescribed opioids.Results Participants had unique reasons for the use of opioid agonist therapy and non-prescribed opioids; while opioid agonist therapy is free, relatively safe, and helps control opioid withdrawal symptoms, non-prescribed opioids satisfy opioid cravings, ease physical and emotional pain, and can be used with more autonomy. The participants' relationships with different opioids are complicated, and some struggle to reconcile their use with their goals.Conclusions Participants shared that opioid agonist therapy and non-prescribed opioids fill complementary roles in their lives, each presenting their own benefits and challenges. Their experiences highlight opportunities for improving the provision of opioid agonist therapy in order to make it more effective and acceptable for people who use non-prescribed opioids, which is a crucial strategy in combatting mortality from the opioid toxicity crisis. Opioid agonist therapy can thus be situated within the harm reduction continuum as a practice that can be beneficial whether or not it results in abstinence, and clinicians should offer tailored regimens that take patient preferences and goals into account.
SN - 1940-0632
SN - 1940-0640
ER -