Development and validation of the opioid prescription medication motives questionnaire: a four-factor model of reasons for use

Abstract

There is considerable evidence that understanding reasons for using substances is important for understanding patterns of use and related consequences as well as for developing assessment and intervention strategies. Despite increases in prescription opioid use and related problems (e.g., overdose deaths), a comprehensive measure of prescription opioid motives has yet to be developed. As such, the current study sought to develop and provide validation evidence for a measure of prescription opioid motives. One hundred eleven male and 226 female undergraduate students completed an initial pool of motive items based on the current literature and measures of prescription opioid use and related problems. Confirmatory factor analysis results demonstrated that the predicted 4-factor model provided a good fit to the data. The 4 motives-pain, social, enhancement, and coping-each showed differential patterns of associations with prescription opioid-related contextual and use variables. Enhancement motives were associated with quantity of use (past 3 months and maximum use in 1 day), frequency of use, in multiple contexts, misuse, and related problems. Coping motives demonstrated relations with maximum pills (in 1 day), frequency of use, and prescription opioid misuse, consequences, and dependence features. For social motives, significant associations were found with frequency of use (in past 3 months), typical number of pills (in 1 day), dependence features, and use both on weekdays and on weekends; this motive had a negative association with maximum number of pills taken in 1 day. Pain motives were largely related to frequency of use (in past 3 months), consequencess, and dependence features. The present study is the first to present an empirical measure of prescription opioid motives and demonstrates how these motives have important implications for understanding patterns of prescription opioid use and related problems.