Causes of Lapse and Relapse of Opioid Use: A Qualitative Study of High-Risk Situations in Iranian Women

Introduction: Substance use disorders are increasing in women, in contrast, withdrawal and failure in treatment have a high rate in them and it is necessary to identify the specific causes of female relapse. Therefore, the purpose of this study was to identify the factors affecting the relapse of substance use based on high-risk situations in Iranian women with opioid use disorder. Methods: The research approach is qualitative and of the type of thematic analysis. Data were collected using purposive sampling and through semi-structured interviews and focus group discussions. Theoretical sampling continued until data saturation was reached. 25 individual interviews were conducted for 30 to 90 minutes and 2 focus groups of 15 people were conducted for 105 and 120 minutes and the data were saturated. Data analysis was performed using thematic analysis method (Sterling). Recoding and Holstie methods were used to assess the reliability and validity was calculated through content validity. Results: 55 women with opioid use disorder with an average lapse of 4.5 participated in the study. In the results of the research, a total of 6 organizing themes including negative interpersonal emotional states, interpersonal conflicts, social and environmental factors, positive emotional states, coping and Consequences of expectations and 73 basic themes were identified and categorized. Conclusions: High-risk situations can lead to lapse, relapse, and failure in treatment, but the good news is that these situations can be prevented. Identifying high-risk situations in women with opioid use disorders, in addition to increasing knowledge in this field, can be basis of the way for specific preventive therapeutic interventions in this group.