The nonmedical use of prescription opioids and illicit opioid use constitute a critical public health concern among adolescents and young adults. Although recent evidence suggests that opioid use shares multiple risk factors with other substance use, identifying the unique motives and experiences associated with opioid use has been emphasized as essential for refining and tailoring prevention strategies. While theoretical discussions have proposed motives such as pain relief, curiosity or experimentation, social influences, recreation, and ease of access, most research has focused on adult populations, leaving limited understanding of young adults’ perspectives. Therefore, the present study aims to explore self-reported motives and experiences of opioid use among young adults and to identify the distinctive factors they perceive by comparing opioid use with other substance use.
The study collected both quantitative and qualitative data to examine motives and self-reported factors associated with opioid use compared to other substances. A total of 30 adolescents and young adults (aged 19–29) who identified as being in recovery from opioid use disorder (OUD) at the time of recruitment participated in the study. Participants took part in semi-structured interviews that explored their current life circumstances, reflections on their substance use—particularly their experiences with opioids—their recovery journeys, and their suggestions for prevention. After the interviews, participants completed a survey assessing retrospective motives for opioid use. Quantitative data were analyzed using descriptive statistics, and qualitative data were analyzed using a thematic analysis approach.
Quantitative findings indicated that the most frequently endorsed motives for opioid use were enhancement (e.g., seeking fun or excitement; M = 4.39) and coping (e.g., relieving worries or negative mood; M = 4.37), followed by social motives (M = 3.59), whereas conformity motives showed minimal endorsement (M = 1.93). Qualitative analyses identified four key themes distinguishing opioid use from other substances. First, participants described feelings of escape and emotional numbing, using opioids to avoid pain or distress. Second, opioids were perceived to allow functional use, enabling individuals to remain active and appear normal while intoxicated, unlike other substances such as alcohol. Third, some participants perceived opioids as less harmful, particularly in pill form prescribed by doctors. Finally, others noted that environmental accessibility, rather than unique effects, primarily influenced their opioid use.
Takeaway: Opioid use prevention strategies may need to address coping and enhancement motives while also correcting young people’s misperceptions that prescription opioids are less harmful than other substances.
Ballard, P. J., Vidrascu, E. M., Arnold, T. J., Hernandez, G. C., Ozer, E. J., Lassiter, R., … & Wolfson, M. (2025). Understanding Opioid Use from Retrospective Accounts of Young Adults in Recovery: Motives, Experiences, and Implications for Prevention. Journal of Prevention, 1-17. https://doi.org/10.1007/s10935-025-00861-y