Pending

Abstract

Beliefs about medicine expressed by people who co-use benzodiazepines/z drugs and opioids

The Necessity-Concerns Framework (NCF) demonstrates how beliefs about medications influence adherence. While it has been effectively applied to prescribed drugs, its application to illicit drug use remains unexplored. This study aims to investigate whether beliefs about medicines are present in existing data involving individuals’ experiences of co-using opioids, benzodiazepines, and/or Z-drugs, to further inform treatment engagement and substance use behaviours. Secondary analysis of 48 interviews with individuals using prescribed or illicit opioids and benzodiazepines and/or Z-drugs. Most reported broader polysubstance use and were taking opioid agonist therapy (OAT). Participants were recruited from Glasgow, Bristol, and Teesside. A qualitative approach was used combining deductive analysis using the NCF and inductive thematic analysis to explore additional beliefs participants expressed around the drugs they took. Participants expressed NCF medicines beliefs about their illicit and prescribed drugs including OAT e.g. ‘They put me on a maintenance script that saved my life’ (P16) (Necessity belief). ‘I know if I don’t stop, it’s going to stop me the hard way’ (P35) (Concerns belief). Inductive coding identified themes, such as ‘I don’t know who I am when I’m not taking drugs’. We identified NCF beliefs about illicit and prescribed drugs. The findings highlight the potential utility of incorporating belief systems into treatment approaches. For example, addressing these beliefs may enhance counselling efforts, especially within motivational enhancement therapy, to support discussions around reduction and detox. This could also support discussions around optimising OAT and other prescription medicine use in the context of illicit drug use.