title: Social context and perspectives of non-medical prescription opioid use among young adults in Rhode Island: A qualitative study.
abstract: This pilot study examined the context of nonmedical prescription opioid (NMPO) use and related risk behaviors among young adults in Rhode Island, a New England region with markedly high prevalence of NMPO use and overdose mortality.
  
  
  
  We conducted semi-structured interviews (n = 13) with young adults (18-29 year-olds) who reported current or recent NMPO use. We also conducted focus groups (two groups, n = 14 total) with professional service providers recruited from service organizations. Data were audio-recorded, transcribed, and key themes were analyzed.
  
  
  
  Participants discussed high levels of access to prescription opioids for nonmedical use via prescriptions originally provided to family and friends. The contexts described by participants included social environments such as parties, in which mixing opiates with benzodiazepines, alcohol or other types of drugs, and incidents of unintentional overdose were reported. Participants attributed risk for overdose to individual-level factors (eg, users who "couldn't handle it"), rather than contextual factors, and described negative reactions to being labeled as an "addict" or "addicted." Professional service providers had first-hand experience with young adults in treatment settings, yet limited exposure to young adults who were treatment-naïve.
  
  
  
  Young adult NMPO users described social settings where polysubstance use and pill use were common, and highlighted an aversion to being labeled as having a substance use disorder.
  
  
  
  To reduce harms of NMPO use among young adults, interventions should address the social context in which drug use and risk behaviors occur. (Am J Addict 2016;25:659-665).
authors.affiliation: Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island.
authors.forename: Jesse L
authors.initials: JL
authors.lastname: Yedinak
authors.affiliation: Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island.
authors.forename: Elizabeth N
authors.initials: EN
authors.lastname: Kinnard
authors.affiliation: Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts.|Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.
authors.forename: Scott E
authors.initials: SE
authors.lastname: Hadland
authors.affiliation: Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island.|Department of Emergency Medicine, The Warren Alpert School of Brown University, Providence, Rhode Island.|Department of Emergency Medicine, Boston University School of Medicine, Boston, Massachusetts.
authors.forename: Traci C
authors.initials: TC
authors.lastname: Green
authors.affiliation: Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island.|Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts.
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Clark
authors.affiliation: Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island.
authors.forename: Brandon D L
authors.initials: BD
authors.lastname: Marshall
mesh_terms: D000293:Adolescent; D000328:Adult; D000701:Analgesics, Opioid / Q000494:pharmacology*; D005260:Female; D033062:Friends; D006801:Humans; D008297:Male; D009293:Opioid-Related Disorders / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control / Q000523:psychology; D010865:Pilot Projects; D000067561:Potentially Inappropriate Medication List / Q000706:statistics & numerical data*; D015995:Prevalence; D036301:Qualitative Research; D012237:Rhode Island / Q000453:epidemiology; D040242:Risk Reduction Behavior; D012931:Social Environment; D012944:Social Support
chemical_list: D000701:Analgesics, Opioid