BACKGROUND The use of opioids to relieve chronic pain has increased during the last decades, but experiences of chronic opioid therapy (COT) (> 90 days) point at risks and loss of beneficial effects. Still, some patients report benefits from opioid medication, such as being able to stay at work. Guidelines for opioid use in chronic pain do not consider the individual experience of COT, including benefits and risks, making the first person perspective an important scientific component to explore. The aim of this study was to investigate the lived experience of managing chronic pain with opioids in a sample who have severe chronic pain but are able to manage their pain sufficiently to remain at work. METHODS We used a qualitative research design: interpretative phenomenological analysis. Ten individuals with chronic pain and opioid therapy were purposively sampled in Swedish tertiary care. RESULTS Three super-ordinate themes emerged from the analyses: Without opioids, the pain becomes the boss; Opioids as a salvation and a curse, and Acknowledgement of the pain and acceptance of opioid therapy enables transition to a novel self. The participants used opioids to regain control over their pain, thus reclaiming their wanted life and self, and sense of control over one's life-world. Using opioids to manage pain was not unproblematic and some of the participants had experienced a downward spiral of escalating pain and uncontrollable opioid use, and stigmatisation. CONCLUSIONS All participants emphasised the importance of control, regarding both pain and opioid use. To accomplish this, trust between participants and health care providers was essential for satisfactory treatment. Regardless of the potential sociocultural benefits of staying at work, participants had experiences of balancing positive and negative effects of opioid therapy, similar to what previous qualitative research has found. Measurable improvement of function and quality of life, may justify the long-term use of opioids in some cases. However, monitoring of adverse events should be mandatory. This requires close cooperation and a trusting relationship between the patients and their health care provider.

中文翻译：

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“使用这些药物可以控制我的生活”：解释性现象学分析，旨在解决阿片类药物的慢性疼痛。

背景技术在过去的几十年中，使用阿片类药物缓解慢性疼痛的方法有所增加，但是长期使用阿片类药物治疗（COT）（> 90天）会带来风险和有益作用的丧失。尽管如此，仍有一些患者报告说阿片类药物治疗有益，例如能够继续工作。在慢性疼痛中使用阿片类药物的指南并未考虑到COT的个人经验，包括收益和风险，这使得第一人称视角成为需要研究的重要科学组成部分。这项研究的目的是调查在患有严重慢性疼痛但能够充分控制疼痛以继续工作的样本中使用阿片类药物治疗慢性疼痛的经验。方法我们使用了定性研究设计：解释现象学分析。目的在瑞典的三级医疗机构中抽样抽取十名患有慢性疼痛和阿片类药物的患者。结果分析得出了三个上位的主题：没有阿片类药物，痛苦就变成老板；阿片类药物作为救赎和诅咒，对疼痛的承认和对阿片类药物疗法的接受使人们可以过渡到新的自我。参与者使用阿片类药物重新控制了自己的痛苦，从而重获了自己想要的生活和自我，以及对自己生活世界的控制感。使用阿片类药物治疗疼痛并非没有问题，并且一些参与者经历了不断加剧的疼痛和无法控制的阿片类药物使用以及污名化的螺旋式下降。结论所有参与者都强调控制疼痛和使用阿片类药物的重要性。为此，参与者与医疗保健提供者之间的信任对于令人满意的治疗至关重要。不管停留在工作中可能带来的社会文化益处，参与者都具有平衡阿片类药物治疗的正面和负面影响的经验，这与以前的定性研究相似。功能和生活质量的显着改善可能在某些情况下证明长期使用阿片类药物是合理的。但是，对不良事件的监测应该是强制性的。这需要患者与其医疗保健提供者之间密切合​​作并建立信任关系。与先前的定性研究相似。功能和生活质量的显着改善可能在某些情况下证明长期使用阿片类药物是合理的。但是，对不良事件的监测应该是强制性的。这需要患者与其医疗保健提供者之间密切合​​作并建立信任关系。与先前的定性研究相似。功能和生活质量的显着改善可能在某些情况下证明长期使用阿片类药物是合理的。但是，对不良事件的监测应该是强制性的。这需要患者与其医疗保健提供者之间密切合​​作并建立信任关系。