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

Background: 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. Aim: To explore the reasons and motives of opioid users seeking buprenorphine treatment in a tertiary care center in Kashmir. Materials and Methods: 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. Results: 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. Conclusion: 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.