Opioids are potent analgesics commonly used for acute and cancer pain, and their use is steadily increasing in New Zealand (NZ). While opioids play a critical role in pain management, they also carry significant addictive potential. People's beliefs about medicines are known to influence medication behaviours and health outcomes, yet beliefs about opioids remain poorly understood. The aim of this study was to assess the beliefs and experiences of opioid use, among recent users with and without persistent opioid use (POU, opioid use for > 90 days).
An anonymous online survey was administered between June 2024 and November 2024, to recent opioid users in NZ, without a prior diagnosis of opioid misuse or dependence. Participants were asked about demographics, opioid use patterns, beliefs about medicines were measured on the Beliefs and Medicines Questionnaire (BMQ-specific), and agreement on different experiences from opioid therapy. Medicine beliefs were analysed using the necessity-concern differential (NCD, -4 to 4) and each participant was classified into four attitudinal groups, which provides a representation of how a patient weighs their perceived need relative to concerns.
Of 777 responses, 686 responses were included in the analysis (75.4% female, median age 46 years, 74.5% NZ European), with 61.0% (n=419) considered to have POU. The most common attitudinal group was ambivalent (high necessity, high concern, 43.0%), followed by accepting (high necessity and low concern, 24.2%). Among those with POU, 45.3% of participants were classified as ambivalent and 30.8% as accepting. We found that for every point increase on the NCD, there was an increased association of POU (aOR= 1.25; 95% CI: 1.01-1.55, p=0.036).
Overall, the study highlights a reduction in treatment concerns with ongoing opioid use, which may drive future addiction and dependence on opioids. Our study highlights the importance of considering medication beliefs in opioid use.