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In this study we aimed to fill this important knowledge gap by exploring the POA initiation experiences of 90 prescription opioid abusers currently in treatment and their narrative accounts of the circumstances surrounding their POA onset. This research was conducted within a storyline framework, which operates on the premise that the path to drug abuse represents a biography or a process rather than a static condition. Audiotapes of in-depth interviews were transcribed, coded, and thematically analyzed. Analyses revealed the presence of four trajectories leading to POA. This study adds to the limited research on POA etiology by not only illuminating the psychosocial factors that contribute to POA onset, but also by situating initiation experiences within broader life processes. The study findings provide crucial insights to policymakers and interventionists in identifying who is at risk for POA, and more important, when and how to intervene most efficaciously.<\/jats:p>","DOI":"10.1177\/1049732313488837","type":"journal-article","created":{"date-parts":[[2013,5,9]],"date-time":"2013-05-09T00:13:46Z","timestamp":1368058426000},"page":"963-975","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":37,"title":["Understanding the Etiology of Prescription Opioid Abuse"],"prefix":"10.1177","volume":"23","author":[{"given":"Khary K.","family":"Rigg","sequence":"first","affiliation":[{"name":"Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John W.","family":"Murphy","sequence":"additional","affiliation":[{"name":"University of Miami, Coral Gables, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2013,5,8]]},"reference":[{"key":"bibr1-1049732313488837","doi-asserted-by":"publisher","DOI":"10.1177\/0022427805280052"},{"key":"bibr2-1049732313488837","volume-title":"American Psychiatric Association practice guidelines for the treatment of psychiatric disorders: Compendium 2006","author":"American Psychiatric Association","year":"2006"},{"key":"bibr3-1049732313488837","first-page":"209","volume-title":"Challenges & choices: Constructionist perspectives on social problems","author":"Bogard C. 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