Exploring motivational factors for opioid treatment engagement among substance users in Kashmir: A qualitative study

Substance use disorder is a significant public health challenge globally, especially in conflict-affected regions like Kashmir, where opioid dependence poses a severe health and social burden. Opioid substitution therapy (OST) with buprenorphine is increasingly used to address opioid addiction in Kashmir.

To explore the reasons and motives of opioid users seeking buprenorphine treatment in a tertiary care center in Kashmir.

This qualitative study was conducted at the Drug Deaddiction Center; 31 male opioid users were purposively sampled and interviewed. Inclusion criteria included individuals over 18 years with diagnosed opioid use disorder. Data were collected via in-depth interviews in Urdu or Kashmiri and analyzed using Braun and Clarke's six-step thematic analysis.

Six primary themes and many subthemes emerged from the data analysis, namely, (1) Family Responsibility and Social Pressure, with subthemes highlighting concerns over family reputation and children's wellbeing; (2) Regret Over Financial Consequences, particularly income loss due to addiction; (3) Emotional and Relational Impact, including familial disconnection and marital discord; (4) Desire for Self-Respect and Social Acceptance; (5) Personal Growth and Redemption, with a focus on aspirations for a drug-free future; and (6) External Influence, noting family encouragement for seeking treatment.

Findings reveal that treatment motivations for opioid users are largely rooted in family and social considerations, financial impacts, and a desire for personal growth. These insights highlight the importance of family-centered support and socioeconomic interventions in enhancing the effectiveness of OST programs for opioid dependence in conflict regions like Kashmir.