Opioid use following spinal cord injury: a qualitative study of the perspectives of healthcare providers and people with lived experience

Purpose This qualitative study sought to understand opioid use following spinal cord injury (SCI) and identify capacity for improving patient safety from the perspective of people with lived experience and healthcare providers (HCPs).Materials and methods Semi-structured interviews were conducted with 23 participants (14 HCPs; 9 people with SCI) from January to September 2025, using interpretive description. Participants included prescribing and non-prescribing clinicians; and people who had used opioids post-SCI.Results Three themes were identified. First, understanding the person and their pain, recognised individual experiences of pain; tensions between opioid harms and benefits; and the need for appropriate assessment and management. The second theme, optimising versus impeding opioid management in the hospital setting, identified competing clinical priorities for physicians and the normalisation of opioid use in acute care. The third theme, being out there on their own, described how limited follow-up, reduced access to specialist and non-pharmacological pain supports, and the burden of complex care falling to general practitioners could contribute to a continued reliance on opioids in the community setting.Conclusions Practical recommendations generated from findings included involving pharmacy in hospital-based opioid stewardship approaches; enhancing resources for HCPs and people with SCI; and building supports for general practitioners.