Katherine Hadlandsmyth, Kenda R Stewart, Monica B Paez, Melissa Steffen, Molly Meth, Heather Schacht Reisinger, Hilary J Mosher

To elucidate perspectives on opioids and opioid use from hospitalized veterans with comorbid chronic pain using qualitative methods. This was an analysis of individual qualitative interviews. The semistructured interview guide was developed by a hospitalist with clinical expertise in pain treatment with guidance from a medical anthropologist. Interviews aimed to understand participants' experiences of chronic pain. A Midwestern Veterans Health Administration inpatient hospital unit. Nineteen inpatient veterans with a history of chronic pain or antecedent opioid use. Recently admitted veterans were screened for chronic pain diagnosis on admission and antecedent opioid use. Eligible veterans were approached to participate in an in-person interview during their hospitalization. The following themes were identified in relation to opioid use: other patients as the problem (by misusing opioids resulting in broad limits to opioid access), empathy for providers (perceived to be working under prescribing constraints), and opioids as a last resort. Although participants were not specifically questioned about opioid medications, discussion of opioids was prevalent in discussions of chronic pain. Findings suggest the potential utility of engaging hospitalized veterans in conversations about opioids and alternative pain management strategies.