{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,10]],"date-time":"2026-05-10T17:16:44Z","timestamp":1778433404352,"version":"3.51.4"},"reference-count":41,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2020,7,7]],"date-time":"2020-07-07T00:00:00Z","timestamp":1594080000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["1163961"],"award-info":[{"award-number":["1163961"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Drug and Alcohol Review"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction and Aims<\/jats:title><jats:p>Despite growing concerns over the extramedical use of pharmaceutical opioids, few studies have focused on the contexts that shape this use or how it might lead to harm. There is also limited research examining how contexts might vary across different opioids, such as those with well\u2010established abuse liabilities (e.g. oxycodone) and newer \u2018atypical\u2019 opioids (e.g. tapentadol). We aimed to address these gaps.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design and Methods<\/jats:title><jats:p>We analysed Australian paramedic case descriptions for tapentadol cases (<jats:italic>n<\/jats:italic> =\u200982) and a representative sample of oxycodone cases (<jats:italic>n<\/jats:italic> =\u200982) from a 6\u2010year period (2013\u20132018). We used framework analysis to identify \u2018contexts\u2019 shaping extramedical use from cases where use of tapentadol or oxycodone was assessed to have significantly contributed to the attendances.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Demographically, case descriptions from both drug types were broadly similar (approximately 55% female, 44% were 35\u201354\u2009years old), as were the contextual factors. The most prevalent contexts common to both oxycodone and tapentadol cases were psychological distress, physical pain and social stressors. Suicidal intent was present across multiple contexts.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion and Conclusions<\/jats:title><jats:p>This study is one of the first to explore the contexts of extramedical pharmaceutical opioid use leading to acute harm. Our analysis found patients in complex, emergency situations, seeking rapid relief from physical pain, psychological distress, social issues and\/or suicidal thoughts. These data highlight the complex needs of those experiencing harm from extramedical pharmaceutical opioid use, regardless of opioid type, and the importance of contextual factors shaping both use and subsequent harm.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dar.13118","type":"journal-article","created":{"date-parts":[[2020,7,7]],"date-time":"2020-07-07T10:01:31Z","timestamp":1594116091000},"page":"870-878","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["\u2018Extreme personal stress\u2019 and \u2018a lot of pain\u2019: Exploring the physical, mental and social contexts of extramedical pharmaceutical opioid use in Australian paramedic case descriptions"],"prefix":"10.1111","volume":"39","author":[{"given":"James","family":"Wilson","sequence":"first","affiliation":[{"name":"Turning Point, Eastern Health  Melbourne Australia"},{"name":"Monash Addiction Research Centre, Eastern Health Clinical School Monash University  Melbourne Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4902-7293","authenticated-orcid":false,"given":"Tina","family":"Lam","sequence":"additional","affiliation":[{"name":"Monash Addiction Research Centre, Eastern Health Clinical School Monash University  Melbourne Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Debbie","family":"Scott","sequence":"additional","affiliation":[{"name":"Turning Point, Eastern Health  Melbourne Australia"},{"name":"Monash Addiction Research Centre, Eastern Health Clinical School Monash University  Melbourne Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1814-1330","authenticated-orcid":false,"given":"Rose","family":"Crossin","sequence":"additional","affiliation":[{"name":"Turning Point, Eastern Health  Melbourne Australia"},{"name":"Monash Addiction Research Centre, Eastern Health Clinical School Monash University  Melbourne Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharon","family":"Matthews","sequence":"additional","affiliation":[{"name":"Turning Point, Eastern Health  Melbourne Australia"},{"name":"Monash Addiction Research Centre, Eastern Health Clinical School Monash University  Melbourne Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Preventive Medicine Monash University  Melbourne Australia"},{"name":"Ambulance Victoria  Melbourne Australia"},{"name":"Department of Community Emergency Health and Paramedic Practice Monash University  Melbourne Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dan I.","family":"Lubman","sequence":"additional","affiliation":[{"name":"Turning Point, Eastern Health  Melbourne Australia"},{"name":"Monash Addiction Research Centre, Eastern Health Clinical School Monash University  Melbourne Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5341-1055","authenticated-orcid":false,"given":"Suzanne","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Turning Point, Eastern Health  Melbourne Australia"},{"name":"Monash Addiction Research Centre, Eastern Health Clinical School Monash University  Melbourne Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,7,7]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6626a4"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/dar.12089"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/ip.2010.029611"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6450a3"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.7326\/M17-0865"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1465-3362.2010.00283.x"},{"key":"e_1_2_7_8_1","unstructured":"Australian Institute of Health and Welfare. 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